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PubMed2002

Factors influencing total mercury levels among Lebanese dentists.

The aim of the current study is to examine the various factors, which contribute to high levels of mercury (Hg) in the hair of Lebanese dentists. The survey, which was carried out on ninety-nine dentists in the greater Beirut area, included a structured questionnaire designed to provide information about the parameters that influenced their occupational exposure to Hg. These included: precautionary measures, dental fillings, work habits and lifestyle of the tested dentists. The study showed that two of the four investigated precautionary measures had a significant effect on Hg level. The results revealed that, at the 95% confidence levels, Hg concentration in hair was significantly lower among the dentists who always used gloves and masks. Multiple regression analysis showed that the use of masks (P = 0.055) had significant effects on mercury accumulation in hair. In addition, dentists who saw more than eight patients per day had marginally higher mercury levels in their hair than those who did not. Since it was shown that precautionary measures could limit exposure to Hg concentration, then the use of protective measures needs to be emphasized.

Adult↗
PubMed1997

Determination of environmental reference concentration of six PAHs in urban areas (Pavia, Italy).

We propose a sampling strategy, using individual dosimetry to measure the daily inhaled quantity of PAHs in urban air. The method was applied to monitor 56 subjects living in an Italian town (Pavia; 80 000 inhabitants) and the Environmental Reference Concentration (E.R.C.) of six PAHs (classified as 'possible' carcinogenic agents for humans) was determined. The individual environmental samplings took place in two different seasons (winter and summer), for persons living in four different urban areas with different traffic density. Subjects were selected using a specific questionnaire designed to collect information on indoor and indoor+outdoor exposure times. The mean +/- S.D. value of Benzo[a]pyrene [BaP] was 0.37 +/- 0.15 ng m-3 in winter and 0.12 +/- 0.07 ng m-3 in summer. Assuming 18 m3 as the daily inhaled quantity the estimate of the BaP inhaled quantity was 6.66 ng/day in winter and 2.16 ng/day in summer.

Air Pollutants↗
PubMed1984

Does unequal leg length cause back pain? A case-control study.

In a case-control study, in which a specially designed questionnaire and a "locating jig" were used to investigate the association between difference in lower limb length and other disproportion at or around the sacroiliac joints and the existence of chronic low back pain, no association was found. Chronic back pain is thus unlikely to be part of the short-leg syndrome.

Anthropometry↗
PubMed1997

Reports of severe physical punishment and exposure to animal cruelty by inmates convicted of felonies and by university students.

A self-report questionnaire designed to assess abusive childhood environments and exposure to animal cruelty was administered to 314 inmates in a prisoner classification center. Although high rates of physical punishment characterized the entire sample, persons charged with violent, but nonhomicidal crimes reported more severely punitive childhood histories than those charged with homicidal crimes, sex offenses, and nonviolent offenses. Some exposure to animal cruelty was widespread in the sample, but there was no association between experiencing animal cruelty and the type of crime committed. Moreover, there were only modest associations between animal cruelty experiences and the aversive childhood histories of the subjects, as well as the subjects' reported use of physical and sexual coercion in dating and intimate relationships. To determine whether the high base rate of exposure to animal cruelty was unique to the incarcerated sample, a follow-up study was completed with university undergraduates. Widespread exposure to some animal cruelty was reported by undergraduates; there were modest associations between reporting animal cruelty and reporting punitive and acrimonious childhood histories. In general, the findings were consistent with the hypothesis that there is an association between punitive childhood histories and antisocial behavior but not consistent with the hypothesis that exposure to animal cruelty is importantly related to antisocial behavior or child maltreatment.

Adolescent↗
PubMed1998

Potential mediators of post-traumatic stress disorder in child witnesses to domestic violence.

OBJECTIVE: The aim was to examine variables that might mediate the incidence of Post-Traumatic Stress Disorder (PTSD) in child witnesses to domestic violence. These variables included age, gender, locus of control, self-blame, perception of threat, active versus palliative coping style, maternal emotional health plus aspects of the violence witnessed (intensity, frequency, age of child when first witnessing violence, and time since the last violent episode). METHOD: Following screening for other PTSD inducing experiences, a sample of 20 child witnesses to domestic violence, 15 matched control children, and their mothers were assessed using the following tools: The Straus Conflict Tactics Scale; the Child Post-Traumatic Stress Reaction Index; the Nowicki-Strickland Locus of Control Scale; the General Health Questionnaire, and a Screening Questionnaire designed to elicit qualitative information from both children and mothers including data about any other potential PTSD inducing stressor the subject child may have been exposed to. RESULTS: None of the factors under examination were found to contribute significantly to the severity levels of Post-Traumatic Stress Disorder in relation to witness status. CONCLUSION: The small sample size of the study necessitates that the results be interpreted with caution. Nevertheless the findings indicate that the impact of witnessing domestic violence, in terms of PTSD, is not mediated by factors such as maternal emotional well-being, age and gender of the child, or the child's style of coping with parental conflict. Evidence that variables specifically related to the violence witnessed did not mediate the impact suggests that all domestic violence may have severe and long-term impact on child witnesses.

Adaptation, Psychological↗
PubMedDate not supplied

Purpose of family photographs displayed in the pediatric intensive care unit.

OBJECTIVE: To investigate why parents frequently display family photographs on their children's beds in the intensive care unit (ICU). DESIGN: Questionnaire. SETTING: Tertiary-care pediatric ICU. SUBJECTS: Twenty-three parents who displayed pictures, 25 parents who did not, and 50 ICU nurses. OUTCOME MEASURE: Content analysis. RESULTS: Parents' stated primary reasons for displaying pictures were (1) to motivate the staff and (2) to comfort themselves. Parents not displaying photographs had not thought of displaying them, and the idea had not been suggested to them. Sixty-eight percent of the nurses surveyed reported that they invite parents to display photographs. CONCLUSIONS: We recommend that ICU staff consider discussing with parents the potential benefit of displaying photographs of their children. Pictures may open an avenue for communication, allow parents to express unspoken concerns, and give parents comfort or a goal to strive for and thus alleviate some of the stress associated with having a child in the ICU.

Adaptation, Psychological↗
PubMed2002

The Life Functioning Questionnaire (LFQ): a brief, gender-neutral scale assessing functional outcome.

The Life Functioning Questionnaire (LFQ) is a 5-min, 14-item, gender-neutral self-report questionnaire designed to assess role function over the preceding month in four domains: workplace, duties at home, leisure time with family and leisure time with friends. To validate the LFQ for use as an instrument assessing functional outcome in patients with a mood disorder, the LFQ was administered to three different samples of patients (N=87). Fifty-nine concurrently completed the self-report version of the Social Adjustment Scale (SAS-SR) and 32 concurrently had a Clinical Global Impression Scale for Bipolar Disorder (CGI-BP) assessment. The LFQ proved to have high internal consistency reliability, high test-retest reliability, excellent concurrent validity with the SAS-SR, and high validity as a measurement of severity of illness when compared with the CGI-BP. The LFQ provides a reliable, consistent and valid assessment of function at work and home in both male and female patients with a mood disorder.

Activities of Daily Living↗
PubMed1998

Premorbid personality traits of patients with organic (ICD-10 F0), schizophrenic (F2), mood (F3), and neurotic (F4) disorders according to the five-factor model of personality.

The present article aims to examine premorbid personality traits of psychiatric patients with various diagnoses by asking their close relatives to retrospectively rate the patients' usual self with a questionnaire designed for the five-factor model of personality, a rapidly emerging comprehensive theory of personality structure. Data for 140 patients and 84 controls were analyzed. Although psychiatric patients as a group were characterized by high neuroticism and low conscientiousness when compared with the healthy controls, there were only a few traits that distinguished a particular diagnostic group from either the normal control or from the rest of the patients: neurotic disorder patients had higher neuroticism scores than the normal controls; unipolar depressives had a higher conscientiousness score than the rest of the patient group. No salient premorbid trait was noted for patients with organic mental disorders, schizophrenic disorders or bipolar disorders.

Adult↗
PubMed2001

Inverse association between sense of humor and coronary heart disease.

Prospective studies have suggested that antisocial Type A personality traits may be associated with an increased incidence of coronary heart disease (CHD). However, few data have addressed whether more favorable personality characteristics may be inversely correlated with CHD. Therefore, two standardized questionnaires designed to either assess anger and hostility or to measure the propensity to laugh under a variety of situations encountered in everyday life, were administered to 300 consecutive subjects. Compared to controls, CHD subjects were significantly less likely to experience laughter during daily activities, surprise situations or social interactions (P<0.005). Logistic regression analysis revealed an inverse correlation between humor and CHD, even after adjustment for other covariates, including hypercholesterolemia, hypertension and diabetes mellitus (P=0.03). A significant inverse association was also observed between humor production and antisocial Type A personality traits (P=0.0001). These data extend previous observations linking antisocial Type A personality traits to CHD and raise the possibility that the propensity to laugh may contribute to cardioprotection.

Analysis of Variance↗
PubMed2000

Prevalence of behaviour problems reported by owners of dogs purchased from an animal rescue shelter.

This study examined the prevalence of behaviour problems exhibited by dogs within 4 weeks of acquisition from a rescue shelter in Northern Ireland. One thousand five hundred and forty-seven people who had purchased a dog from a rescue shelter in Northern Ireland were sent a postal questionnaire designed to collect information on the behaviours exhibited by their dog within the first month of acquisition. Five hundred and fifty-six people responded to the survey, representing a response rate of 37%. The majority of respondents (68.3%) reported that their dog exhibited a behaviour problem, the most common being fearfulness. Most of those respondents (89.7%) who returned their dog to the shelter did so because the animal exhibited behaviour that they considered undesirable. Male dogs showed more unacceptable behaviours than females, specifically inter-male aggression, sexual problems and straying tendencies. More stray dogs displayed undesirable behaviour than unwanteds, specifically straying tendencies. Puppies were less likely to exhibit unacceptable behaviours than juveniles or adults, particularly fearfulness, sexual problems and straying tendencies. More juvenile dogs showed excessive activity and excessive barking than puppies or adults. More adult dogs displayed aggression towards other dogs than juveniles or puppies. Findings indicate that dogs purchased from rescue shelters do exhibit behaviour problems that may lead to their return. The number of dogs admitted or returned to rescue shelters with behaviour problems may be reduced by raising public awareness regarding the value of behaviour therapy and introducing behaviour therapy schemes to rescue shelters.

Journal Article↗
PubMed1998

Non-insulin-dependent diabetes in Kuwait: prevalence rates and associated risk factors.

Non-insulin-dependent diabetes mellitus (NIDDM) is a major clinical and public health problem in Kuwait. The objective of the study was to determine prevalence rates of NIDDM among a representative sample of the Kuwaiti adult population aged 20 and older in two out of five governorates and identify the associated risk factors for the disease. A total of 3003 subjects (1105 men and 1898 women) were interviewed and examined by the research team during the period September 1995 to June 1996. A specially designed questionnaire was completed and the physical examination included height, weight and blood pressure measurements. Fasting blood samples were withdrawn, centrifuged immediately and refrigerated. Interpretation of oral glucose tolerance tests were based on the World Health Organisation diagnostic criteria for diabetes mellitus (1985). The denominator used for computing the prevalence was obtained from the 1995 Kuwait census. The overall prevalence of NIDDM in this study was found to be 14.8% (14.7% in men, 14.8% in women). Diabetic subjects presented at a relatively young age, prevalence rate in the age group 20-39 was 5.7% (95% confidence interval, 4.4-7.0) and in the age group 40-59 was 18.3% (95% confidence interval, 16.1-20.6). Obesity was found to be a significant risk factor, P < 0.001. The strong association of family history of NIDDM (adjusted odds ratio = 1.80, P < 0.001) suggests a genetic component. Hypertension was markedly associated with NIDDM and IGT (P < 0.001). With the demographic transition which already started among the Kuwaiti population and if the prevalence of NIDDM remains the same, aging of the population will contribute to even more upward trends in prevalence of abnormal glucose tolerance with its serious impact on morbidity and mortality among the Kuwaiti population. The strong association between hypertension and NIDDM may suggest a common approach to the prevention and control of these two conditions.

Adult↗
PubMed1989

Feelings of stigmatization in patients with psoriasis.

The concept of stigma, defined as a discrediting mark that sets a person off from others, is used in a systematic, in-depth examination of how 100 adults with psoriasis experience their illness. Information on demographic and illness variables that might predict feelings of being stigmatized were obtained. Through factor analysis of a specially designed questionnaire, six dimensions of the stigma experience were identified: anticipation of rejection, feeling of being flawed, sensitivity to others' attitudes, guilt and shame, secretiveness, and positive attitudes. There was marked variability in the presence and magnitude of these feelings. Different predictors emerged for different dimensions of the stigma experience, the most frequent being age at onset, extent of bleeding, employment status, duration, and rejection experience. Of all the aspects of the illness, bleeding proved the strongest predictor of stigma feelings and of despair, which correlates highly with stigma. Despair and feeling stigmatized may lead to noncompliance with treatment, possibly worsening the status of the psoriasis.

Adult↗
PubMed1994

Emergency department response to battered women in Massachusetts.

STUDY OBJECTIVES: To determine the prevalence of written protocols for response to battered women and the perceived incidence of such cases in the emergency department and to examine general issues of responsiveness to this patient population. DESIGN: Questionnaires were sent to all 90 EDs in Massachusetts in 1991, and a response rate of 79% was obtained. TYPE OF PARTICIPANTS: ED directors (75% of respondents). MEASUREMENTS: Self-reported response to written survey. MAIN RESULTS: Fourteen EDs (20%) reported having a written protocol in use. 58% of the EDs estimated that they see five or fewer battered women each month. Half of respondents estimated that 2% or less of adult female trauma stems from battering. Few differences were found between EDs with and without protocols. CONCLUSION: In 1991, prior to several initiatives on domestic violence in the health care sector, written protocols for response to battered women were rare. The majority of EDs perceived battering as an infrequent cause of adult female trauma, contrary to prior research findings.

Clinical Protocols↗
PubMedDate not supplied

How surgeon age affects posttreatment surveillance strategies for upper aerodigestive tract cancer patients.

PURPOSE: Strategies for the surveillance of patients with upper aerodigestive tract (UADT) epidermoid cancer after potentially curative treatment are not uniform, and the most suitable regimen remains unknown. We investigated the effect of surgeon age on follow-up strategy. MATERIALS AND METHODS: The 824 members of the Society of Head and Neck Surgeons (SHNS) and the 522 members of the American Society for Head and Neck Surgery (ASHNS) who were not members of the SHNS were surveyed using a custom-designed questionnaire to measure how these surgical experts performed follow-up on patients with UADT cancer. Subjects were asked how often they used 14 specific follow-up modalities for patients with resectable UADT cancer during years 1 to 5 after potentially curative primary treatment. Repeated-measures analysis of variance was used to compare practice patterns by surgeon age, as well as by tumor, node, metastasis (TNM) stage and year postsurgery. RESULTS: Responses from 199 SHNS members (24%) and 221 ASHNS members (42%) were considered assessable. Strategies were highly correlated across TNM stages and years postsurgery for most of the 14 modalities. Mean follow-up intensity differed significantly by surgeon age only for bone scan and liver function tests. Although statistically significant, the differences in surveillance strategies among age groups were clinically small. CONCLUSION: Surveillance practice patterns of surgeons caring for patients after treatment for UADT cancer do not vary substantially with practitioner age. Postgraduate education is a plausible mechanism for this homogenization of practitioner behavior.

Adult↗
PubMed2004

[Poliomyelitis eradication initiative. Search for and control of wild poliovirus stored at Spanish laboratories].

INTRODUCTION: An initiative to achieve global eradication of poliomyelitis was proposed in 1988. Since then, World Health Organization (WHO) efforts have been focused on reaching and maintaining high vaccination coverage and on implementing effective surveillance systems. Additionally, since 1998 the WHO has urged health authorities from countries over the world to locate and control the wild polioviruses stored in laboratories as well as potentially infectious materials that could contain these viruses or originate them under particular circumstances. METHODS: In Spain the Wild Poliovirus Containment Plan was initiated in 1999. All Spanish laboratories were inventoried and a specially designed questionnaire was distributed to them. The responses were analyzed. RESULTS: A total of 3209 laboratories were surveyed and 10 of them were found to contain infectious or potentially infectious material with wild poliovirus. The heads of these laboratories were informed about the Containment Plan and were requested to destroy this material under proper conditions. The laboratories that did not destroy the viruses adopted the BSL2/polio bio-safety measures. CONCLUSION: Despite its complexity, the search process was completed within the schedule established by the WHO, thanks to the efforts of health authorities from the Autonomous Communities. Spain reported its results to the WHO Regional Commission for the Certification of Poliomyelitis Eradication in May 2002.

Africa↗
PubMedDate not supplied

[Burnout syndrome in health workers and relationship with personal and environmental factors].

OBJECTIVES: High rates of professional burnout syndrome have been found among health service professionals. Our objective was to study the prevalence of burnout syndrome in hospital health workers and to determine its relationship with personal and environmental factors. METHODS: A total of 2290 health workers from five hospitals in the province of Girona (Spain) were invited to participate. Interviewees were given a specifically designed questionnaire, a questionnaire on organizational climate, and the Spanish version of the Maslach Burnout Inventory, which includes three scales: emotional exhaustion, depersonalization, and reduced personal accomplishment. RESULTS: Responses were received from 1095 health workers (a response rate of 47.8%). A high level of emotional exhaustion was found in 41.6% of staff members, especially among doctors and nurses; a high level of depersonalization was found in 23%, mainly among doctors, and reduced personal accomplishment was found in 27.9%, mainly among technicians and doctors. Multiple logistic regression revealed that a high level of emotional exhaustion was associated with frequent consumption of tranquilizers or antidepressants, whereas optimism and job satisfaction showed an inverse association. The variables that were inversely associated with a high level of depersonalization were the number of years in the profession, optimism, evaluation of work as being useful and the perception of being valued by others. Reduced personal accomplishment was also inversely associated with optimism, satisfaction with the usefulness of one's work, and satisfaction with teamwork. CONCLUSIONS: In view of the results obtained, to reduce professional burnout in hospitals, optimism and a sense of self-worth among individuals should be encouraged and the organizational environment should be improved.

Adult↗
PubMed1997

Midwifery education for safe motherhood.

OBJECTIVE: To determine the useability (relevance, clarity and quality of content), applicability (ease of use) and accessibility (structure and form) of a series of new safe motherhood midwifery education modules. DESIGN: Questionnaire survey and focus group discussions, preceded by a two week clinical skills course and an eight day orientation to using the modules. SETTING: Nursing and midwifery education institutions, regional training centres, acute-care hospital facilities and community settings in Ethiopia, Fiji, Lesotho, Mozambique and Nepal. PARTICIPANTS: Thirty-six teachers, 82 midwives, nurse-midwives and auxiliary nurse-midwives from practice settings, and 60 post basic midwifery students. KEY FINDINGS: Overall it was found that the introductory information and the technical content of the modules were easy to understand and use as were the instructions for both teachers and students. The presentation of the material was orderly and easy to follow; the language was comprehensible; and the illustrations were appropriate, clear and facilitated teaching. The teachers found that they were able to use most of the teaching/learning methods, teach most of the skills in the modules, and use the guidelines for assessing competence. The main difficulties encountered included adherence to the recommended time frame for some of the classroom sessions; the limited availability of clinical cases for teaching the specific skills in the modules and time limitations in the clinical area for practising the skills; and the provision of transport for community visits, data to complete community profiles, and time to complete other planned community activities. The students identified the need for a set of learning materials which they could take with them for future reference, and both teachers and students expressed concern about resources to support, and legislation to cover, the application of the skills taught/learned. KEY CONCLUSIONS: The modules have the potential to strengthen and support the education of midwives in developing countries, enabling them to make motherhood safer and contribute to a reduction in maternal mortality by providing better midwifery care.

Adult↗
PubMed1999

A prospective study of women's views of factors contributing to a positive birth experience.

OBJECTIVE: To explore the aspects of a woman's childbirth experience which she perceived as being important. DESIGN: As part of a large randomised trial, which assessed the timing of intervention in prolonged labour, women's views were explored using a specifically-designed questionnaire. The questionnaire, which was administered on the second postnatal day, incorporated a rating scale followed by an open question. The responses to the open question are presented in this paper. SETTING: Regional teaching hospital in the north west of England. SAMPLE: 615 primigravid women received a copy of the questionnaire. Of the 519 women who returned the questionnaire, 412 women answered the relevant section, the findings of which are presented in this paper. ANALYSIS: The responses to the open-ended question were analysed by the generation of themes from the most frequently occurring responses. MAIN FINDINGS: The main themes which emerged were support, information, intervention, decision making, control, pain relief and trial participation. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Most women are able to identify important contributors to a positive intrapartum experience. Midwives have an important role in identifying these contributors and supporting women to fulfil their individual needs.

Adult↗