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PubMed2006

Gastrointestinal malformations in Gorgan, North of Iran: epidemiology and associated malformations.

The aim of this prospective study was to evaluate the prevalence and pattern of gastrointestinal malformations (GIM) among Iranian newborns in Gorgan, North of Iran. From 1998 through 2003, 37,951 live births in Dezyani hospital in Gorgan, North of Iran, were screened for gastrointestinal malformations. Clinical and demographic factors of diagnosed cases were recorded in a pre-designed questionnaire for analysis; sex, ethnicity, type of GIM and associated anomalies. The overall prevalence rate of gastrointestinal malformations was 10 per 10,000 births. The imperforate anus (5 per 10,000) was the commonest birth defect in gastrointestinal tract. The prevalence rate of GIM was 8.2 per 10,000 in males and 10.7 per 10,000 in females. According to the parental ethnicity, the prevalence rates of GIM were 6.7, 15.8 and 17.6 per 10,000 in Fars, Turkman, and Sistani, respectively. There were eight cases (21%) with associated anomalies. The prevalence rate of GIM in North of Iran is not similar to the previous studies in Iran and Middle East and ethnic background may be a causative factor in the rate of GIM in this area.

Digestive System Abnormalities↗
PubMed2000

Comparing self- and expert rating: a self-report screening version (SIAB-S) of the structured interview for anorexic and bulimic syndromes for DSM-IV and ICD-10 (SIAB-EX).

OBJECTIVE: Carrying out structured interviews in larger numbers by well-trained interviewers is costly and time consuming. Therefore, we developed parallel to the existing Structured Interview for Anorexic and Bulimic Syndromes (SIAB-EX) a similarily designed questionnaire for symptoms of disordered eating and related areas (SIAB-S). METHOD: 377 treated eating disordered patients were assessed within a two-week time period using both the SIAB-EX and SIAB-S. RESULTS: Generally, self-ratings based on the SIAB-S were quite similar to expert ratings. Cohen's kappa showed good agreement between self- and expert ratings. Factor structure based on principal component analyses of expert ratings or self-ratings led to rather similar results confirming the robustness of the subscales in self- and expert ratings. Using expert rating as a criterion, the self-rating (SIAB-S)--which can more easily be used for screening purposes--had a sensitivity of 0.70, a specificity of 0.80 and a PPV = 0.91 for the DSM-IV diagnoses of AN and/or BN (worst ever condition). Diagnostic sensitivity (79/73%) and specificity (66/63 %) were in an acceptable range (past/current). If we focus on the differences between the two approaches the following was found: self-rating (compared to expert-rating) resulted in lower scores for items inquiring about binges and inappropriate compensatory behaviour, attitudes towards food and eating, and social interaction. On the other hand, self-rating (compared to expert-rating) led to higher scores for items measuring general psychopathology and atypical binging. CONCLUSION: Compared to the "gold standard" of t data obtained with investigator-based standardised or structured interviews, data based on self-rating with items formulated clearly and concisely can lead to reliable and valid results. While complex issues (what is a binge) are difficult to assess in self-ratings, some (very personal) questions may even be better asked in a self-report questionnaire.

Adult↗
PubMed1999

The influence of personal protection, environmental hygiene and exposure to pesticides on the health of immigrant farm workers in a desert country.

OBJECTIVES: Farm workers in developing countries tend not to use protective measures while handling pesticides. This study investigates the use of personal protection equipment and the practice of safety and hygiene procedures in the handling of pesticides in agriculture. METHODS: Through a multi-stage sampling technique, one-fifth of the farms in a region were selected and all the farm workers at these farms were included in the study. A comparison population matching in age, socio-economic status and stay in the region was selected. A specifically designed questionnaire was used to collect information on the use of protective measures and the practice of safety and hygiene during work and on the disposal of empty pesticide containers. Blood pressure and erythrocyte acetylcholinesterase (AChE) activity were measured in the exposed and the unexposed populations. RESULTS: Protective equipment was worn by a minority of farm workers - gloves, by 35%; work coveralls, by 36%; a scarf to cover the nose and mouth, by 39%; and shoes at work, by 79%. With regard to personal hygiene measures, 83% of the workers changed clothes after work and the same proportion took a shower after work; 63% and 46% drank and ate while at work respectively; and 11% used articles of domestic use in the preparation of pesticides on the farm. Most of the farm workers (96%) were asked to prepare pesticides for spraying by the foreman and 61% were asked to spray the pesticides on the crops. AChE activity was highly significantly depleted in the exposed population as compared with the unexposed population. CONCLUSIONS: AChE depletion was found to be negatively associated with the use of gloves, of work coveralls, and of a scarf to cover the nose and mouth and with the implementation of safety and hygiene procedures on the farm. AChE depletion was positively associated with the frequency of pesticide spraying.

Acetylcholinesterase↗
PubMed2001

Laparoscopic spinal fusion of L4-L5 and L5-S1.

BACKGROUND: Patients with degenerative disc disease were treated by laparoscopic spondylodesis. Clinical outcome and quality of life were then analyzed in a retrospective study. METHODS: Thirty patients with a mean age of 43 years (range, 26-63) who suffered from instability of levels L4-L5 (n = 23), L5-S1 (n = 3), or both (n = 2) underwent surgery. Spondylodesis was achieved with two BAK cylinders. After 6 months, all patients completed a questionnaire designed to assess satisfaction with the operative outcome. RESULTS: After a median follow-up of 2.3 years (range, 0.9-3.5), 23 patients were free of pain or greatly improved. Complications included bleeding (n = 2), cage displacement (n = 1), retrograde ejaculation (n = 3), and postoperative ileus (n = 1). Good improvement was reported in daily activities and quality of life. CONCLUSION: Laparoscopic spondylodesis has a good clinical outcome with a low rate of morbidity. Notable improvements can be achieved in terms of daily activities and quality of life; however, these improvements are moderate in degree, and patient activity remains somewhat limited.

Adult↗
PubMed2001

Laparoscopy and the internet. A surgeon survey.

BACKGROUND: The Internet has become an important new tool for the delivery and acquisition of medical information. METHODS: A 13-item questionnaire designed to collect information on the attitudes and practices of surgeons regarding the use of the Internet as a medical resource was posted on the World Wide Web and also sent via e-mail. RESULTS: Over a 2-month period, 459 surgeons were enrolled in this study. Most of the respondents were identified as male surgeons (96%) between the ages of 31 and 50 years (79.25%). They accessed the Internet mainly from their homes (67.10%) and offices (17%) using 56 Kbps (34.86%) and 33.6 Kbps (21.79%) modems. These participants indicated that they use the Internet to expand their knowledge of general surgery (78.87%), learn more about technologies related to the practice of surgery (74.51%), access the Medline medical database (73.20%), and locate other resources for academic purposes (68%). Approximately half of them said that they favored the use of robotic assist devices in the operating room (53%), and most supported the use of technology for telementoring purposes (78%). Almost 80% professed an interest in video streaming technology applied to surgical education. CONCLUSIONS: This study showed that the Internet is a useful and powerful real-time survey tool that can help us to assess the impact of the World Wide Web and related technologies on surgical education and practice. However, the respondents in this study belong to a biased group that is already familiar with the Internet and computer technology and thus may not be representative of the surgical community as a whole.

Adult↗
PubMed2004

Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers.

BACKGROUND: The Oral Care Study Section of the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society for Oral Oncology (ISOO) conducted a survey on clinical practices of oral/dental management of cancer patients among supportive health care providers. The main purpose was to evaluate the knowledge and current practice for preventing and managing oral side effects associated with intensive chemotherapy (ICT), hematopoietic cell transplant (HCT), and radiation therapy to the head and neck (H&N RT). MATERIALS AND METHODS: A questionnaire designed and pretested was sent to 212 MASCC/ISOO members around the world with different dental and medical backgrounds. MAIN RESULTS: Seventy-four individuals (35%) responded. The majority of respondents were aware of possible oral complications and provided patients with clinical strategies and recommendations although there was considerable variability among the respondents. Approximately 75% stated that patients were referred for oral/dental care prior to H&N RT and ICT including HCT. However, integrated dental and medical services were reported available in only about 25% of the institutions, and most patients were referred to community-based dental professionals. MAIN CONCLUSIONS: The survey represents a first review of current, international oral care practices. It suggests a need to develop evidence-based clinical guidelines to support effective oral/dental interventions and management strategies for this population. Furthermore, strategies for implementation of oral care protocols and better integration of dental and medical services should be developed. Caution in interpreting these findings is urged due to the limited response rate.

Antineoplastic Agents↗
PubMed2006

Injection therapy of lumbar facet syndrome: a prospective study.

BACKGROUND: Chronic low back pain remains a major health problem. Facet joint injection therapy is an easy to perform therapeutic option. However, few prospective studies use a standardized protocol to investigate injection therapy. The aim of our study was to evaluate quantity and duration of clinical improvement after this protocol, and to identify the best time for additional repetitive injection therapy. MATERIALS AND METHODS: Thirty-nine patients (21 men, 18 women; mean age 55.2 years [range, 29-87 years]) with lumbar facet syndrome were treated with injection using a standardized protocol (prednisolone acetate, lidocaine 1%, phenol 5%) under fluoroscopic control. Follow-up was based on a specially designed questionnaire. Analysis included MacNab criteria, visual analogue scale, and pain disability index. RESULTS: Reduction of pain was found up to 6 months after treatment. The outcome was assessed excellent or good by 62% (24 patients) of the patients after 1 month, by 41% (16 patients) after 3 months, and by 36% (14 patients) after 6 months. There was no influence of age, body mass index, or previous lumbar spinal surgery on improvement after treatment. There were no severe side effects. Short-lasting self limiting mild side effects were found in 26% (increased back pain, numbness, heartburn, headache, allergy). CONCLUSION: Facet joint injection therapy using a standardized protocol is safe, effective, and easy to perform. The clinical effect is limited, and we recommend repetitive injection according to this protocol after 3 months.

Adult↗
PubMed1998

[Withdrawal therapy of patients with alcoholism and nicotine dependence with carcinomas in the area of the head and neck. Luxury or necessity?].

PURPOSE: Alcohol and nicotine abuse play a major role in the etiology of oral squamous cell carcinomas. In the present study, we investigated the number of patients with oral/oropharyngeal carcinomas who regularly consume alcohol and nicotine and what type of specific treatment should be prescribed for the addiction. PATIENTS AND METHOD: A total of 105 patients (90 men, 15 women) with oral/oropharyngeal squamous cell carcinomas were studied based on catamnestic data as well as a special questionnaire designed to assess drinking and smoking habits (40 g alcohol/day for men and 20 g alcohol/day for women was taken as the standard measure for those considered at risk for alcoholism). For smokers, the number of packs smoked per year was determined and compared to clinical data (i.e., tumor size, location) and laboratory data (gamma-GT). Particular attention was given to the addiction behavior before and after tumor therapy (recorded at least 1 year after successful tumor treatment). RESULTS: At the time of diagnosis, 83.1% regularly drank alcohol (71.9% reported drinking over 40 g/ 20 g of alcohol per day). Another 17.9% stopped drinking after therapy. Of the alcoholics 59.8% had been exposed to a daily consumption level above the threshold amount for more than 20 years. Some 70% of the patients reported that they exclusively drank beer. Tobacco consumption came from cigarette smoking 92.7% and 89.7% reported that they smoked before therapy--after therapy only 37.8% smoked. Carcinomas of the floor of the mouth indicated a prevalence toward alcohol and nicotine abuse. Of the patients with a T3 and T4 carcinoma 84% had daily alcohol consumption levels over the threshold value stated above. None of the 105 patients underwent specific alcohol treatment therapy. CONCLUSION: In light of the high prevalence of carcinomas of the oral cavity in patients with alcohol and nicotine addiction, mandatory withdrawal therapy should be offered in the form of postoperative treatment to prevent recurrence or the development of second primary tumors, as well as to improve the quality of life and encourage social rehabilitation. Before further treatment, for example, with retinoids, a successful withdrawal treatment should be completed.

Adult↗
PubMed2004

Type of anaesthesia and patient acceptance in groin hernia repair: a multicentre randomised trial.

BACKGROUND: Groin hernia repair can be performed under general (GA), regional (RA), or local (LA) anaesthesia. This multicentre randomised trial evaluates patient acceptance, satisfaction, and quality of life with these three anaesthetic alternatives in hernia surgery. METHODS: One hundred and thirty-eight patients at three hospitals were randomised to one of three groups, GA, RA, or LA. Upon discharge, they were asked to complete a specially designed questionnaire with items focusing on pain, discomfort, recovery, and overall satisfaction with the anaesthetic method used. The global quality-of-life instrument EuroQol was used for estimation of health perceived. RESULTS: Significantly more patients in the LA group than in the RA group felt pain during surgery ( P<0.001). This pain was characterised as light or moderate and for the majority of LA patients was felt during infiltration of the anaesthetic agent. Postoperatively, patients in the LA group first felt pain significantly later than patients in the other two groups ( P=0.012) and significantly fewer LA patients consumed analgesics more than three times during the first postoperative day ( P=0.002). The results concerning nausea, vomiting, and time to first meal all favour LA. No difference was found among the three groups concerning overall satisfaction and quality of life. CONCLUSION: In a general surgical setting, we found LA to be well tolerated and associated with significant advantages compared to GA and RA.

Adult↗
PubMed2007

The use of cyberpornography by young men in Hong Kong: some psychosocial correlates.

This study examined the prevalence of online pornography viewing and its psychosocial correlates among a sample of young Chinese men in Hong Kong. A total of 229 participants completed a questionnaire designed to measure their online pornography viewing, peer and parental influences, openness to experience, and various types of sex-related attitudes. Results showed that online pornography viewing was common and was strongly associated with peer influence and susceptibility to peer pressure. Moreover, participants who reported to have more online pornography viewing were found to score higher on measures of premarital sexual permissiveness and proclivities toward sexual harassment. Conceptual and applied implications of these findings are discussed.

Adult↗
PubMed2006

Customers' expectations and satisfaction with a pharmacy not providing advanced cognitive services.

OBJECTIVE: To assess customers' expectations and satisfaction with a community pharmacy which does not provide advanced professional cognitive services (APCS). METHOD: A non-validated questionnaire was designed; the questionnaire included items on expectations with pharmacy services and on satisfaction with the existing services. An independent interviewer was appointed to survey people leaving the pharmacy; the questionnaire was administered on two randomly chosen days. RESULTS: The mean age of respondents (n=61) was 46 years. Expectations: The most highly ranked item was "Drug available in the pharmacy" (4.97 on a 5-point Likert scale), followed by "Having queries and questions about health problems answered" (4.84). People found it easy "To seek advice on health problems or about medicines from the pharmacist at the counter" (4.48). The lowest ranked item was "reduced waiting time" (3.13). The overall Satisfaction with pharmacy services was high (4.89). CONCLUSIONS: Customers reported a high level of satisfaction in a pharmacy where advanced cognitive services were not available. However, this should not discourage pharmacists from implementing APCS, because patients' expectations are based only on experiences with current distributive services, which fulfill their perceived needs.

Community Pharmacy Services↗
PubMed1994

Multiple factors affect dietitians' counseling practices for high blood cholesterol.

OBJECTIVE: To examine the association of factors from social cognitive theory with dietitians' counseling practices for high blood cholesterol. DESIGN: A cross-sectional mail survey of 1,500 dietitians that included a 67-item, specially designed questionnaire to collect data. SUBJECTS: The sample comprised clinical dietitians and dietitians in consulting and private practice who were members of The American Dietetic Association and were practicing in Pennsylvania; Delaware; Washington, DC; Maryland; North Carolina; and Virginia (N = 1,500). Questionnaires were returned by 1,011 (67%) respondents; the 508 respondents (50%) who counseled adults for high blood cholesterol completed the entire questionnaire. STATISTICAL ANALYSES PERFORMED: Statistical analyses proceeded in three steps: descriptive statistics on questionnaire items, calculation of composite index scores, and bivariate and multivariate analyses. RESULTS: Of the key hypothesized factors, greater self-efficacy, higher levels of outcome efficacy, and greater adherence expectations significantly correlated with compliance-enhancing counseling practices. Outpatient dietitians used more compliance-enhancing counseling practices than did inpatient dietitians. Stepwise multiple regression analysis showed that the outpatient setting, a greater number of counseling sessions, follow-up counseling, and a charge to patients for counseling positively correlated with compliance-enhancing counseling practices. APPLICATIONS: Recommendations suggested by the findings include structuring professional training and continuing education programs for dietitians to strengthen self-efficacy, providing more feedback to improve perceived outcome efficacy, and changing the organization of the delivery of nutrition counseling services for prevention to allow more outpatient counseling.

Adult↗
PubMed1994

Patient acceptance of implantable cardioverter defibrillator devices: changing attitudes.

Clinical experience suggests that the implantable cardioverter defibrillator (ICD) can reduce sudden cardiac death and total mortality in patients with malignant ventricular arrhythmia who meet the selection criteria for implantation. In addition to surgical problems, patients are faced with psychological and social adjustments. Patient acceptance for such therapy is marked by perceived concerns regarding device discharge, life-style alterations, and complications. We included 57 patients with ICDs in a study of their acceptance of the device. Results of a specially designed questionnaire (state-trait personality inventory) showed that 47 of 57 patients felt that their symptoms improved with the ICD system, 32 were constantly aware of the device, and 24 patients acclimated to the ICD system within less than 2 months. With respect to the need for battery replacement, only 27 patients requested a repeat electrophysiologic evaluation, 20 patients stated fear of ICD discharges, 12 patients revealed physical discomfort from the device, and limited quality of life occurred in eight patients. Fifty-five of 57 patients answered that it was worth having an ICD device implanted, 30 (53%) patients returned to active life, and 56 (98%) would advise another patient to have an ICD implantation if necessary. In conclusion, in general, the acceptance of the ICD as a tool for management of life-threatening ventricular tachyarrhythmias is very high. Quality of life and patient acceptance are important criteria for successful ICD therapy in addition to the improved survival rate.

Attitude to Health↗
PubMed1995

Gestational diabetes survey.

OBJECTIVE: Our purpose was to determine how residents in obstetrics and gynecology and fellows in maternal-fetal medicine are currently being trained to diagnose and manage gestational diabetes mellitus. STUDY DESIGN: Questionnaires were mailed to 202 obstetrics and gynecology residency program directors and 78 maternal-fetal medicine fellowship directors. RESULTS: Sixty-four (82%) of the maternal-fetal medicine directors versus 142 (70%) of the residency directors responded. Universal screening, use of a 50 gm glucose challenge with a 1-hour-postingestion sample, no requirements for fasting before the screening test, use of two abnormal values on the 3-hour glucose tolerance test to define gestational diabetes mellitus, and initiation of insulin for elevated fasting glucose levels in spite of diet therapy were each recommended by > 90% of the respondents. CONCLUSION: Although the optimal management of gestational diabetes mellitus remains controversial, program directors are in general agreement with many aspects of the diagnosis and management.

Data Collection↗
PubMed1981

The dichotomy between classical conditioned and cognitively learned anxiety.

This paper describes how fears develop on the basis of one or other of two distinct processes--direct autonomic conditioning or the establishment of new cognitive associations to already existing fears. The dichotomy relates both to the appropriate fears of everyday life and to neurotic fears. In the case of the latter, the appropriate treatment procedure should be dictated by the fear basis that behavior analysis reveals. Failure to carry out such analysis is the reason for much confusion and inconclusiveness in therapeutic outcome studies. A retrospective survey of anxiety cases revealed that one-third of their fears were cognitively based and two-thirds due to autonomic conditioning. A study of a clinical population on the basis of a questionnaire designed to separate between cognitively based and conditioned fears has shown the expected bi-modal distribution. These findings undercut the conditioning versus cognition controversy on the causation of neurotic fears.

Adolescent↗
PubMed1991

The factorial structure of sleep dissatisfaction.

Research into sleep problems has been dominated by a number of theoretical perspectives from each of which useful treatment applications have been derived. However, the rich diversity of problems that are subsumed under insomnia or sleep disturbance often remain unappreciated. This paper reports the results of a factor analysis performed on the combined items of two questionnaires designed to assess sleep disturbance. Six factors are described, two of which relate to cognitive aspects of sleep disturbance; two which map onto sleep onset and sleep maintenance problems; and two which are drawn from dissatisfaction with poor sleep. Correlations of factor scores with measures of neuroticism, worry and various sleep history variables provide a strong level of construct validity. The results are discussed in terms of their treatment implications.

Attitude to Health↗
PubMed1995

Method of test administration as a factor in test validity: the use of a personality questionnaire in the prediction of cancer and coronary heart disease.

This study examines the predictive accuracy of four different methods of administration of a questionnaire designed to predict cancer and coronary heart disease (CHD) in healthy probands. The method of administration uses the establishment of trust and the explanation of questions as variables in all four possible combinations, i.e. trust and explanation, trust only, explanation only, and neither, the prediction being that the combination of trust and explanation would produce the most accurate prediction, the treatment using neither the worst prediction, with methods using either trust alone or explanation alone intermediate. The criterion was the successful prediction of cancer and CHD. A total population of 3563 men and women was used, and followed up over 15 years, death certificates being used to establish cause of death. As predicted, the combination of trust and explanation did best, use of neither worst. Explanation seemed more important than trust, and the combination seemed to have a synergistic effect. It is apparent that method of administration had an important effect on the outcome of the experiment.

Adult↗
PubMed1994

Two dimensional views of psychopathology.

Two dimensional views of adult psychopathology are discussed: (a) the phenomenological view according to which symptoms of psychopathology can occur in normal people in less intense, persistent and debilitating, but not qualitatively different forms; and (b) the vulnerability view according to which the degree to which a person possesses the apparent normal counterparts of the symptoms of a psychopathological disorder is an index of that person's vulnerability for the disorder. Examples of research using questionnaires designed by two prominent advocates of these dimensional views, namely, H. J. Eysenck and L. J. Chapman, are reviewed. It is concluded that the research strategies to date do not provide adequate tests of the phenomenological view and provide only weak support for the vulnerability view. Alternative, more direct, research strategies are proposed.

Humans↗