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PubMed1996

Occupational risk of hepatitis C infections among general dentists and oral surgeons in North America.

PURPOSE: To assess the occupational risk of hepatitis C virus (HCV) infection among dental personnel. METHODS: Three hundred forty-three oral surgeons and 305 general dentists were recruited at national meetings of the American Dental Association and matched by gender, age, years of practice, and location of practice. Each participant completed a detailed questionnaire designated to measure occupational risk of blood-borne infections and supplied a sample of blood. Antibodies to HCV (anti-HCV) were assessed by second-generation enzyme immunoassay and recombinant immunoblot assay. As a marker of occupational exposure to blood-borne viruses, hepatitis B virus (HBV) surface antigen and antibodies to HBV surface and core antigens were measured by enzyme immunoassay. RESULTS: Anti-HCV was found in 2.0% of oral surgeons and 0.7% of general dentists (odds ratio [OR] = 3.2, P = 0.133). Anti-HCV was more prevalent (P < 0.01) in dental personnel who were older, had more years of practice, and had serologic markers of HBV infection. Serologic markers of HBV infection were found in 7.8% of general dentists and 21.2% of oral surgeons (OR 3.1, P < 0.001). CONCLUSIONS: These data confirm high rates of HBV infection among dental personnel, but suggest that the risk of HCV infection is considerably lower.

Adult↗
PubMed2003

Geographic variation in posttreatment surveillance intensity for patients with cutaneous melanoma.

BACKGROUND: We investigated whether geographic determinants could account for variation in posttreatment melanoma surveillance intensity among plastic surgeons. METHODS: A custom-designed questionnaire was mailed to U.S. and non-U.S. members of the American Society of Plastic and Reconstructive Surgeons (ASPRS). Subjects were asked how they use 14 specific follow-up modalities during years 1 to 5 and 10 following primary treatment for patients with cutaneous melanoma. Repeated-measures analysis of variance was used to compare practice patterns by TNM stage, year postsurgery, U.S. census region, metropolitan statistical area (MSA), and managed care organization (MCO) penetration rate. RESULTS: Of the 1,142 respondents, 395 were evaluable. Those who did not perform melanoma surgery or follow-up were excluded. Correlation analysis showed that mean follow-up intensity for the modalities surveyed was highly correlated across TNM stages and years postsurgery. Within MSAs, only chest radiograph utilization varied significantly. The pattern of testing varied significantly by geographic region for seven modalities (office visit, computed tomography scan of the brain and chest/abdomen, alpha-fetoprotein level, 5S-cysteinyl dopa level, abdominal ultrasonogram, bone scan); in each of these, utilization by non-U.S. surgeons exceeded utilization in any U.S. census region. The pattern of testing varied significantly by MCO penetration rate for chest radiograph (greater utilization in the lowest MCO penetration rate areas) and 5S-cysteinyl dopa level (greater utilization in the highest MCO penetration rate areas). CONCLUSIONS: The intensity of posttreatment surveillance recommended by ASPRS members caring for patients with cutaneous melanoma varies markedly. This analysis provides the first evidence that geographic factors significantly affect the surveillance strategies of clinicians following patients with cutaneous melanoma. Variation by census region was most prominent, although the size of detected differences was small.

Censuses↗
PubMed1998

Parental report of pediatric tracheostomy care.

OBJECTIVE: There are little data on the actual care given pediatric tracheostomy patients in their homes. Information on the use of supplies and on techniques and frequency of care is valuable for a better understanding of the needs of this population. DESIGN: Questionnaires were distributed by mail or at clinic visits from May 1995 to June 1996 to a convenience sample of tracheotomized patients at the University of Michigan Pediatric Physical Medicine and Rehabilitation clinic. SETTING: Tertiary care clinic. RESULTS: Clean technique for suctioning was reported by 96.7% of subjects and the rest reported sterile technique. Fifty percent of subjects reported reusing suction catheters. Cleaning solutions used to clean suction catheters for reuse varied. Tracheostomy tube reuse was reported by 55% of subjects. Sixty percent of those who reused tracheostomy tubes had had pneumonia within the previous year, whereas only 25% of those who never reused the tracheostomy tube had pneumonia in the same time period. CONCLUSIONS: Suctioning frequency, suction catheter, and tracheostomy tube reuse and cleaning methods are variables that warrant further investigation of safety and efficacy.

Adolescent↗
PubMed1997

Are emotions frightening? An extension of the fear of fear construct.

Proposed in this paper is an expansion of the concept of fear of fear to include fear of other emotions (anger, depression, and positive emotions). In Study 1, initial evidence of the reliability and validity of a questionnaire designed to measure this construct, the Affective Control Scale, is provided. In Study 2, an analogue experiment of susceptibility to panic disorder was conducted. The ability of fear of anger, depression, and positive emotions to predict fear of laboratory-induced bodily sensations in a population with no history of panic attacks was demonstrated.

Adult↗
PubMed1980

Self-report of memory skills after temporal lobectomy: the effect of clinical variables.

Forty-eight patients who had undergone unilateral temporal lobectomy for the relief of focal epilepsy 6 months to 6 years prior to contact were asked to rate themselves on a questionnaire designed to look at "real-life" memory skills. The temporal lobe patients, as a group, saw themselves as having poorer memories than normals, but only 3 out of 43 items showed significant differences between right-and left-sided lobectomy patients. Our hypotheses that age at operation, reduction in seizure frequency and time since operation (in the left temporal lobe patients only) would determine the extent of subject complaint of memory were fully confirmed. In addition, sex of the patient was found to be a significant variable. The status of subjective and objective measures of memory as indices of "real-life" memory skills is discussed.

Adult↗
PubMed1979

Acceptability of reversible versus permanent tubal sterilization: an analysis of preliminary data.

Data regarding the acceptability of reversible versus permanent tubal ligation were randomly collected from 147 ever-married, obstetrics-gynecology patients of reproductive age during a pilot study in 1977. Subjects were potential candidates for sterilization in that none was medically or contraceptively sterile, nor married to a vasectomized male. The research questionnaire designed for this study elicited basic sociodemographic data and attitudinal information with respect to both permanent and hypothetically reversible tubal ligation. Responses toward both procedures were compared and analyzed for statistically significant differences. Results indicate that approval of, serious interest in, intention eventually to undergo, and immediate demand for tubal ligation would be increased by 30%, 85%, 171%, and 92%, respectively, if reversible procedures were available. All increases were statistically significant at P less than 0.001. It is concluded that if results from the larger ongoing study confirm those of the pilot study, they will provide support for biomedical research in this area.

Adolescent↗
PubMed1996

Attitudes of in vitro fertilization and intrauterine insemination couples toward multiple gestation pregnancy and multifetal pregnancy reduction.

OBJECTIVE: To determine attitudes regarding multiple pregnancy and multifetal pregnancy reduction in couples embarking on gonadotropin therapy. DESIGN: Questionnaire given to couples initiating gonadotropin therapy. SETTING: University hospital-based infertility unit. PATIENTS: Twenty-seven couples undergoing IVF and 50 couples undergoing IUI. RESULTS: The groups' responses tended to be quite similar, with all groups reporting declining favorability ratings as the fetal order increased. The IUI group did feel more favorable than the IVF group toward all gestational outcomes and less favorable toward multifetal pregnancy reduction. A history of live births and length of infertility had no significant impact on the results. CONCLUSION: Couples undergoing gonadotropin therapy have an overall favorable attitude toward multiple gestational pregnancies of triplets or twins and an increased willingness to consider multifetal pregnancy reduction for quadruplets and more.

Attitude↗
PubMed2000

Isolated finger injuries in children--incidence and aetiology.

Details were recorded prospectively in a specifically designed questionnaire for all children presenting to the Accident and Emergency Department with isolated finger injuries over a period of 6 months, in order to understand the incidence and aetiology. Among the 426 injuries in 283 children, most occurred at home (59%) more in the <5 year age group (38%), involving the middle finger (25%) and terminal phalanges (47%). "Jamming/crushing" was the commonest reason (48%), mostly caused by a child (59%) at the living room door (32%) and more commonly at the hinge side (49%). Nail injuries were seen in 48% of cases and 16 amputations of terminal phalanges were noticed in 15 children. Tendon injuries were only caused when cut by sharp objects, and were not caused by jamming/crushing. Both children and adults should be educated about causation, reiterating that damage to fingers can be prevented or reduced by observing safety measures.

Accidents, Home↗
PubMed2003

The rate of ectopic pregnancy for 24,589 quinacrine sterilization (QS) users compared to users of other methods and no method in 4 provinces in Vietnam, 1994-1996.

OBJECTIVE: To determine the rates of ectopic pregnancy with the use of quinacrine sterilization (QS) compared to other methods and no method (non-users). METHODS: Four provinces were selected for their above average numbers of women who had undergone QS: Nam Dinh, Nam Ha, Hai Duong and Hung Yen. Case histories related to surgical treatment of all ectopic pregnancies in these 4 provinces from 1994 through 1996 were collected from all hospitals by researchers from the Ministry of Health in June 1997. Using a questionnaire designed for this study, 120 physicians interviewed every woman in her home who had had an ectopic pregnancy during this period. If deceased, a family member was consulted. All interviews were completed in September 1998. The numbers of users of each method and nonusers were calculated from service statistics and demographic data. RESULTS: Based on 2,551,355 woman-years of exposure, the rate of ectopic pregnancy among users per 1000 woman-years was calculated to be: 0.26 with QS; 0.42 with surgical sterilization (TL) and IUD; 0.45 with the Pill; 0.50 with condoms; 0.78 relying on withdrawal; and 1.18 among non-users. CONCLUSION: Ectopic pregnancy rates for QS, TL, IUD and the Pill were similar and much lower than the rate for non-users of contraception.

Adolescent↗
PubMed2001

A comparative study of the experiences of violence of English and Swedish mental health nurses.

Recent studies suggest that violence in health care environments, especially mental health care, appears to be increasing. Although there is a lack of cross-cultural studies to prove it, this increase in violence would seem to be an international phenomenon. The present study sought to compare the extent and nature of violence encountered by mental health nurses in Sweden and England. Systematic studies of violence have previously been carried out independently in both countries but this was the first attempt to compare levels of violence. Clearly defined study protocols were put in place, an operational definition of 'violence' adhered to, and random samples recruited. A specially designed questionnaire was sent to every subject (Swedish nurses n=720; English nurses n=296) enquiring about the extent of nurses' exposure to violence, the nature and severity of the violence experienced, and the effect of violence on self-esteem and job satisfaction. Significant differences were found with English nurses experiencing more violence than their Swedish counterparts. Yet support for English nurses appeared to be less good than for Swedish nurses. Reasons for the differences are discussed along with possible measures to minimise the frequency of violence against nurses and the negative effects on their work.

Adult↗
PubMed1996

Hernia survey of the Section on Surgery of the American Academy of Pediatrics.

The members of the Section on Surgery of the American Academy of Pediatrics were surveyed to determine the practice of North American pediatric surgeons in infants with inguinal hernia (IH). Case-scenario multiple-choice-design questionnaires regarding hernias and hydroceles were sent to all members of the Surgical Section, and responses were received from 292 (50%). In healthy full-term infant boys with asymptomatic reducible IH, 82% of responders perform repair electively, no matter what the age or weight. In full-term girls with a reducible ovary, 59% perform surgery at the next available time; if the ovary is nonreducible but asymptomatic, 44% operate emergently or urgently and 42% at the next elective slot. In former preemies, the pattern of repair is as follows. (1) For those recently discharged after 2 months in the neonatal intensive care unit (NICU) with reducible IH, 65% perform the repair when convenient. (2) A general anesthetic is used in 70%; 15% use spinal anesthesia, and 11% use caudal block with sedation. (3) If the repair is done in the hospital outpatient (same-day) unit, 36% wait until 50 weeks postconception (PC) and 33% wait until 60 weeks PC. (4) if the baby's weight is at least 1,000 g. 71% perform the repair before discharge. The pain control choice after childhood IH repair is Tylenol for 30%, local infiltration biquivacaine for 30%, caudal block for 22%, regional block for 11%, and Tylenol/codeine combined for 7%. In 6-week-old full-term infants with communicating hydroceles without definite "hernia," two thirds treat as an IH with elective repair as soon as possible. With respect to contralateral exploration in infants with unilateral IH, 65% perform it in males if they are < or = 2 years of age and 84% use it in females of up to 4 years of age. This approach is not influenced by presenting side, presence of hydrocele, or history of prematurity. Laparoscopic evaluation of the contralateral IH is performed by only 6% of responders, 40% of whom use the open ipsilateral sac for laparoscope introduction.

Age Factors↗
PubMed2003

Distress and concerns in couples referred to a specialist infertility clinic.

OBJECTIVES: The aims of this study were to examine emotional distress and infertility-related concerns in male and female members of couples referred to a specialist infertility clinic and to determine changes in these over time. METHODS: A prospective cohort study with a 6-month follow-up. Emotional distress was measured using the Hospital Anxiety and Depression Scale, and concerns by a specially designed questionnaire. RESULTS: The response rate achieved was 38%. At baseline, 25.7% of women and 8.9% of men had scores of greater than 10 on the Hospital Anxiety and Depression Scale (HADS) Anxiety subscale, and 2.7% of women and 1.8% of men had scores of greater than 10 on the HADS Depression subscale. At 6-month follow-up the HADS scores were substantially unchanged. Females reported a significantly greater infertility-related concerns regarding life satisfaction, sexuality, self-blame, self-esteem and avoidance of friends compared with males. CONCLUSIONS: The prevalence of emotional disorder identified was low. There were gender differences in the nature of the specific concerns reported. The degree of distress and concerns did not change significantly over time. There are a minority of patients, mainly females, with clinically significant distress and infertility-related concerns amongst patients attending infertility clinics who deserve psychological attention.

Adult↗
PubMed1998

Posthysterectomy vaginal vault prolapse: primary repair in 693 patients.

OBJECTIVE: To examine the results of primary repair of posthysterectomy vaginal vault prolapse in a current, large series of patients with long-term follow-up. METHODS: From January 1976 to December 1987, 693 patients underwent primary repair of vault prolapse at the Mayo Clinic. The Mayo culdoplasty technique was used in 95% of these patients. Patients were followed up by reference to their Mayo Clinic medical records, a specifically designed questionnaire, and pelvic examination in a subgroup of patients. RESULTS: The median age at operation was 66 years. Abdominal hysterectomy had been performed on 49.5% of patients and vaginal hysterectomy on 43.4% (hysterectomy type was not documented on 7.1%). The median number of years to vault prolapse repair after hysterectomy was 15.8 (range 0.4-48.4). Information about prolapse after primary repair was available for 504 patients (72.7%) and 80 had evidence or complaint (bulge, protrusion) of recurrent prolapse. Thirty-six of 693 patients (5.2%) had subsequent prolapse repair. Eighty-two percent of patients indicated satisfaction with the result. Complications of operation included entry into the bladder or rectum (2.3% of patients), vault hematoma (1.3%), cuff infection (0.6%), and ureteral complications (0.6%). The number of patients presenting for vault prolapse repair increased during the study interval. CONCLUSION: The Mayo culdoplasty can be performed with minimal morbidity. It achieved an anatomic restoration of upper vaginal support in a high percentage of patients with long-term follow-up.

Adult↗
PubMed1989

Eating attitudes, behaviors, and disorders in female juvenile delinquents.

Forty-one female juvenile delinquents completed a self-report questionnaire designed to assess their eating attitudes and behaviors. Responses were analyzed using DSM-III-R criteria to determine the presence of clinically significant eating disorders. Aberrant eating behaviors were very common, and 22% of respondents had probable eating disorders. Significant eating problems may exist in this delinquent population.

Adolescent↗
PubMed1991

Effects of uncomplicated acute myocardial infarction on biochemical parameters of stress and sexual function.

The blood levels of several "stress indicators" (prolactin [PRL], growth hormone [hGH], total catecholamines, and adenosine 3',5'-cyclic monophosphate [cAMP]) were measured in men during the first 2 weeks of uncomplicated acute myocardial infarction (AMI) and during a 3-month follow-up period. PRL levels were significantly elevated during the first day, and hGH was elevated during the week after the AMI. The levels returned to the control baseline values thereafter. The levels of the total catecholamines and cAMP in blood remained normal throughout the study period. Sexual function during the 3-month follow-up was measured in 29 patients, using a specially designed questionnaire. Impotence was found in five patients and decreased libido in four. No correlation was noted between PRL values, the other stress indicators, and sexual dysfunction. A trend toward increased incidence of sexual dysfunction was found among patients with recurrent AMI.

Adult↗
PubMedDate not supplied

Globus pharyngis, personality, and psychological distress in the general population.

The authors approached 1,158 middle-aged women, who were assessed for the presence of the globus sensation in the prior 3 months. Seventy globus "cases" (6.0%) were identified. Twenty-eight women with globus and 35 control subjects completed a series of questionnaires designed to assess personality traits and psychological distress. The globus subjects were significantly higher on neuroticism and low on extra-version and had significantly elevated levels of psychological distress, including anxiety, low mood, and somatic concern when compared with the control subjects. Severity of throat symptoms, but not personality or psychological distress scores, predicted the degree of medical help sought for the symptom.

Adult↗
PubMedDate not supplied

Psychological distress among women with recurrent spontaneous abortion.

Fifty-seven of 100 women with recurrent abortion completed questionnaires designed to assess demographic and reproductive variables, depression, anxiety, social desirability, self-esteem, locus of control, and marital adjustment. The results indicated that 32% of the women could be classified as depressed. The subjects also reported higher than average levels of acute and chronic anxiety. Fifty-three percent of the subjects reported below average marital adjustment. Post hoc analyses indicated that the women who had a previous elective abortion had higher levels of anxiety, lower marital adjustment, and different attributions regarding their pregnancy losses than the women who had not had an elective abortion. Having a living child was not a protective buffer against psychological distress.

Abortion, Habitual↗
PubMed2006

[Identification errors and delusions of false identification in Alzheimer's disease: a regional survey].

INTRODUCTION: Misidentification syndromes are the main symptoms in Alzheimer's disease. Underlain by complex cognitive, agnosic, and amnesic disturbances of degenerative etiology, they can be expressed by misidentification delusions, as in psychoses. To date, research has focused on identification disturbances of persons selected according to various definitions. OBJECTIVE: Our main objective was to evaluate the frequency of identification disturbances among patients suffering from Alzheimer's disease within the current conditions of diagnosis and treatment. The secondary objective aimed to establish a detailed analysis of symptoms and clinical correlations, and evaluate the effects of the troubles on the caregiver. METHODS: We conducted a regional survey using a questionnaire designed for the caregiver, proposed to the 60 geriatric doctors and neurologists in the Poitou-Charentes region of France, for all patients suffering from Alzheimer's disease (defined according to DSM IV criteria) seen between June 1st and August 31st of 2003. Statview software was used for statistical analysis. RESULTS: The survey was completed for 104 patients: 69.5 percent women and 30.5 percent men, with a mean age of 79 years. The majority of the patients were seen by a neurologist and presented an average cognitive deficiency (MMS ranging from 11 to 20). An identification disturbance, whether or not it was delusional, all domains included, was found in 81.6 percent of the patients and was related to a more severe cognitive deficiency and greater hardship on the part of the caregiver. DISCUSSION: We observed a high prevalence of identification disturbance, which can be explained by the systematic and exhaustive search for identification disturbance. The most frequent disturbance concerned the identification of places, whereas self-identification was less often affected; the authentic Capgras delusion was found less often. CONCLUSION: The study of identification disturbances in Alzheimer's disease can contribute to a better understanding of the cognitive, psychopathological, and physiopathological aspects of the disease as well as to a better knowledge and better care for the patient.

Aged↗