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At least 145 records · Page 8Linked to original sources
PubMed1987

Normative studies of the TSEP. The basis of an objective sensory testing procedure in oral and maxillofacial surgery.

Disturbances of oro-facial sensation may frequently complicate dental surgical procedures, including the extraction of impacted third molars and osteotomies, and are often associated with fractures of the facial bones. The development and refinement of an objective measure of this clinical problem is highly desirable, particularly as it is increasingly being raised as a medico-legal issue. Evoked potential techniques have attracted considerable attention as a means of assessing the function and integrity of nervous pathways. An investigation of the trigeminal somatosensory evoked potential (TSEP) has been undertaken, in the hope of providing a safe, simple objective test of oro-facial sensibility that is acceptable to the patient. The 'normal' TSEP response has been standardised in 23 healthy volunteers, and the typical evoked waveform was found to be in line with the findings of other investigators. The TSEP waveform begins with a positive deflection at 20 ms (P20), followed by a negative deflection at 29 ms (N29) and then a second positive deflection at 37 ms (P37). In all cases, standard stimulation and recording procedures were followed. Stimulation of the maxillary or mandibular branches of the trigeminal nerve at the lip or the gingiva was employed. Evoked potentials were recorded at scalp loci overlying the oro-facial representation area of the post-central gyrus. Averaging and display of data was governed by microcomputer. A standardised method for recording trigeminal evoked responses was satisfactorily achieved and it is suggested that the technique may be useful in the clinical assessment of oro-facial sensory loss.

Adult↗
PubMed2004

Gender and the treatment of heart disease in older persons in the United States, France, and England: a comparative, population-based view of a clinical phenomenon.

BACKGROUND: Gender disparities in the treatment of coronary artery disease (CAD) have been extensively documented in studies from the United States. However, they have been less well studied in other countries and, to our knowledge, have not been investigated at the more disaggregated spatial level of cities. OBJECTIVE: This study tests the hypothesis that there is a common international pattern of gender disparity in the treatment of CAD in persons aged > or =65 years by analyzing data from the United States, France, and England and from their largest cities-New York City and its outer boroughs, Paris and its First Ring, and Greater London. METHODS: This was an ecological study based on a retrospective analysis of comparable administrative data from government health databases for the 9 spatial units of analysis: the 3 countries, their 3 largest cities, and the urban cores of these 3 cities. A simple index was used to assess the relationship between treatment rates and a measure of CAD prevalence by gender among age-adjusted cohorts of patients. Differences in rates were examined by univariate analysis using the Student t test for statistical differences in mean values. RESULTS: Despite differences in health system characteristics, including health insurance coverage, availability of medical resources, and medical culture, we found consistent gender differences in rates of percutaneous transluminal coronary angioplasty and coronary artery bypass grafting across the 9 spatial units. The rate of interventional treatment in women with CAD was less than half that in men. This difference persisted after adjustment for the prevalence of heart disease. CONCLUSIONS: A consistent pattern of gender disparity in the interventional treatment of CAD was seen across 3 national health systems with known differences in patterns of medical practice. This finding is consistent with the results of clinical studies suggesting that gender disparities in the treatment of CAD are due at least in part to the underdiagnosis of CAD in women.

Aged↗
PubMed2001

Mammography, routine ultrasonography in pregnancy, and PSA screenings in Italy.

OBJECTIVE: To present current scientific statements and practice on mammography, ultrasonography in pregnancy, and PSA within the Italian National Health Service (NHS). METHODS: Information on the three screenings was found in several position papers prepared by working groups at national and regional levels. RESULTS: For mammography the adjusted mortality rate for breast cancer increased in the last four decades and decreased in the last few years. Only 4.9% of women aged 50-70 years are covered by screening. In 1996 a consensus paper stated that biennial examination for women aged 50-69 years should be offered to reduce breast cancer mortality. A national program for breast cancer screening was launched under the responsibility of regional governments, but data about its implementation are not yet available. Regarding PSA screening, the results show that prostate cancer is the fourth most frequent neoplasm in males. A formal evaluation of prostate cancer screening was done in 1995 by the National Research Council and the Italian Association for Cancer Research; they did not recommend the NHS implement this service. In the National Health Plan 1998-2000, prostate cancer screening is not mentioned. So far, an organized and standardized screening program, based on routine PSA testing, does not exist in Italy. Nevertheless, a lot of PSA tests are performed at the clinical level to detect early prostate cancers. The results with regard to routine ultrasonography in pregnancy show that in 1996 the birth rate was 9.30 per 1,000 inhabitants, with 536,740 live births. In the period from 1992-94, the percentage of babies with a birth weight less than 2,500 gm and less than 1,500 gm were 5.85% and 0.91%, respectively. A formal screening program for detecting fetal growth retardation, based on the routine ultrasonography in the third trimester of the normal pregnancy, doesn't exist in Italy, but this test is widely performed. It is paid for under NHS coverage. CONCLUSION: In 1998 the National Health Plan 1998-2000 stated that the NHS should offer only evidence-based preventive and diagnostic interventions and stressed the importance of appropriate use of health technology.

Adult↗
PubMed1998

We're off to see the genome.

We discuss some societal and legal ramifications of the human genetics revolution. Our reflections were stimulated by discussions among scientists, citizens and legal experts at a large public symposium. We outline key issues regarding oversight of genetic research on human subjects, banking of DNA data by governments and corporations, the potential impact of behavioural genetics and effects upon racial and racist thinking. We contend that, in some cases, well-intentioned but naive efforts to protect the rights of individuals and groups may hurt everyone by blocking the progress of useful research.

Databases, Factual↗
PubMed2006

A qualitative study exploring barriers to a model of shared care for pre-school children's oral health.

OBJECTIVE: To explore the oral health beliefs and practices of primary health care professionals which may act as barriers to the development of a model of shared care for the oral health of pre-school children. DESIGN: Qualitative focus group discussions and semi-structured interviews. SETTING: Four rural local government areas in Victoria, Australia, 2003. SUBJECTS AND METHODS SUBJECTS: maternal and child health nurses, general medical practitioners, dental professionals and paediatricians working in the four local government areas. DATA COLLECTION: discipline specific focus groups and semi-structured interviews. DATA ANALYSIS: transcription, coding, clustering and thematic analysis. RESULTS: Several strong themes emerged from the data. All participants agreed that dental caries is a significant health issue for young children and their families. Beliefs about the aetiology of dental caries and its prevention were variable and often simplistic focusing predominantly on diet. Dental professionals did not believe that they had a primary role in the oral health of pre-school aged children but that others particularly maternal and child health nurses did. However other health care professionals were not confident in assuming this role. CONCLUSIONS: This study has identified important barriers and possible strategies for the development of an integrated and shared approach to preventing dental caries in pre-school aged children. Clear and consistent oral health information and agreed roles and responsibilities need to be developed.

Attitude of Health Personnel↗
PubMed2003

Tobacco-related diseases.

OBJECTIVE: To provide an overview of the disease risks associated with cigarette smoking and the benefits of smoking cessation. DATA SOURCES: Government reports and monographs, and research articles. CONCLUSION: Cigarette smoking causes over 400,000 deaths per year and is a major cause of coronary heart disease, chronic obstructive pulmonary disease, and lung cancer. The disease risks associated with cigarette smoking are proportional to the intensity and duration of smoking. Cessation of cigarette smoking results in a decline in risk in relation to the risks of continuing smokers. IMPLICATIONS FOR NURSING PRACTICE: Clinicians must be aware of the magnitude of smoking-related risks and the benefits of smoking cessation as a critical intervention.

Adult↗
PubMed2000

Nutrition as a component of alternative therapy.

OBJECTIVES: To discuss common "alternative" nutritional strategies that may be used by patients as a primary or adjunctive means of cancer treatment. DATA SOURCES: Government reports, textbook chapters, published articles, and research reports. CONCLUSIONS: The use of diet and nutrition to prevent and treat disease is one of six fields of alternative medicine. A number of dietary regimens have been purported to be effective in the treatment of cancer. Most have been inadequately tested with regard to safety and efficacy. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses need to be knowledgeable of the use of alternative methods so that they may provide accurate information to patients considering these approaches.

Complementary Therapies↗
PubMed2002

Control of cancer: the promise of the future.

OBJECTIVES: To review the progress being made against cancer and a new legislative approach, the National Cancer Act of 2002, to renew the nation's resolve towards eliminating cancer. DATA SOURCES: Government reports, books, and newspaper and magazine articles. CONCLUSIONS: The major issues affecting cancer have to do with the economy, the status of employment, the environment, and the health care delivery system and access to it. IMPLICATIONS FOR NURSING PRACTICE: Nurses can participate in the major issues affecting cancer and influence the political process to eradicate cancer as a major public health problem.

Adult↗
PubMed2000

The multiple-race population of the United States: issues and estimates.

This paper presents national estimates of the population likely to identify with more than one race in the 2000 census as a result of a new federal policy allowing multiple racial identification. A large number of race-based public policies-including affirmative action and the redistricting provisions of the Voting Rights Act-may be affected by the shift of some 8-18 million people out of traditional single-race statistical groups. The declines in single-race populations resulting from the new classification procedure are likely to be greater in magnitude than the net undercount in the U.S. census at the center of the controversy over using census sampling. Based on ancestry data in the 1990 census and experimental survey results from the 1995 Current Population Survey, we estimate that 3. 1-6.6% of the U.S. population is likely to mark multiple races. Our results are substantially higher than those suggested by previous research and have implications for the coding, reporting, and use of multiple response racial data by government and researchers. The change in racial classification may pose new conundrums for the implementation of race-based public policies, which have faced increasing criticism in recent years.

Censuses↗
PubMedDate not supplied

Road traffic accidents and policy interventions in Korea.

The high rate of road traffic crashes, in conjunction with the absence of order on the road, has long been considered a critical social problem in Korea. The Korean public seems to agree that high priority ought to be placed on policies for improving road safety. Using data from government sources, this study describes what has happened in the area of road traffic crashes since 1970, the causes of traffic crashes, and the relative importance of traffic injuries as a cause of death in Korea. Road traffic crashes in Korea increased nearly eight-fold, from 37,000 in 1970 to 290,481 in 2000. The fatalities increased three-fold and injuries ten-fold over the same period. Road traffic injuries were the leading cause of death for people under 29. However, through multiple policy interventions, partly in response to the 2002 FIFA World Cup, about two thousand road traffic deaths and nine thousand traffic-related disabilities were averted in 2001 alone. The policy interventions included enforcement of penalties for seven risky driving behaviours, including drunk driving and speeding, installation of traffic-monitoring cameras, financial rewards for citizens who reported traffic violations, introduction of a road safety evaluation system, correction of accident black spots in existing roads, and road safety education programs. Through multiple policy interventions, road traffic crashes in Korea were reduced in a relatively short time period, along with their associated injuries and fatalities. However, road traffic crashes still pose a major public health problem, threatening the quality of life of the Korean people.

Accidents, Traffic↗
PubMedDate not supplied

Health effects of residential exposure to aluminum plant air pollution.

In this study, the authors evaluated the relative risk of residential exposure to air pollution from an aluminum plant. The authors used government-compiled data to compare hospital admissions in 1997 for selected respiratory diseases for 2 communities in Brazil. One community, Ouro Preto, was located near an aluminum plant, and the other, Diamantina, was located far from any source of industrial air pollution. The relative risk of hospital admissions for selected respiratory diseases was 4.11 (95% confidence interval = 2.96, 5.70). The risk was highest among individuals between 30 and 39 yr of age (relative risk = 11.70; 95% confidence interval = 1.52, 89.96). Admissions per thousand residents were highest for individuals under 10 yr of age and for individuals older than 70 yr of age. The authors assessed exposure with environmental measurements. Dust deposition was collected in the residences of participants (n = 36 in each location), and the dust was analyzed for aluminum, manganese, magnesium, and calcium content. There were significantly different (p < .05) levels of aluminum in the 2 communities; the highest quantities were found near the aluminum plant. Measurements from independent studies indicated that both 24-hr maximum values and annual mean concentrations of suspended particulate matter exceeded the average of international standards in Ouro Preto (i.e., aluminum plant area). These results suggested that exposure to greater air pollution in the aluminum plant area (i.e., Ouro Preto, Brazil) versus the control area resulted in statistically significant health effects in those individuals who resided in Ouro Preto.

Adult↗
PubMed2006

Trachoma control in Southern Zambia--an international team project employing the SAFE strategy.

PURPOSE: To determine the prevalence of trachoma and to measure the impact of the SAFE strategy (World Health Organization GET 2020 strategy) for treating trachoma in the Gwembe District of Southern Zambia. DESIGN: This is an observational study of the introduction of the SAFE strategy employing a collaborative approach and its impact on trachoma in the area. PARTICIPANTS: Three thousand eight hundred ninety two persons in communities at 26 well sites in the Gwembe district of Southern Zambia were included in this study. METHODS: New, clean water wells were drilled under local supervision for each of 26 identified villages. All people living in villages near the wells were screened for trachoma and then treated with antibiotic if required. Education on personal and environmental hygiene was provided by trained volunteers. Patients affected by trichiasis and corneal scarring received surgery, locally if possible. Attempts to control fly populations by cleaning villages, penning livestock, and digging latrines were undertaken. This was performed under advisement and consultation with local villagers and government officials. Data was collected on variables normally associated with trachoma and others relating to demographics, water quality, environment and hygiene. MAIN OUTCOME MEASURES: Prevalence of trachoma in the area at two years post introduction of SAFE strategy. RESULTS: The overall prevalence of trachoma in the area was 47% in 2001; however, the prevalence was 55% among children under 10 years. At two years post intervention, the overall prevalence of trachoma reduced to 7.6%, and decreased to 10.6% in children under 10 years, and 5.9% among adults. CONCLUSIONS: Continued monitoring and risk factors will need to continue to be addressed in order to sustain this trachoma control project in this area of Zambia.

Adult↗
PubMed2004

Bridges, pathways and valleys: labour market position and risk of hospitalization in a Swedish sample aged 55-63.

BACKGROUND: The combination of population ageing and increasingly early labour market exit (LME) throughout Europe has made older age a key issue in social policy and research. There is increasing awareness that older people are a heterogeneous group in which health inequalities persist. However, the effects of different types of LME on health have received relatively little attention. Existing studies reach different conclusions. This might be due to several reasons: different types of LME are rarely explored in conjuncture; studies often lack objective assessments of health and frequently rely on small populations. This paper aims to test the relative effects of different LME on the risk of hospitalization compared with those who remained in paid employment. METHODS: Using Government register data on pooled cross-section samples of Swedish workers aged 55-63 years (n=7,024) the authors have compared the likelihood of hospitalization for three types of LME - disability pension (fortidpension), unemployment, and early retirement - with those who continue working. RESULTS: Controlling for previous hospitalization, sex, age, social class, and health at work a significant increased risk of hospitalization was found following LME for the unemployed (OR=1.98). CONCLUSION: Early LME is a varied process with mixed effects on health, and hence is of possible importance for policy, which, therefore, requires more attention. Programmes to help older unemployed workers back into work will have positive health effects for individuals and reduce welfare costs of hospitalization.

Age Factors↗
PubMed2000

Secular trends in growth and changes in eating patterns of Japanese children.

Changes in the daily macronutrient intake of Japanese children have been studied over the past half century to determine the effects of such changes on a child's healthy growth and development. Data from government and other reports show that in 5-y-old boys in the Tokyo metropolitan area, the intake of fat as a percentage of total energy intake was 12.6%, 20.9%, 28.4%, 33.8%, and 33.2% in 1952, 1960, 1970, 1982, and 1994, respectively. The prevalence of obesity in school-aged children is increasing; recently, nearly 10% of the children in this age group were considered obese. About 5% of obese children experience some adverse effects caused by obesity, eg, hypertension and hyperlipidemia. Nationwide surveys on serum cholesterol concentrations conducted in 1960, 1970, 1980, and 1990 showed that the cholesterol concentrations in 10-19-y-old males and females increased year after year. The height of boys and girls rapidly increased during the 15-y period from 1945 to 1960, and after 1970 the adult height in Japan was thought to have reached its maximum. The factors that contribute to the health problems facing today's Japanese children include their sedentary lifestyle, irregular intake of meals (especially skipping breakfast), and the increasing daily ratio of fat to total energy intake. Presently, changing the sedentary lifestyle is the most significant issue to be resolved.

Adolescent↗
PubMed1982

'Pseudodiagnosticity' in an idealized medical problem-solving environment.

Sixty-five senior medical students chose symptom information that would allow them to assess which of two diagnoses was more appropriate for hypothetical patients. Although Bayes' theorem should have governed their data selection, 83 percent of the subjects did not choose the symptom information required for Bayesian computation. Instead, they showed an overwhelming tendency to seek data relevant to a single disease, while ignoring information related to an equally plausible alternative diagnosis. The tendency for subjects to select diagnostically irrelevant information in such tasks has been labeled "pseudodiagnosticity." The effect result from the difficulty of simultaneously evaluating the relevance of a single symptoms in relation to single diagnosis. Medical educators might incorporate classroom demonstrations of the pseudodiagnosticity effect in order to increase students' accuracy in differential diagnosis.

Bayes Theorem↗
PubMed2002

Gaining insight into age-related macular degeneration.

PURPOSE/OBJECTIVE: To enhance nurse practitioner (NP) recognition of clients with age-related macular degeneration (AMD) based on history and physical examination findings, to encourage prompt initial referral of these clients to an ophthalmologist for a treatment evaluation, and to acquaint NPs with low vision rehabilitation services. DATA SOURCES: Government documents, professional association practice guidelines, original research articles, journal articles, and Internet resources. CONCLUSIONS: Age-related macular degeneration is a common, chronic vision-threatening condition necessitating prompt recognition and professional evaluation. If not recognized early, AMD can lead to low vision and a diminished quality of life for the elderly client. IMPLICATIONS FOR PRACTICE: Even though NPs have a limited role in the treatment of AMD, they are in an instrumental position as a primary care providers to screen for this disease chiefly by: (a) adherence to eye examinations intervals, (b) recognition of risk factors, (c) use of the Amsler grid, (d) awareness of psychosocial dimensions, (e) making appropriate referrals, and (f) advocating low vision rehabilitation services.

Age Factors↗
PubMed2006

Blowing the whistle on healthcare fraud: should I?

PURPOSE: The purpose of this article is to explore some of the factors involved when a nurse practitioner (NP) is confronted with a healthcare fraud situation. Ethical concepts and decision-making strategies are provided, as well as practical legal considerations. DATA SOURCES: Government Internet Web sites; healthcare management, ethics, and nursing journals. CONCLUSIONS: There are many forms of healthcare fraud. Healthcare fraud saps financial resources from the healthcare system and from individuals. The decision to blow the whistle on a colleague or organization is not an easy one and has potential for great discomfort. There are ethical decision-making strategies and practical considerations for the process of whistle-blowing should it become necessary. IMPLICATIONS FOR PRACTICE: NPs may be confronted daily with billing and reimbursement issues. Being prepared to recognize healthcare fraud and knowing the ramifications of whistle-blowing are important tools to have in one's practice repertoire.

Attitude of Health Personnel↗
PubMed2001

Success and future of demography: the role of data and methods.

Demography typifies paradigmatic success; that is, cumulative scientific work that has provided useful perspectives on a set of important questions. This success can be traced partly to the core subject matter of demography, which is relatively conducive to quantitative, observational science. The development of demography was further aided by extrinsic factors, such as the import of its data for government administration, for business purposes, and the import of demographic questions for social problems and public policy. These observations make suspect any simple projection of demography's success into the future or the transport of its experience to other disciplines.

Benchmarking↗