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Demographic Data (demographic + data)
Kinds of Demographic Data Selected AbstractsUsing Insurance Claims and Demographic Data for Surveillance of Children's Oral HealthJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2004Keith E. Heller DDS ABSTRACT Objectives: This paper examines the utility of using private insurance and Medicaid dental claims as well as demographic data for assessing the oral health of children aged 5,12 years in Genesee County, Michigan, communities. Methods: Dental insurance claims data from Delta Plan of Michigan and Michigan Medicaid, plus demographic data from the 1990 US Census (percent poverty) and from the 1995 National Center for Educational Statistics (percent free or reduced lunch eligibility), were compared to findings from two school-based oral health surveys. These surveys were the 1995 Genesee County Oral Health Survey and the 1998,2001 Mott Children's Health Center oral health screenings. Data were analyzed using zip codes, representing communities, as the comparison unit. Statistical comparisons using correlation coefficients were used to compare the findings from the six data sets. Results: Using the insurance claims and school-based data, some communities consistently demonstrated high levels of dental caries or treatment for the primary dentition. The demographic measures were significantly associated with many of the primary dentition survey measures. The demographic data were more useful in identifying communities with high levels of dental disease, particularly in the primary teeth, than the insurance claims data. Conclusions: When screening is not practical, readily available demographic data may provide valuable oral health surveillance information for identification of high-risk communities, but these data do not identify high-risk individuals. In these analyses, demographic data were more useful than dental insurance claims data for oral health surveillance purposes. [source] Demographic Data on the Victims of the September 11, 2001 Terror Attack on the World Trade Center, New York CityPOPULATION AND DEVELOPMENT REVIEW, Issue 3 2002Article first published online: 27 JAN 200 The magnitude of the death toll resulting from the attack on the World Trade Center is without precedent in the history of terrorist acts. Because of the scale and destructiveness of the buildings' collapse, a final list of the victims required a lengthy process, more so than was the case at the other sites of terrorist violence on the same day,at the Pentagon, Virginia (193 killed, 68 of these on American Airlines Flight 77), and near Shanksville, Pennsylvania (45 killed in the crash of United Airlines Flight 93). After the passing of a year, the list of the victims in New York, while essentially complete, is still not officially closed. On August 19, 2002, the city's medical examiner's office issued a list containing 2,819 names. Reproduced below are some data, released by the city's office of vital statistics, on the demographic characteristics of 2,723 victims (59 of these on United Airlines Flight 175 and 89 on American Airlines Flight 11) for whom a death certificate had been issued,an exacting procedure,as of August 16,2002. The cause of death, in each instance, was entered as homicide. The age distribution reflects the character of the World Trade Center,a workplace,and the time of day,early for tourist visits. The youngest victims perished as passengers in the two airplanes flown into the twin towers. [source] Exploring the possibility of risk assessment of Japanese sexual offenders using Static-99CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2006Junya Sudo Background,The number of sexual offences reported in Japan doubled between 1992 and 2002. This has prompted attention to assessment of risk of recidivism. Aims,To explore whether an actuarial assessment of risk widely used in the West can be meaningfully applied to Japanese men serving a prison sentence for sexual offences. Method,All sex offenders incarcerated in Kitakyushu Medical Prison in Fukuoka at any time in a period of one year (1 July 2002-30 June 2003) were identified. Demographic data, characteristics of offences and the Static-99 were rated from records. Results,Following a slightly modified application of coding rules, all items of the Static-99 were rateable. Nine offenders of 45 whose Static-99 score was over 6 were thus identified as high-risk offenders. The items distinguishing apparently high-risk men were history of institutionalization as a delinquent and mental retardation. Conclusions and implications for practice,The Static-99 may be a useful tool in assessing sex offenders in Japan. With apparently increasing recognition of sex crimes here, it seems timely to be developing a systematic approach to assessment. Further work is required to test its value in practice as a predictor of recidivism. Copyright © 2006 John Wiley & Sons, Ltd. [source] Chronic post-traumatic headache after head injuryin children and adolescentsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2008Charlotte Kirk MBChB MRCPCH BSc This was a prospective, observational study of children aged 3 to 15 years admitted to hospital with head injury (HI). Demographic data and information on the nature of the HI, and history of premorbid headache were collected. A structured telephone questionnaire was used to interview parents and children 2 months after injury and at 4-monthly intervals for up to 3 years, if headache was reported. One hundred and ninety children were admitted with HI. Data were available on 117 children (81 males, 36 females; mean age 8y 5mo [SD 3y 1mo]). HI was minor in 93 patients and significant in the rest. Minor HI was defined as a closed injury, no loss of consciousness, and a Glasgow Coma Score (GCS) of 13 to 15. Significant HI was associated with loss of consciousness for >30 minutes, GCS of <13, and post-traumatic amnesia for >48 hours. Eight children (five males, three females; mean age 10y 7mo [SD 2y]) reported chronic post-traumatic headache (CPTH). Five children had episodic tension-type headache and three had migraine with or without aura. Headache resolved over 3 to 27 months in all except one child who was lost to follow-up. Premorbid headache in three children transformed in frequency and type following HI. These patients were excluded from the study. CPTH is common after minor and significant HI. It has the clinical features of tension-type headache and migraine and has a good prognosis. [source] The association of coronary calcium score and conventional cardiovascular risk factors in Type 2 diabetic subjects asymptomatic for coronary heart disease (The PREDICT Study)DIABETIC MEDICINE, Issue 10 2004R. S. Elkeles Abstract Aim To determine the association between coronary calcification score (CACS) obtained by electron beam computed tomography (EBCT) and cardiovascular risk factors in Type 2 diabetic subjects entered into a prospective cohort study. Methods Type 2 diabetic subjects attending routine hospital diabetic clinics without known coronary heart disease (CHD) underwent EBCT to measure CACS. Demographic data were obtained and conventional cardiovascular risk factors were measured at baseline. Results Four hundred and ninety-five subjects were assessed of whom 67.7% were male. They had a mean (sd) age of 62.9 (7.1) years, with median (inter-quartile range) duration of diabetes of 8 (4,13) years. None had a history of coronary artery disease. Forty-five per cent were receiving lipid-lowering agents (including 36% statins). In a univariate analysis, there were significant associations between increased CACS and age, duration of diabetes, male gender, waist,hip ratio (WHR), systolic blood pressure, and the use of statins. In a multivariate model adjusting for the possible interaction of these and other factors, the significant association between CACS and WHR, systolic blood pressure, male gender and statin use remained. Conclusions The close association between CACS and WHR and the association with systolic blood pressure suggest that coronary calcification may be particularly linked to the metabolic syndrome in Type 2 diabetes. [source] Prospective Study of Accuracy and Outcome of Emergency Ultrasound for Abdominal Aortic Aneurysm over Two YearsACADEMIC EMERGENCY MEDICINE, Issue 8 2003Vivek S. Tayal MD Abstract Determination of the presence of an abdominal aortic aneurysm (AAA) is essential in the management of the symptomatic emergency department (ED) patient. Objectives: To identify whether emergency ultrasound of the abdominal aorta (EUS-AA) by emergency physicians could accurately determine the presence of AAA and guide ED disposition. Methods: This was a prospective, observational study at an urban ED with more than 100,000 annual patient visits with consecutive patients enrolled over a two-year period. All patients suspected to have AAA underwent standard ED evaluation consisting of EUS-AA, followed by a confirmatory imaging study or laparotomy. AAA was defined as any measured diameter greater than 3 cm. Demographic data, results of confirmatory testing, and patient outcome were collected by retrospective review. Results: A total of 125 patients had EUS-AA performed over a two-year period. The patient population had the following characteristics: average age 66 years, male 54%, hypertension 56%, coronary artery disease 39%, diabetes 22%, and peripheral vascular disease 14%. Confirmatory tests included radiology ultrasound, 28/125 (22%); abdominal computed tomography, 95/125 (76%); abdominal magnetic resonance imaging, 1/125 (1%); and laparotomy, 1/125 (1%). AAA was diagnosed in 29/125 (23%); of those, 27/29 patients had AAA on confirmatory testing. EUS-AA had 100% sensitivity (95% CI = 89.5 to 100), 98% specificity (95% CI = 92.8 to 99.8), 93% positive predictive value (27/29), and 100% negative predictive value (96/96). Admission rate for the study group overall was 70%. Immediate operative management was considered in 17 of 27 (63%) patients with AAA; ten patients were taken to the operating room. Conclusions: EUS-AA in a symptomatic population for AAA is sensitive and specific. These data suggest that the presence of AAA on EUS-AA should guide urgent consultation. Emergency physicians were able to exclude AAA regardless of disposition from the ED. [source] Pediatric Emergency Medicine Education in Emergency Medicine Training ProgramsACADEMIC EMERGENCY MEDICINE, Issue 7 2000Vincent P Tamariz MD Abstract. Background: The educational goal of emergency medicine (EM) programs has been to prepare its graduates to provide care for a diverse range of patients and presentations, including pediatric patients. Objective: To evaluate the methods used to teach pediatric emergency medicine (PEM) to EM residents. Methods: A written questionnaire was distributed to 118 EM programs. Demographic data were requested concerning the type of residency program, number of residents, required pediatric rotations, elective pediatric rotations, type of hospital and settings in which pediatric patients are seen, and procedures performed. Information was also requested on the educational methods used, proctoring EM received, and any formal curriculum used. Results: Ninety-four percent (111/118) of the programs responded, with 80% of surveys completed by the residency director. Proctoring was primarily performed by PEM attendings and general EM attendings. Formal means of PEM education most often included the EM core curriculum (94%), journal club (95%), EM grand rounds (94%), and EM morbidity and mortality (M&M) conference (91%). Rotations and electives most often included the pediatric intensive care unit (PICU) and the emergency department (ED) (general and pediatric). Conclusions: Emergency medicine residents are exposed to PEM primarily by rotating through a general ED, the PED, and the PICU, being proctored by PEM and EM attendings and attending EM lectures and EM M&M conferences. Areas that may merit further attention for pediatric emergency training include experience in areas of neonatal resuscitation, pediatric M&M, and specific pediatric electives. This survey highlights the need to describe current educational strategies as a first step to assess perceived effectiveness. [source] River corridor plants (Stromtalpflanzen) in Central European lowland: a review of a poorly understood plant distribution patternGLOBAL ECOLOGY, Issue 5 2001Michael Burkart Abstract Aim and location In Central European lowlands certain plant species grow mainly or exclusively in the corridors of large rivers. In German-speaking plant geography, they are known as ,Stromtalpflanzen'. The aim of this paper is to review the literature about definitions, explanations and species characteristics and to suggest future directions in research concerning this species group. Results A preliminary list contains 129 ecologically heterogeneous plant species. The mechanisms generating the peculiar distribution pattern may include hydrochory along river corridors, high levels of disturbance by water, variable water availability including inundation and summer drought, warm summers and high nutrient supply on alluvial soils. There is evidence from observational studies for all above mechanisms. However, none of them has been tested experimentally. Demographic data of river corridor plants are limited to very few species, including mainly invasive annuals (Artemisia annua, Bidens frondosa, Cuscuta campestris, Xanthium albinum) and annual (hemi)parasites (Cuscuta campestris, Melampyrum cristatum). Metapopulation studies do not exist to date for European species. Apart from their habitat requirements, river corridor plants were grouped according to their similarities in overall distribution pattern or their distribution within particular river corridors. Main conclusions River corridor plants include a high proportion of threatened plant species. In order to preserve them, and in order to understand the mechanisms generating the peculiar distribution pattern, much more has to be known about their population biology and metapopulation dynamics. [source] Low Leptin Levels in Migraine: A Case Control StudyHEADACHE, Issue 7 2008Baburhan Guldiken MD Background., Obesity has been shown to be a risk factor for transformation of episodic migraine to chronic form, and adipocytokines have been implicated to modulate some of the cytokins such as interleukin-6 and tumor necrosis factor, which also act in the neurogenic inflammation in migraine. The aim of the study was to assess leptin levels, one of the adipocytokines, in headache-free period of migraine patients and investigate its relation to vascular risk factors. Material and Methods., Sixty-one patients with episodic migraine headaches and 64 control subjects were enrolled in the study. Demographic data and anthropometric measurements were obtained from all participants; body mass index and fat mass values were calculated. Glucose and lipid parameters were measured by oxidase technique and cholesterol esterase enzymatic assays, and leptin levels were measured by ELISA in serum samples obtained after an overnight fasting. Results., Leptin levels were found significantly lower in migraineurs than controls (40.1 ± 21.2 ng/mL, 48.5 ± 24.5 ng/mL; P < .05). Although body mass index did not differ between 2 groups, fat mass, and fat percentages were significantly lower in migraine patients (19.4 ± 8.8 kg, 26.0 ± 8.7 kg; P < .001 and 28 ± 9%, 34 ± 5%; P < .001, respectively). Conclusion., Migraine patients have low leptin levels and fat mass which may be related to the pathogenesis of migraine. The importance and impact of our findings on the prevalence, characteristics, and treatment of migraine needs to be investigated in further detailed studies. [source] Vitamin D deficiency is common and unrecognized among recently arrived adult immigrants from The Horn of AfricaINTERNAL MEDICINE JOURNAL, Issue 1-2 2003S. A. Skull Abstract The prevalence of and risk factors for vitamin D deficiency were examined for recent adult immigrants from East Africa living in Melbourne. Demographic data were collected via a face-to-face questionnaire and risk factors predicting deficiency were examined. Suboptimal levels <25 nmol/L were found in 61 patients (53%; 74% of women; 20% of men). Lower levels were more likely in: (i) patients with a longer duration of residence in Australia, (ii) patients who were mostly covered when outdoors and (iii) women. Routine assessment for vitamin D deficiency should be considered for male and female immigrants from East Africa. (Intern Med J 2003; 33: 47,51) [source] Clinical characteristics of basal cell carcinoma in a tertiary hospital in Sarawak, MalaysiaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2010Felix Boon Bin Yap MD MRCP Background, Basal cell carcinoma (BCC) is the most common skin cancer among Orientals. Data on this malignancy is lacking in Malaysia, prompting a retrospective study to determine the clinical characteristics in the skin clinic, Sarawak General Hospital between 2000 and 2008. Methods, Demographic data and clinical features of 64 histopathologically proven BCC from 43 patients were retrieved. Statistical analysis was performed comparing the clinical characteristics based on the region of involvement and gender. Results, The mean age of presentation was 60.9 years. Male to female ratio was 1.05. Majority of the patients were Chinese (44.2%) followed by Malays (32.6%), Bidayuhs (14.0%) and Ibans (6.9%). Nodular BCC accounted for 95.3% of cases while 4.7% were superficial BCC. All the nodular BCC were pigmented. Ulceration was noted in 18%. There were 82.8% of BCC on the head and neck region and 17.2% on the trunk and limb region. BCC on the latter region were larger (mean 35.0 cf. 14.4 mm, p < 0.001) and ulcerated (45.5% cf. 11.3%, p = 0.01). Superficial BCC were also more frequently encountered in this region (18.2% cf. 1.9%, p = 0.02). Compared to women, men had larger BCC (mean 21.1 cf. 13.3 mm, p = 0.03) and kept them for a longer duration (mean 21.6 cf. 13.3 months, p = 0.04). Conclusion, Clinical characteristics of BCC in Sarawak were similar to other Asian studies. Additionally, BCC on the trunk and limbs and in men were larger, ulcerative and long standing warranting better efforts for earlier detection. [source] Change in pattern of skin disease in Kaduna, north-central NigeriaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2007Husain Yahya MSc Background, We report our experience on the pattern of skin disease in Kaduna, north-central Nigeria over a 6-year period, and compare it with a similar survey conducted in the same area 30 years ago and with surveys from Nigeria and from other parts of Africa. Methods, The medical records of new patients attending the dermatology outpatient clinics of Barau Dikko Specialist Hospital and Habbat Medical Center from March 2000 to December 2005 were retrieved. Demographic data (age and sex) and the diagnoses of skin disease were extracted and analyzed. Results, A total of 5982 cases was seen. Forty-nine per cent were males and 51% were females. One-third of the patients were aged under 20 years, and three quarters were aged below 40 years. Eczematous dermatitis was the most common skin disorder seen, making up 35% of cases, and had replaced dermatophyte infections and scabies, which were the most dominant skin diseases 30 years previously (now constituting 6% and 1.4% of cases, respectively). Atopic dermatitis had more than doubled in frequency (13.8% vs. 5.2%), and contact dermatitis had tripled in frequency (5.8% vs. 1.8%). Acne vulgaris (6.7%), pigmentary disorders (3.9%), urticaria (3.6%), papular urticaria (3.6%), hair disorders (3.3%), lichen simplex chronicus (3%), viral warts (2.9%), and drug eruptions (2.7%) had also increased. Human immunodeficiency virus-related skin disease constituted 4.3% of cases, with pruritic papular eruption being the most common condition. Conclusion, These changes in skin disease can be attributed mainly to an increase in urbanization and improved socio-economic conditions. [source] A clinical prospective comparison of anesthetics sensitivity and hemodynamic effect among patients with or without obstructive jaundiceACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2010L.-Q. YANG Background: To compare isoflurane anesthesia in patients with or without hyperbilirubinemia undergoing hepatobiliary surgery. Methods: Forty-two patients with obstructive jaundice and 40 control patients with normal liver function scheduled for hepatobiliary surgery under isoflurane anesthesia were studied. Anesthesia was induced with propofol (1.5,2 mg/kg) and remifentanil (2 ,g/kg). After tracheal intubation, anesthesia was titrated using isoflurane in oxygen-enriched air, adjusted to maintain a bispectral index (BIS) value of 46,54. Ephedrine, atropine and remifentanil were used to maintain hemodynamic parameters within 30% of the baseline. The mean arterial blood pressure (MAP), heart rate (HR), drug doses and the time taken to recover from anesthesia were recorded. Results: Demographic data, duration and BIS values were similar in both groups. Anesthesia induction and maintenance were associated with more hemodynamic instability in the patients with jaundice and they received more ephedrine and atropine and less remifentanil and isoflurane (51.1±24.2 vs. 84.6±20.3 mg/min; P for all <0.05) than control patients. Despite less anesthetic use, the time to recovery and extubation was significantly longer than that in control. Conclusion: Patients with obstructive jaundice have an increased sensitivity to isoflurane, more hypotension and bradycardia during anesthesia induction and maintenance and a prolonged recovery time compared with controls. [source] The suitability of the BSRS-5 for assessing elderly who have attempted suicide and need to be referred for professional mental health consultation in a metropolitan city, TaiwanINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2009Wei-Jen Chen Abstract Objectives The goals of this study are to (1) investigate the prevalence of necessary referral for professional mental health consultation for elderly people who attempted suicide ("suicide-attempted") in Kaohsiung city, Taiwan during 2006,2007, (2) assess whether the 5-item Brief Symptom Rating Scale (BSRS-5) can be used as an efficient screening instrument for assessing the probability of a second suicide attempt among the elderly, and (3) examine predictors of needing referral among the suicide-attempted. Methods During the study period, 144 suicide-attempted elderly subjects were enrolled. Demographic data, BSRS-5, SAD PERSONS scale, and Medical Outcome Study Short Form-12 (MOS SF-12) data were collected by a trained semi-professional. The prevalence of necessary referrals for the suicide-attempted elderly was estimated, and the salient factors for their referral were evaluated with logistic regression analysis. Results A total of 109 participants out of the 144 recruited completed the questionnaires, giving a response rate of 75.7%. The prevalence of necessary referrals for professional mental health consultation was 33.9% (37/109). The significant predictors of needing referrals were lower scores for MCS (OR,=,0.89; 95% CI,=,0.83,0.96), family discord (OR,=,3.86; 95% CI,=,1.17,12.75), and type of interviewee (OR,=,4.97; 95% CI,=,1.57,15.74). Conclusion When the BSRS-5 is used to evaluate the referral of elderly patients who have attempted suicide for a professional mental health consultation, it is best to conduct in-person interviews to ask whether the elderly patient still has any suicidal ideation. In addition, evaluating quality of life and level of family discord may also be crucial for suicide prevention in the elderly. Copyright © 2009 John Wiley & Sons, Ltd. [source] The influence of education on the interpretation of pharmaceutical pictograms for communicating medicine instructionsINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2003Ros Dowse senior lecturer Objective To assess the influence of formal education on the interpretation of pharmaceutical pictograms. Method A total of 46 pictograms were used: 23 were extracted directly from the USP-DI, and 23 with corresponding meanings were designed in accordance with the local culture (local pictograms). One hundred and thirty Xhosa respondents, who ranged from having no formal education to tertiary level education, were interviewed with the aid of an interpreter. Demographic data were collected, a literacy test was conducted and respondents were tested for their interpretation of all 46 pictograms. Preference for either the USP-DI or the local pictogram was determined. Setting Respondents were interviewed in primary health care clinics, a variety of work settings or in their homes in Grahamstown, South Africa. Key findings Standard of education had a significant influence on the interpretation of 24 of the 46 pictograms. Generally, significant differences in interpretation were apparent between those with only primary school education and those who had completed at least some senior school education (P < 0.05). The group with tertiary education was significantly better than the other groups (P < 0.05). Only 15 of the 46 pictograms met the American National Standards Institute (ANSI) 85% correct criterion. Conclusion Interpretation was dependent on education and the development of visual literacy skills, but potential for misinterpretation in all educational groups was noted. These results suggest that pictograms should only be used as a communication aid in combination with text or verbal information from the health care provider. [source] Our experience with third renal transplantation: Results, surgical techniques and complicationsINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2007Mohammad Hossein Nourbala Background: Despite the popularity of kidney transplantation in the current era, second and third kidney transplantation are not yet widely accepted and practiced. Each center has its own regulations and experiences and there is no accepted protocol for third kidney transplantation. We report here our 15 years of experience with third kidney transplantation. Methods: This is a report of all the third kidney transplantations performed in Baqiyatallah Hospital, Tehran, Iran, between 1991 and 2006. Demographic data, surgical techniques, complications and outcomes are reported. Results: Of the nine third kidney transplant patients, six were male. The median age was 43 years (32,52). All of the patients received kidney from living donors. All operations were performed by a midline incision and the grafts were placed at the midline, in the intraperitoneal space. For arterial anastomosis, we used internal iliac, right common iliac and both the right external iliac and inferior mesenteric artery in 4, 4 and 1 case(s), respectively. For venous anastomosis, we used vena cava, common iliac and external iliac veins in 3, 5 and 1 case(s), respectively. During the follow up period (38 months), 6 grafts (66.6%) were functioning. None of the graft rejections were due to surgical complications. Wound dehiscence occurred in two patients. No other surgical complications including infection, lymphocele or hemorrhage were observed. Conclusion: Third kidney transplantation is a field that has not been fully explored. The rate of complications seems to be not much higher than the first transplantation. Defining a standard protocol seems necessary. [source] Hand-assisted laparoscopic and open living donor nephrectomy in KoreaINTERNATIONAL JOURNAL OF UROLOGY, Issue 5 2005JA HYEON KU Abstract Background: We compared the results of hand-assisted laparoscopic living donor nephrectomy (LLDN) and conventional open living donor nephrectomy (OLDN). Methods: The clinical data on 49 hand-assisted LLDN and 21 OLDN on the left side performed at two institutions in Korea from January 2001 to February 2003 were reviewed. Demographic data of donors and recipients were similar in the two groups. Results: There was one conversion to an open procedure due to bleeding in the LLDN group. The median operation times (180 min in LLDN versus 170 min in OLDN) and warm ischemic times (2.5 min in LLDN versus 2.0 min in OLDN) in the two groups were similar. The estimated mean blood loss, duration of hospital stay and complication rate was also similar in the two groups. The LLDN group reported less pain (visual analog scale) postoperatively (4.1 versus 5.3), but this was not significant (P = 0.058). The time to oral intake in the LLDN group was significantly longer by an average of 1 day (P = 0.001). Return to work was sooner in the LLDN group (4.0 weeks versus 6.0 weeks; P = 0.026). The recipient graft function was equivalent between the two groups. Hand-assisted LLDN appears to be a safe and effective alternative to OLDN. Conclusion: Our findings suggest that this technique may give the ability provide grafts of similar quality to OLDN, while extending to the donors the advantages of a traditional LLDN procedure. [source] Beliefs about the causes of cervical cancer in Botswana: implications for nursingINTERNATIONAL NURSING REVIEW, Issue 4 2009D. M. McFarland rn Background:, Cervical cancer is the most common cause of cancer mortality and morbidity for women in Botswana. Yet, little is known about what women believe to be the causes of the disease. Aim:, This paper presents data on factors women in Botswana believe are responsible for the high incidence of cervical cancer in their country. Data were part of a larger study that explored knowledge and perceptions about cervical cancer and Pap smear screening from the perspectives of the clients and the healthcare providers. Methods:, The study that generated the data included 30 women of all socio-economic levels, recruited by network sampling. The women's ages ranged from 31 to 54 years. Demographic data were analysed descriptively. Individualized interview data were content-analysed. Findings:, The identified causes of cervical cancer were classified as cervical irritants and non-irritants. The most commonly cited cervical irritants were vaginally inserted chemical agents and traditional medicine. Discussions:, Participants identified vaginally inserted chemical substances and traditional medicines as possible explanations for the high incidence of cervical cancer in Botswana. They reported that women used these substances for sexual and hygienic purposes. Although these factors are believed to be the causes of cervical cancer and have not yet been medically acknowledged, verbal reports suggest that their use is problematic. Conclusion:, There is a need for health education and for further research to affirm women's beliefs about the harmful effects of intravaginal agents. [source] Home Intravenous Antimicrobial Infusion Therapy: A Viable Option in Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2007(See editorial comments by Dr. Kevin High on pp 79 OBJECTIVES: To determine whether older adults and younger adults are equally able to administer home intravenous antimicrobial infusion therapy (home IV antimicrobials) without intensive support from home care agencies. DESIGN: Retrospective cohort study. SETTING: Veterans Affairs Ann Arbor Healthcare System, a 100-bed tertiary care medical center. PARTICIPANTS: All patients who received home IV antimicrobials from July 1, 2000, through December 31, 2003. MEASUREMENTS: Demographic data, underlying medical conditions, indications for therapy, antimicrobial agents administered, concomitant medications, frequency of patient visits and phone calls, adverse events, and outcomes of infections. RESULTS: A total of 205 patients received 231 courses of home IV antimicrobials, with 107 courses in patients aged 60 and older and 124 courses in patients younger than 60. For both groups, the most common indication for therapy was osteoarticular infections, and the predominant pathogens were Staphylococcus aureus and coagulase-negative Staphylococcus. Older patients were significantly more likely than younger patients to require the assistance of family members to help with the infusion and were more likely to be seen in urgent care or to call the infectious diseases pharmacist or physicians with questions. Overall, clinical outcomes and numbers of adverse events were similar in both groups, with the exception of nephrotoxicity, which was greater in the older group (P=.02). CONCLUSION: With appropriate support from a hospital-based home IV antimicrobials therapy team, home IV antimicrobial appears to be a viable option for older adults. [source] Simplifying Detection of Cognitive Impairment: Comparison of the Mini-Cog and Mini-Mental State Examination in a Multiethnic SampleJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2005Soo Borson MD Objectives: To compare detection of cognitive impairment using the Mini-Cog and Mini-Mental State Examination (MMSE) and to identify sociodemographic variables that influence detection in an ethnoculturally diverse sample. Design: Cross-sectional. Setting: A registry of the University of Washington Alzheimer's Disease Research Center Satellite. Participants: A heterogeneous community sample (n=371) of predominantly ethnic minority elderly assessed using a standardized research protocol, 231 of whom met criteria for dementia or mild cognitive impairment (MCI). Measurements: Demographic data, a standardized research protocol for cognitive assessment and dementia diagnosis, MMSE, and Mini-Cog. Results: Both screens effectively detected cognitive impairment, the Mini-Cog slightly better than the MMSE (P<.01). Overall accuracy of classification was 83% for the Mini-Cog and 81% for the MMSE. The Mini-Cog was superior in recognizing patients with Alzheimer-type dementias (P=.05). Low education negatively affected detection using the MMSE (P<.001), whereas education did not affect the Mini-Cog, and low literacy minimally affected it. Conclusion: The Mini-Cog detects clinically significant cognitive impairment as well as or better than the MMSE in multiethnic elderly individuals, is easier to administer to non-English speakers, and is less biased by low education and literacy. [source] Site reoccupation in fragmented landscapes: testing predictions of metapopulation theoryJOURNAL OF ANIMAL ECOLOGY, Issue 2 2001Ralph S. Hames Summary 1,Populations of formerly continuously distributed species subdivided by habitat fragmentation may show distributions in space and time that are consistent with predictions of metapopulation theory. Local extinctions and recolonizations should result in the most fragmented sites being infrequently occupied and the least fragmented sites being continuously occupied by sensitive species. The probability of extinction is predicted to be negatively correlated with patch size and the amount of habitat in the landscape. Conversely, recolonization is predicted to be negatively correlated with the isolation of the patch, and positively correlated with the amount of habitat in the landscape. 2,Data from a 3-year study of the effect of fragmentation were used to test whether these predictions from metapopulation theory apply to populations of the long-distance migrant forest bird Piranga olivacea (Scarlet Tanager) in fragmented North American landscapes. 3,Principal components analysis was used to derive a composite measure of fragmentation. This measure was used in a logistic regression as a predictor of the number of years that territorial males would occupy a site, given that it was occupied at least once. More fragmented sites were more likely to be occupied only once; the least fragmented sites were more likely to be occupied in all three years. Data on fragmentation were necessary, but not sufficient, to predict site reoccupation, and were poor predictors at medium levels of fragmentation. 4,The univariate measures of fragmentation (patch size and isolation, proportion of forest, and forest/non-forest edge), were also used in logistic regressions to predict the separate probabilities of local extinction or recolonization. Local extinctions were negatively correlated with patch size and amount of forest in the landscape, as predicted. Recolonizations were negatively correlated with isolation of the patch as predicted, and surprisingly, also with the amount of edge in the landscape. This suggests that stochasticity may drive extinctions, but that habitat selection may play an important role in recolonization. 5,Demographic data are usually required to establish the suitability of habitat to support persistent populations, but multiple-year distributional data can provide information on habitat quality far above that obtained from single-year studies. [source] Genetic and demographic variation in new recruits of Naso unicornisJOURNAL OF FISH BIOLOGY, Issue 4 2002S. Planes Demographic data showed that larvae of Naso unicornis colonizing the reefs of Moorea, French Polynesia, on the same night within a restricted area originated from several spawning events that occurred 67 to 94 days previously. Based on the demographic structure of larvae of N. unicornis colonizing the reef, it cannot be entirely dismissed that siblings colonize together because five spawning dates grouped c. 55% of the captured larvae. Relatedness analysis reinforced these observations and also confirmed that larvae colonizing together were not all siblings. Larvae of the same spawning dates, however, appeared related in some age-classes (72, 74 and 77 days old), suggesting that siblings recruited together. In addition, the larvae appeared genetically different from adults (P=0·002) and juveniles (P<0·001) while juveniles and adults were similar (P=0·100). The variations in allelic and genotypic frequencies in the larvae probably reflect a family-structure that is diluted once larvae are recruited into the lagoon because of high mortality and active movement of fish. [source] Breastfeeding failure in a longitudinal post-partum maternal nutrition study in Hong KongJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2000Sm Chan Objective: To describe factors associated with breastfeeding failure during the first 6 months post-partum in a sample of Hong Kong Chinese women participating in a longitudinal study of maternal nutrition. Methodology: Forty-four Hong Kong Chinese lactating mothers who intended to breastfeed exclusively for at least 3 months were recruited and followed for 6 months post-partum. Demographic data were compared with 20 mothers who intended to use formula feeding. Mothers were followed up at 2 and 6 weeks and 3 and 6 months and details of infant feeding practices were obtained. Information was sought on breastfeeding management in hospital, reasons for discontinuation of breastfeeding or for providing supplements to babies and intention to seek, and sources of, lactation support. Results: Thirty-nine mothers who planned to breastfeed completed the follow up. Compared with mothers in the formula-feeding group, breastfeeding mothers were more likely to be professionals or housewives. Continuation of any breastfeeding (total and partial) was noted in 30 (77%), 22 (57%), 16 (41%) and 12 (31%) mothers at 2 and 6 weeks and 3 and 6 months post-partum, respectively. The majority (97%) of mothers stated that they were given information on the benefits and management of breastfeeding. However, late initiation of breastfeeding and providing supplements to babies were common. Perceptions of insufficient milk supply (44%), breast problems (31%) and being too tired (28%) were the main reasons stated for stopping breastfeeding or for providing supplements to babies. Midwives from the postnatal wards and hotlines were the main sources of lactation support. Conclusions: These results highlight difficulties in sustaining breastfeeding, either exclusive or partial, in Hong Kong Chinese women. Despite being recruited on the basis of intending to exclusively breastfeed for 3 months, less than half these mothers were still breastfeeding and only approximately one-third were exclusively or predominantly breastfeeding at 3 months. More needs to be done within the hospital environment to initiate breastfeeding immediately after birth and to avoid giving unnecessary supplements and more effort is needed to foster a mother's confidence, commitment and knowledge of breastfeeding. [source] Alopecia areata in Turkey: demographic and clinical featuresJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2008A Kavak Abstract Background, Alopecia areata is a complex genetic disease with still many unknown aspects, and many studies have been tried to find some clues about it. Objective, We aimed to investigate the demographic and clinical characteristics of alopecia areata in Turkish patients. Methods, Demographic data, localization, attack number in addition to some parameters such as disease duration, severity, age of onset, family history and ophiasis pattern were evaluated in 539 alopecia areata patients. Results, The male to female ratio was 1.6 : 1. Occipital and beard-moustache areas were mostly affected. Positive family history was noticed in 24.1% of the patients. The age of onset was earlier in women than in men (P = 0.04). Severe forms showed more persistent (, 1 year) disease duration (P = 0.00). Ophiasis was more common in severe, long duration (, 1 year) and early onset (, 18 years) disease (P = 0.00 for all parameters). Childhood alopecia areata (, 18 years) was also associated with long duration of the disease (P = 0.016) and positive family history (P = 0.008) when compared with adult onset (> 18 years) alopecia areata. [source] Predictors of gastroduodenal erosions in patients taking low-dose aspirinALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2010J. HART Summary Background, Gastroduodenal ulcers are common in patients taking low-dose aspirin. However, the factors predisposing to mucosal erosions, the precursor lesions, are not well known. Aims, To examine the potential risk factors for the development of erosions in patients chronically taking low-dose aspirin. Methods, Patients included were taking aspirin 75,325 mg daily for >28 days. Exclusion criteria included use of nonsteroidal anti-inflammatory and ulcer-healing drugs. Demographic data were collected at baseline, prior to endoscopy to determine the frequency and number of erosions and Helicobacter pylori status. In those without ulcer or other exclusions, endoscopy was repeated at 3 months. Results, Fewer patients had gastric erosions if they were H. pylori +ve (48.5% vs. 66.4% in H. pylori,ve patients at baseline, P = 0.17; 40.0% vs. 64.1% at 3 months, P = 0.029). If gastric erosions were present, they were also less numerous in H. pylori +ve patients (3.61 ± 0.83 vs. 4.90 ± 0.53 at baseline, P = 0.026; 2.17 ± 0.68 vs. 5.68 ± 0.86 at 3 months, P = 0.029). There was a trend (0.1 > P > 0.05) for more gastric erosions in those taking >100 mg/day aspirin. Males had more duodenal erosions at baseline (25.2% vs. 7.5%, P = 0.016). Patient age did not affect the presence or number of erosions. H. Pylori was not significantly associated with duodenal erosion numbers. Conclusions,Helicobacter pylori infection may partially protect against low-dose aspirin-induced gastric erosions; damage to the stomach appears weakly dose-related; and older age does not increase the risk of erosions. [source] Identification and characterization of errors and incidents in a medical intensive care unitACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2005J. Graf Background:, To assess the frequency, type, consequences, and associations of errors and incidents in a medical intensive care unit (ICU). Methods:, Two-hundred and sixteen consecutive patients with predominantly cardiovascular and pulmonary disorders admitted between December 2002 and February 2003 were enrolled. Demographic data, SAPS II, and TISS-28 were obtained for all patients. Prior to patient enrolment all staff members (physicians, nurses, physiotherapists) were repeatedly encouraged to make use of the Incident Report Form (IRF) and detailed descriptions on how, why and when to use the IRF were provided. Results:, During the observation period of 64 days, 50 errors involving 32 patients (15%) were reported. Patients subjected to errors were more severely ill (SAPS II 42 ± 25 vs. 32 ± 18, P < 0.05), had a higher hospital mortality (38% vs. 9%), and a longer ICU stay (11 ± 18 vs. 3 ± 5 days, P < 0.05). Gender, age and TISS-28 were equally distributed. Each day of ICU stay increased the risk by 8% (odds ratio 1.078, 95% confidence interval 1.034,1.125, P < 0.001), and by 2.3% per SAPS II point (odds ratio 1.023, 95% confidence interval 1.006,1.040, P < 0.001). The majority of errors and incidents were judged as ,human failures' (73%), and 46 errors and incidents (92%) as ,avoidable'. Conclusions:, The identification and characterization of errors and incidents combined with contextual information is feasible and may provide sufficient background information for areas of quality improvement. Areas with a high frequency of errors and incidents need to undergo process evaluation to avoid future occurrence. [source] Neutrophilic airway inflammation is a main feature of induced sputum in nonatopic asthmatic childrenALLERGY, Issue 11 2009A. C. Drews Background:, Asthma phenotypes are well described among children. However, there are few studies comparing airway inflammation in different clinical presentations of pediatric asthma. We tested the hypothesis that nonatopic asthma is associated with a predominant noneosinophilic inflammation in the airways, as assessed by induced sputum. The objective of this study was to evaluate the cytological characteristics of induced sputum (IS) in atopic (AA), nonatopic asthmatics (NAA) and nonatopic nonasthmatic children (NANA). Methods:, Of 90 selected children, 77 met eligibility criteria for performing IS and were classified as: AA, n = 28, NAA, n = 29 and NANA, n = 19. Subjects answered to a set of ISAAC-based questions and were skin-tested for common aeroallergens. A defined series of exclusion criteria was applied. Results:, Induced sputum was obtained from 54 (70.1%) subjects (21 AA, 20 NAA and 13 NANA). Demographic data and mean FEV1 were similar in the three groups. The proportion of eosinophils [median, inter quartile range (IQR)] was significantly higher in the sputum of AA [(6.0.)12)] compared with NAAs [0 (2)] and NANAs [0 (1)], P < 0.001. The proportion of children with sputum eosinophilia (eos > 3%) was also significantly higher in AA (71.4%) when compared with NAA (28.6%); none of the NANA had sputum eosinophilia. Nonatopic asthmatic children had significantly higher proportions and absolute number of neutrophils than AA and controls. Conclusions:, The results suggest that nonatopic children present IS with a cell pattern that is predominantly neutrophilic while eosinophilia is the hallmark of airway inflammation in the majority of atopic wheezing children not treated with inhaled steroids. [source] Multiple mini-interviews: opinions of candidates and interviewersMEDICAL EDUCATION, Issue 2 2008Sarah Humphrey Objectives, To assess candidates' and interviewers' perceptions of the use of a multiple mini-interview (MMI) for selection of senior house officers (SHOs) to a UK regional paediatric training programme. Methods, Both candidates and interviewers completed anonymous questionnaires (comprising 16 and 25 questions, respectively). Demographic data were recorded for both groups. Data were analysed by frequencies; using Mann,Whitney and Kruskall,Wallis tests for comparisons; and Cronbach's alpha for internal consistency within the data. Results, Both candidates and interviewers were positive about the fairness of the MMI (mean scores of 4.0 and 4.4, respectively). The majority of candidates (83%) had not been to this type of interview before. Gender, age and previous experience of MMIs did not account for differences in candidate responses (P > 0.05). A total of 86% of candidates were international medical graduates who preferred the format more than UK graduates did (P = 0.01). Interviewers were mainly experienced consultants who agreed that the multi-station format was better than the traditional interview (mean score 4.8) and represented a reliable process (mean score 4.4). Interviewers were concerned about the range of competencies covered and the subsequent performance of candidates in post (mean scores 3.6 and 3.2, respectively). Conclusions, Both candidates and interviewers agreed that the MMI format was reliable, fair and asked appropriate, easy-to-understand questions. In high-stakes interviews such as for specialty training in Modernising Medical Careers programmes, it is vital that all concerned have confidence in the selection process. [source] Spinal Cord Stimulation for the Treatment of Chronic Pain in Patients with Lumbar Spinal StenosisNEUROMODULATION, Issue 4 2010Amedeo Costantini MD Objective:, Chronic back and leg pain associated with lumbar spinal stenosis (LSS) is common in the elderly. Surgical decompression is usually performed when conservative treatments fail. We present an evaluation of the long-term outcome of patients suffering from symptomatic LSS treated with spinal cord stimulation (SCS). Materials and Methods:, Data were collected prospectively in three independent registries in three European centers. Pooled data were analyzed retrospectively. Changes in pain intensity, functional status, and analgesic medication were compared at baseline and at the last available follow-up. Demographic data as well as details regarding the implantation procedure and any adverse events were systematically recorded. Results:, Data were recorded in 69 patients with a mean follow-up period of 27 months. All patients showed clinically and statistically significant improvement in pain relief, the visual analog scale decreasing from 7.4 ± 2.3 to 2.8 ± 2.4 (p < 0.05). The use of analgesic medication decreased and the functional status improved. Conclusion:, Spinal cord stimulation seems to be effective in the treatment of patients suffering from chronic pain associated with LSS. Being less invasive and reversible, SCS should be considered before surgical decompression, particularly in patients with increased risks associated with back surgery. [source] Urodynamic findings in female diabetic patients with and without overactive bladder symptoms,,NEUROUROLOGY AND URODYNAMICS, Issue 3 2010Chen-Hsun Ho Abstract Aims The purpose was to analyze urodynamic findings in female diabetic patients with OAB symptoms. Methods Data from 94 female diabetic patients who underwent urodynamic studies in evaluation of various LUTS were retrospectively reviewed. Urodynamic findings, demographic data, and clinical symptoms were compared between patients with and without OAB. Results Among the 94 subjects analyzed, 34 (36.2%) were diagnosed as OAB. Demographic data were similar between the patients with and without OAB. In the OAB group, patients had significantly higher storage symptom scores and marginally higher voiding symptom scores. On cystometry, the OAB group had a higher percentage of increased bladder sensation (41.2% vs 11.7%, P,=,0.001) and detrusor overactivity (29.4% vs 10.0%, P,=,0.023). The OAB group had lower peak flow rate (16.2,±,5.9 vs 19.3,±,6.3 ml/s, P,=,0.023), greater PVR volume (60.3,±,29.4 vs 45.0,±,25.1 ml, P,=,0.009), and lower bladder voiding efficiency (BVE, 75.2,±,2.8 vs 81.5,±,2.9%, P,<,0.001). On pressure-flow studies, the OAB group had a higher percentage of BOO (26.5% vs 6.7%, P,=,0.008). Conclusions Our study shows that the most frequent urodynamic finding of OAB in female diabetic patients is increased bladder sensation, followed by detrusor overactivity. Compared to those without OAB, female diabetic patients with OAB are more likely to have impaired voiding function, characterized by lower peak flow rate, greater PVR volume, lower BVE, and a higher percentage of BOO. In these patients, BOO not only causes voiding difficulty but may also contribute to the development of OAB. Neurourol. Urodynam. 29:424,427, 2010. © 2009 Wiley-Liss, Inc. [source] | |||||||||||||||||||||||||||||||||||||