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Mailed Questionnaire (mailed + questionnaire)
Selected AbstractsGeriatricians Health Survey 2000JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2001David Watts MD OBJECTIVES: To characterize geriatricians' preventive health behaviors including vitamin/supplement use, exercise, smoking, alcohol use, and weight control. DESIGN: Mailed questionnaire. SETTING: United States. PARTICIPANTS: Two thousand six hundred eleven U.S. physicians certified as having added qualifications in geriatric medicine and who were members in the American Geriatrics Society; 1,524 returned completed questionnaires (58%). MEASUREMENTS: Rates of supplement use and recommendations, preventive health visits, advance directive completion, exercise, religious service attendance, smoking, alcohol use, and amount of adult weight gain. RESULTS: Most responding geriatricians took at least one vitamin supplement: 50% vitamin E, 50% a multivitamin (MVI), and 31% vitamin C. Calcium ingestion was common among women. Other supplement use was uncommon: ginkgo compounds were consumed by 47 (3%), and 77 (5%) took a variety of other nonvitamin supplements. Over 90% recommended vitamins, especially multivitamins and vitamin E, at least sometimes. Recommendations for ginkgo (38%) and St. John's wort (33%) were also common. Almost half of respondents had completed a formal advance directive. Exercise was practiced at least weekly by 88%. Cigarette smoking was rare (1%), but at least occasional alcohol use was common (85%). Most of respondents were men (74%), and 35% had completed fellowship training. CONCLUSION: Vitamin/supplement use was common among responding geriatricians but not universal. Respondents often recommended MVI, vitamin E, and vitamin C, but were less likely to consume or recommend other supplements. The most common preventive health behavior among our respondents was exercise. [source] Compulsive Consumption Tendencies Among Television ShoppersFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 4 2000Seung-Hee Lee Compulsive buying and binge eating are consumption behaviors that are similarly related to low self-esteem and poor impulse control, occurring more frequently in women. Using a national random sample, the authors examined the extent to which compulsive buying and binge eating were related in a nonclinical population of known television shoppers. Mailed questionnaires were completed by 334 women. Multiple regression analyses revealed that (a) binge-eating and compulsive-buying scores were positively related, and (b) both compulsive-buying and bingeeating scores were positively related to television shopping channel exposure. About 10% of the television shoppers in this study were found to have compulsive-buying tendencies. Strategies for coping with unwise compulsive consumption are offered. [source] Variations on the CAGE Alcohol Screening Questionnaire: Strengths and Limitations in VA General Medical PatientsALCOHOLISM, Issue 10 2001Katharine A. Bradley Background: Several variations on the CAGE alcohol screening questionnaire have been recommended. This report evaluates modifications and additions to the CAGE. Methods: Alcohol screening questionnaires were evaluated in male VA general medicine patients (n= 227; mean age, 65.8). Mailed questionnaires included two scoring options for the CAGE (standard and last-year time frames), questions about quantity and frequency of drinking, two questions about episodic heavy drinking, and the question "Have you ever had a drinking problem?" Main analyses compared alcohol screening questions, at various cut-points, to a gold standard of hazardous drinking during the past year (,14 drinks/week or ,5 drinks on an occasion) and/or DSM-III-R alcohol abuse or dependence, based on standardized interviews. Results: The CAGE questionnaire with a past-year time frame was much less sensitive (0.57 vs. 0.77) but more specific (0.82 vs. 0.59) than the standard CAGE for detecting hazardous drinking during the past year and/or DSM-III-R alcohol abuse or dependence. An eight-item questionnaire that included the standard CAGE was most sensitive (0.92) but had low specificity (0.50). A single question about the frequency of drinking ,6 drinks on an occasion, included in the eight-item questionnaire, was both relatively sensitive (0.77) and specific (0.83). Conclusion: The CAGE questionnaire with a past-year time frame was an insensitive alcohol-screening test. An eight-item augmented version of the standard CAGE was the most sensitive. A question about the frequency of drinking ,6 drinks on an occasion performed better than the standard CAGE, which made it the optimal brief screening test for at-risk drinking. [source] Employment Status, Depressive Symptoms, and the Mediating/Moderating Effects of Single Mothers' Coping RepertoirePUBLIC HEALTH NURSING, Issue 6 2007Joan Samuels-Dennis ABSTRACT Objective: Single mothers, especially those on social assistance, report significantly more depressive symptoms than the general public. This article examines the relationships among employment status, stressful life events, and depressive symptoms among single mothers, with a special focus on the potential mediating and moderating roles of coping repertoire. Design: Cross-sectional survey design. Sample: Ninety-six single mothers (48 employed and 48 single mothers on social assistance) who were the primary caregiver for at least 1 child 4,18 years old. Measurements: Mailed questionnaires that included an adapted version of the Social Readjustment Rating Scale, the Coping Strategy Inventory, and the Beck Depression Inventory, 2nd ed. were completed by study participants. Results: Coping repertoire did not mediate the relationship between either employment status or stress exposure and depressive symptoms. Coping had an antagonistic and differential moderating effect on the association between employment status and depressive symptoms for employed single mothers and mothers receiving social assistance. Conclusion: Effective strategies aimed at promoting single mothers' mental health need to address both the severity of depressive symptoms found among single mothers, and the social-system factors that threaten single mothers' psychological well-being. The implications for practice and policy are discussed. [source] Impact of Mandatory Physician Reporting on Accident Risk in EpilepsyEPILEPSIA, Issue 8 2007Richard S McLachlan Summary:,Background: In some jurisdictions, physicians are required by law to report patients with seizures to the department of motor vehicles. We assessed the hypothesis that mandatory reporting reduces the risk of automobile accidents in people with epilepsy. Methods: A retrospective survey of driving and accident rates was done by mailed questionnaire to two groups of subjects with epilepsy in Canada, one living in Ontario where reporting is mandatory and the other in Alberta where it is not. Responses were obtained from a control group without epilepsy for comparison. Results: The epilepsy (n = 425) and control (n = 375) groups were comparable in age and sex. Seventy-three percent of the epilepsy group were or had been licensed drivers compared to 94% of the controls (rr 0.77, 95% CI 0.73,0.83, p < 0.001). Lifetime accident rate of licensed drivers was 58% in epilepsy and 60% in controls (rr 0.99, 95%CI 0.82,1.19, ns) while 9% of the epilepsy group and 9% of the controls had an accident in the previous year (rr 1.00, 95%CI 0.95,1.06, ns). All those with epilepsy in Ontario (n = 202) and Alberta (n = 223), also comparable in age and sex, had equal lifetime accident rates of 45 and 46% (rr 0.99, 95%CI 0.67,1.47, ns) and 1-year rates of 11 and 8% (rr 1.38, 95%CI 0.59,3.27, ns). In Ontario, 20% of drivers were unlicensed compared to 9% in Alberta (rr 2.39, 95%CI 1.17,4.89, p = 0.01) Conclusion: Although it is clearly dangerous for many people with ongoing seizures to drive, the findings provide no support for the hypothesis that mandatory reporting of patients by physicians reduces accident risk and suggest that concerns about the impact of epilepsy on driving compared to other medical and nonmedical risk factors may be excessive. [source] Non-medical palliative care and education to improve end-of-life care at geriatric health services facilities: A nationwide questionnaire survey of chief nursesGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 3 2007Yoshihisa Hirakawa Background: Geriatric health services facilities (GHSF) are expected to assume a growing role in caring for the dying elderly. However, research in this area has so far been scant. The purpose of the present study is to reveal the status of non-medical palliative care and staff education aiming at improving and enhancing end-of-life care at GHSF. Methods: The subjects were 2876 chief nurses of GHSF. Data was collected through a mailed questionnaire in 2003. The questionnaire covered the following: (i) staff perception of end-of-life care policies; (ii) staff education; and (iii) available non-medical care. To evaluate the factors correlated with end-of-life care policies at GHSF, we divided the facilities into two groups. Results: We analyzed the answers collected from 313 facilities with a progressive policy toward end-of-life care (PP group) and 818 with a regressive policy toward it (RP group). It was found that staff training was conducted more frequently among PP facilities. Generally, nurses in the PP facilities were more confident that they could provide comprehensive on-site end-of-life care and grieving support, but did not feel so sure about their ability to provide better end-of-life environments for dying residents and family by organizing outside support from voluntary and/or governmental organizations and religious organization for healing and to pursue appropriately a written follow-up communication with the bereaved family. Conclusions: Our results suggest that providing GHSF staff with education about end-of-life issues or setting up collaboration with the outside is an important factor to enhance overall end-of-life care at these facilities. [source] Evaluation of dietary, medical and lifestyle risk factors for incident kidney cancer in postmenopausal womenINTERNATIONAL JOURNAL OF CANCER, Issue 1 2004Kristin K. Nicodemus Abstract Kidney cancer incidence rates in the United States have been increasing and are not fully accounted for by better diagnostic techniques. Risk factors in women are incompletely described. A total of 34,637 Iowan women initially free of cancer completed a mailed questionnaire in 1986. Kidney cancer incidence was identified over 15 years of follow-up (n = 124) through linkage to a statewide cancer registry. Adjusted for age and other risk factors, kidney cancer was associated positively with maximum adult weight (p for trend = 0.02) and current waist-to-hip ratio (p for trend = 0.002). Compared to nondrinkers, consumers of alcohol of 3.0 or more grams per day had a relative risk (RR) of 0.52 (95% CI = 0.29,0.92). Total vitamin C intake was associated positively with risk of kidney cancer (p for trend = 0.04), whereas total vitamin E intake was associated negatively with risk (p for trend = 0.002). The few women who used copper supplements had a 6.52-fold increase in risk of kidney cancer (95% CI = 1.95,21.8). Compared to never users, women who were former users of estrogen had an increased risk of kidney cancer (RR = 1.62; 95% CI = 1.11,2.36), but current users of estrogen were not at a higher risk. Women who were nulliparous or had more than 2 live births were also at increased risk of kidney cancer compared with women who had 1 or 2 live births. In conclusion, in these postmenopausal women, overweight, particularly central adiposity, was an important risk factor for kidney cancer. Potential risk factors that warrant further exploration were low intake of alcohol and vitamin E, higher intake of vitamin C, nulli- or multiparity and use of copper supplements. © 2003 Wiley-Liss, Inc. [source] Dietary risk factors for upper aerodigestive tract cancersINTERNATIONAL JOURNAL OF CANCER, Issue 2 2002Christine M. Kasum Abstract We examined the association between whole-grain intake and incident upper aerodigestive tract cancer in a cohort of 34,651 postmenopausal, initially cancer-free women. We also studied established risk factors for upper aerodigestive cancers, including fruit and vegetable intake, smoking and alcohol intake. A mailed questionnaire at baseline in 1986 included a food-frequency questionnaire and assessment of other cancer risk factors. During the 14-year follow-up period, 169 women developed cancer of the upper aerodigestive tract. For all upper aerodigestive cancers together, significant inverse associations were observed for the highest compared to the lowest tertile of whole grains [relative risk (RR) = 0.53, 95% confidence interval (CI) 0.34,0.81] and yellow/orange vegetables (RR = 0.58, 95% CI 0.39,0.87). In addition, those in the highest compared to lowest tertile of fiber intake from whole grain were less likely to develop upper aerodigestive tract cancer (RR = 0.56, 95% CI 0.37,0.84); fiber intake from refined grain was not significantly associated with upper aerodigestive tract cancer. Findings were generally similar for oropharyngeal (n = 53), laryngeal (n = 21), nasopharyngeal/salivary (n = 18), esophageal (n = 21) and gastric (n = 56) cancers, though numbers of cases were too small for statistical testing within individual cancers. These findings confirm previous observations that high intake of fruits and vegetables and that intake of whole grains and the fiber derived from them may reduce risk of upper aerodigestive tract cancers. © 2002 Wiley-Liss, Inc. [source] Follow up of surgical repair of female pelvic floor disorders by a mailed questionnaireINTERNATIONAL JOURNAL OF UROLOGY, Issue 4 2006HIDEYASU MATSUYAMA Background:, This study was conducted to determine whether surgical repair of pelvic prolapse enhances patients' quality of life (QOL) in the long term. Methods:, A total of 91 patients (median age, 68.0 years) with pelvic prolapse including cystoceles underwent bladder neck suspension with anterior/posterior colporrhaphy between 1997 and 2003. Postoperative QOL was longitudinally assessed by three disease-specific items (sensation of vaginal bulging, obstructive symptoms, urinary incontinence), and one overall health-related QOL (HR-QOL) item. Results:, A longitudinal study demonstrated that a significant improvement in these symptoms was sustained at a median follow up of 65.5 months, although poor HR-QOL was significantly higher in patients whose age was more than 70 years at surgery (P = 0.0234, Fisher's test). Multivariate analysis revealed update urinary incontinence, update obstructive symptoms, and basic comorbidity to be independent prognostic factors for predicting postoperative moderate-to-poor HR-QOL. Conclusions:, Longer follow up with adequate assessment of patients' QOL may be crucial for the management of postoperative patients, in particular those having basic comorbidity and aged 70 years or more at surgery. [source] Association of boiled and filtered coffee with incidence of first nonfatal myocardial infarction: the SHEEP and the VHEEP studyJOURNAL OF INTERNAL MEDICINE, Issue 6 2003N. Hammar Abstract., Hammar N, Andersson T, Alfredsson L, Reuterwall C, Nilsson T, Hallqvist J, Knutsson A, Ahlbom A (Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Stockholm Center of Public Health, Stockholm, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Västernorrland County Council, Sundsvall, Division of Social Medicine, Karolinska Institutet, Stockholm, Norrland University Hospital, Umeå, Sweden) Association of boiled and filtered coffee with incidence of first nonfatal myocardial infarction: the SHEEP and the VHEEP study. J Intern Med 2003; 253: 653,659. Objectives., To evaluate the influence of consumption of filtered and boiled coffee, on the incidence of first nonfatal myocardial infarction. Design., Population-based case,control study. Setting and subjects., The study base consisted of the population 45,65/70 years-old in two Swedish counties, Stockholm and Västernorrland, 1992/93,94. In all, 1943 cases of first nonfatal myocardial infarction were identified. For each case one control was selected from the study base concurrently with disease incidence by matching the sex, age and place of residence of the case. Information about coffee consumption and other factors was obtained by mailed questionnaire and a medical examination. The participation rate was 85% amongst cases and 74% amongst controls. Results., Men with a reported consumption of 7,9 dL filtered coffee per day showed an increased incidence of first myocardial infarction compared with consumers of 3 dL day,1 or less (RR: 1.32; 95% CI: 1.03,1.70). A consumption of at least 10 dL day,1 was associated with an RR of 1.93 (95% CI: 1.42,2.63) for filtered and 2.20 (95% CI: 1.17,4.15) for boiled coffee. Amongst women, no clear association was seen between consumption of filtered coffee and myocardial infarction but consumption of boiled coffee tended to be related to an increased incidence. Comparing subjects drinking boiled coffee with those drinking filtered coffee and adjusting for the amount consumed gave an increased incidence for boiled coffee amongst both men (RR: 1.41; 95% CI: 1.07,1.80) and women (RR: 1.63; 95% CI: 1.04,2.56). Conclusions., Consumption of boiled coffee appears to increase the incidence of first nonfatal myocardial infarction. This increased incidence is consistent with randomized trials showing an adverse impact of boiled coffee on blood lipids. [source] Natural history of extensive Mongolian spots in mucopolysaccharidosis type II (Hunter syndrome): a survey among 52 Japanese patientsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2007T Ochiai Abstract Background, Recent reports have shown a correlation between extensive Mongolian spots and mucopolysaccharidosis type II (Hunter syndrome). However, a statistical survey of the incidence and natural history of extensive Mongolian spots among the patients with Hunter syndrome is lacking. Objectives, To determine the prevalence of extensive Mongolian spots, to determine the natural course of the spots according to age in Japanese patients with Hunter syndrome, and to compare them with the results obtained from the patients' brothers who did not have Hunter syndrome. Patients/Methods, Fifty-two males with Hunter syndrome aged 3 to 40 years were studied. Twenty-five patients were examined in two clinics to determine the existence and characteristics of the spots. We interviewed their families about the spots in their neonates and the natural course of the spots according to their ages. The same survey was done among another 27 patients using a mailed questionnaire to their families. As control, we investigated 21 brothers of the patients by a mailed questionnaire to their families. Results, The extensive Mongolian spots are identified in almost all the infants with Hunter syndrome and disappear extremely later in their life. The lesions had a high incidence of deep-blue hyperpigmentation. Regardless of age, the overall incidence was 78%. All of the brothers who did not have Hunter syndrome had common-type Mongolian spots in neonates, which regressed during their childhood. Conclusion, Our results confirm a strong correlation between extensive Mongolian spots and Hunter syndrome for the Japanese population. The presence of extensive Mongolian blue spots should alert the physician to the possibility of Hunter syndrome. [source] Allergy and infectious disease histories and the risk of childhood acute lymphoblastic leukaemiaPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2005Paula F. Rosenbaum Summary Infectious disease histories were evaluated in a population-based case-control study of childhood acute lymphoblastic leukaemia (ALL) as it has been hypothesised that delays in early infections are associated with an increased risk of disease. Allergy histories were also assessed as part of a broader evaluation of the role of immune factors in ALL. Cases (n = 255) were diagnosed between 1980 and 1991 at one of four referral centres in a 31-county area of New York State; controls (n = 760) were a random sample of live births from the same region, frequency matched to cases by sex, race and birth year. Data were collected by mailed questionnaire, completed by case and control parents in 1995. Allergy and infectious histories before the age at leukaemia diagnosis for cases and an equivalent age for controls were evaluated. The adjusted odds ratio and 95% confidence interval [CI] associated with a positive history of any allergy was 0.58 [95% CI 0.38, 0.88] compared with a negative allergy history. The occurrence of several common childhood illnesses before 25 months of age and ALL were assessed, with both weak positive and weak inverse associations observed. Overall, these analyses provide little support for the hypothesis that infection delay in early life is associated with an increased risk of ALL. Children with positive allergy histories reported significantly more infections than those with negative histories; however, effect modification of the infection-ALL associations by child allergy history was not observed. Nonetheless, these observations suggest the importance of assessing both allergy and infectious histories and their possible interactions when evaluating the association between these immune factors and childhood ALL. [source] Factors associated with safe patient handling behaviors among critical care nursesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2010Soo-Jeong Lee RN Abstract Background Patient handling is a major risk factor for musculoskeletal (MS) injury among nurses. The aims of the study were to describe nurses' work behaviors related to safe patient handling and identify factors influencing their safe work behaviors, including the use of lifting equipment. Methods A cross-sectional study using a mailed questionnaire with a nationwide random sample of 361 critical care nurses. Nurses reported on the physical, psychosocial, and organizational characteristics of their jobs and on their MS symptoms, risk perception, work behaviors, and demographics. Hierarchical multiple linear regression analyses were used to identify significant factors. Results More than half of participants had no lifting equipment on their unit, and 74% reported that they performed all patient lift or transfer tasks manually. Significant factors for safer work behavior included better safety climate, higher effort,reward imbalance, less overcommitment, greater social support, and day shift work. Physical workload, personal risk perception, or MS symptom experiences were not associated with safe work behavior. Conclusions Safe work behaviors are best understood as socio-cultural phenomena influenced by organizational, psychosocial, and job factors but, counter to extant theories of health behaviors, do not appear to be related to personal risk perception. Management efforts to improve working conditions and enhance safety culture in hospitals could prove to be crucial in promoting nurses' safe work behavior and reducing risk of MS injury. Am. J. Ind. Med. 53:886,897, 2010. © 2010 Wiley-Liss, Inc. [source] Attrition in longitudinal studies: who do you lose?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2006Anne F. Young Objective: To describe the risk factors for various types of attrition in three age cohorts of women in a longitudinal study and to discuss strategies to minimise attrition. Methods: Analysis of survey data from the Australian Longitudinal Study on Women's Health, collected by mailed questionnaire. In 1996, the study recruited and surveyed a national random sample of ,younger' (18,23 years, n=14,247), ,mid-age' (45,50 years, n=13,716), and ,older' women (70,75 years, n=12,432), and began a staggered cycle of mailed follow-up questionnaires: 1998 (mid-age), 1999 (older), 2000 (younger) and so on. Demographic, health and social risk factors for attrition were examined using multivariate analysis. Results: Attrition at survey 2 was highest among younger women (32%), mainly because of participants not being contactable (21%), and lower among the older (16%) and mid-age women (10%). At survey 1, the survey 2 non-respondents were more likely to report having less education, being born in a non-English-speaking country and being a current smoker, in all cohorts, and had poorer health (mid-age and older cohort) and more diffculty managing on their income (younger and mid-age). Conclusion: Although the magnitude of different types of attrition was found to differ by age, there were several risk factors for attrition that remained consistent. These fndings are important to inform future studies on ways to lessen or prevent systematic loss of participants. Implications: Recruitment and follow-up methods in longitudinal studies should be tailored to maximise retention of participants at higher risk of dropout. [source] Donor-site morbidity in buccal mucosa urethroplasty: lower lip or inner cheek?BJU INTERNATIONAL, Issue 4 2005Stefan Kamp Authors from Germany debate the issue as to whether the donor site for oral mucosa used in urethroplasty should be taken from the inner cheek or the lower lip, using morbidity as a deciding factor. As a result of their study they have changed their technique, now using the inner cheek as the donor site whenever possible. OBJECTIVE To evaluate donor-site complications of buccal mucosa urethroplasty and whether there is a difference in morbidity between harvesting the mucosa graft from the inner cheek or the lower lip. PATIENTS AND METHODS Twenty-four consecutive patients with recurrent urethral strictures were treated with buccal mucosa urethroplasty in our department between September 2002 and April 2004. In 12 patients the graft was harvested from the lower lip or cheek and lower lip (group 1), and in 12 patients from the cheek (group 2). The mean (range) age of patients was 51 (26,66) years in group 1 and 53 (32,75) years in group 2. The mean (range) graft length was 6.2 (2,16) cm in group 1 and 5.7 (2,13) cm in group 2. All patients were followed up using a mailed questionnaire that asked about pain, numbness, difficulties in mouth opening or ingestion, and satisfaction, monthly for the first 3 months and then every 6 months. The mean (range) follow-up was 12.5 (6,23) months. RESULTS There were no bleeding complications or disturbances in wound healing. All of the patients reported numbness in the area of the mental and buccal nerves, and graft-site tenderness after surgery. In group 1, the pain lasted for a mean (range) of 5.9 (0.5,22) months, compared to 1 (0.1,7) months in group 2 (P = 0.022). Perioral numbness lasted for a mean (range) of 10.3 (0.5,23) months in group 1 and 0.85 (0.1,3) months (P = 0.0027) in group 2. There were no statistically significant differences in problems with mouth opening or food intake between the two groups, but the patients in group 1 seemed to be less satisfied (6/12 patients satisfied) than those in group 2 (11/12 patients satisfied). CONCLUSIONS Buccal mucosa graft harvesting from the lower lip and the inner cheek are both feasible, but harvesting from the lower lip resulted in a significantly greater long-term morbidity, which resulted in a lower proportion of satisfied patients. This seems to be due to a long-lasting neuropathy of the mental nerve. We therefore have changed our technique entirely from lower lip to inner cheek graft harvesting, whenever possible. [source] An unrandomized prospective comparison of urinary continence, bowel symptoms and the need for further procedures in patients with and with no adjuvant radiation after radical prostatectomyBJU INTERNATIONAL, Issue 4 2003T. Hofmann OBJECTIVE To prospectively assess, using a questionnaire-based study, the relative differences and changes in urinary continence and bowel symptoms, and the need for further surgery, within the first year after radical retropubic prostatectomy (RRP) in patients with and with no adjuvant radiotherapy (aRT). PATIENTS AND METHODS The study included 96 men with clinically organ-confined adenocarcinoma of the prostate who underwent RRP between March 1998 and June 1999. A subset of 36 patients was recommended aRT of the prostatic fossa (median dose 54 Gy) because of positive surgical margins and/or seminal vesicle involvement. Using a mailed questionnaire all patients were prospectively assessed at 4-month intervals for the first year after RRP. RESULTS Valid data were analysed from 83 patients (overall response rate 86%), of whom 30 (36%) had received aRT. At 4 months a significantly lower proportion used no pads and significantly more used 1 pad/day in the aRT than in the RRP group (both P < 0.05). Eight and 12 months after RRP there was no statistically significant difference between the groups in urinary incontinence. However, 53% of men in the aRT group had stool urgency and 13% reported fecal incontinence at 4 months, compared with 1.9% and none (both P < 0.01) of the RRP group. At 1 year after RRP bowel symptoms and fecal continence improved in the aRT group and there was no significant difference for these symptoms between the groups. Starting aRT early (, 12 weeks after RP) or late (> 12 weeks) had no significant effect on urinary continence, bowel symptoms and fecal incontinence. Apart from dilatation of urethral strictures in one patient in each group, no further procedures were reported during the follow-up. CONCLUSION A moderate dose of aRT after RRP had a temporary effect on subjective urinary continence at 4 months but not at 8 and 12 months. More patients receiving aRT reported significant bowel symptoms at 4 and 8 months than those with RRP only, but at 1 year most of these symptoms had resolved and there were no significant differences between the groups. [source] What is chronic headache in the general population?ACTA NEUROLOGICA SCANDINAVICA, Issue 2009The Akershus study of chronic headache Background ,, Studies of chronic headache including both primary and secondary causes from the general population is lacking. Aims ,, To provide prevalence data on chronic headache. Materials & Methods ,, We studied chronic headaches defined as headache 15 days per month on average for at least 3 months in the general population. An age and gender stratified random sample of 30,000 persons aged 30,44 years received a mailed questionnaire. Those with self-reported headache on 15 days or more within the last month and/or headache on more than 180 days within the last year were invited to an interview and examination by a neurological resident. The criteria of the International Classification of Headache Disorders were applied. Results ,, Chronic headache occurred in 3.71% of the general population.Women had chronic headache twice as often as men. About half of those with chronic headache also had medication overuse, irrespectively of the types of chronic headache. Secondary chronic headaches attributed to chronic rhinosinusitis, head injury, whiplash injury and cervicogenic headache were relatively frequent, i.e. from 1 of 300 to 1 of 600 persons from the general population. Discussion ,, Primary and secondary chronics headaches should not be ignored. Conclusion ,, Primary and secondary chronic headaches are common in the general population. [source] Allergy, family history of autoimmune diseases, and the risk of multiple sclerosisACTA NEUROLOGICA SCANDINAVICA, Issue 1 2008A. Alonso Objective , Previous reports suggested an association between allergy, autoimmunity, and risk of multiple sclerosis (MS), but results have been inconsistent. The present study assessed the association between history of allergy and autoimmune diseases, and the risk of MS. Methods , We conducted a case,control study nested in the Nurses' Health Study (NHS) and NHS II cohorts. A total of 298 women with MS were matched with 1248 healthy controls and 248 women with history of breast cancer. A mailed questionnaire gathered information about history of allergic conditions and autoimmune disorders. Results , History of allergy was not associated with MS risk [odds ratio (OR) 1.0, 95% confidence interval (CI) 0.8,1.4]. As expected, cases were more likely to have a positive family history of MS than controls (OR 9.7, 95% CI 6.1,15.3). A modest association was found between family history of other autoimmune diseases and MS risk (OR 1.4, 95% CI 1.0,1.8). We obtained similar results when we used women with breast cancer as comparison group. Conclusion , Family history of other autoimmune diseases was associated with a higher MS risk, suggesting a common genetic background or shared environmental triggers. There was no clear association between personal history of allergy and risk of MS. [source] Parenting Stress in Mothers of Children With Autism Spectrum DisordersJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 3 2009Supapak Phetrasuwan PURPOSE., The purpose of this paper is to describe the sources of parenting stress in mothers of children with Autism Spectrum Disorders (ASD) and examine the relationship between parenting stress and maternal psychological status (depression and well-being). DESIGN AND METHODS., A descriptive correlational design was used. Data were collected via mailed questionnaires. RESULTS., Behavioral symptoms were the primary source of parenting stress for mothers. There was no relationship between child characteristics and parenting stress. Mothers reporting more parenting stress had more depressive symptoms and lower levels of well-being. PRACTICE IMPLICATIONS., Our findings have implications for interventions with mothers to help them manage their children's behavior and focus on stress reduction and well-being. [source] Identifying predictors of breastfeeding self-efficacy in the immediate postpartum period,RESEARCH IN NURSING & HEALTH, Issue 4 2006Cindy-Lee E. Dennis Abstract Researchers have found evidence that breastfeeding self-efficacy is an important variable that significantly influences initiation and duration rates. The purpose of this study was to develop a multi-factorial predictive model of breastfeeding self-efficacy in the first week postpartum. As part of a longitudinal study, a population-based sample of 522 breastfeeding mothers in a health region near Vancouver, British Columbia completed mailed questionnaires at 1-week postpartum. Bivariate correlations were used to select variables for the multiple regression analysis. The best-fit regression model revealed eight variables that explained 54% of the variance in Breastfeeding Self Efficacy Scale (BSES) scores at 1-week postpartum: maternal education, support from other women with children, type of delivery, satisfaction with labor pain relief, satisfaction with postpartum care, perceptions of breastfeeding progress, infant feeding method as planned, and maternal anxiety. The BSES may be used to identify risk factors, enabling health professionals to improve quality of care for new breastfeeding mothers. © 2006 Wiley Periodicals, Inc. Res Nurs Health 29: 256,268, 2006 [source] Short-term impact of a robot-assisted laparoscopic prostatectomy ,mini-residency' experience on postgraduate urologists' practice patterns,THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 1 2006Elspeth M. McDougall Introduction To assist practising urologists acquire and incorporate robot-assisted laparoscopic prostatectomy (RALP) into their practice, a 5 day mini-residency (M-R) programme with a mentor, preceptor and potential proctor experience was established at the University of California, Irvine, Yamanouchi Center for Urological Education. The follow-up results from the initial 21 RALP M-R participants are presented. Methods Between September 2003 and September 2004, 21 urologists from six states and four countries underwent a RALP M-R. Each participant underwent 1:2 teacher:attendee instruction over a 5 day period, which included inanimate model skills training, animal/cadaver laboratory skills training and operating room observation experience. Participants were also offered a proctoring experience at their hospital if they so desired. A questionnaire survey was mailed 1,14 months (mean 7.2 months) following completion of the mini-residency and these results were tabulated and reviewed. Results A 100% response rate was achieved from the mailed questionnaires. The mean M-R participant age was 43 years (range 33,55 years). One-third of the M-R participants were practising in an academic environment. Most of the participants (55%) had no fellowship training. Of those with fellowship training (45%), three (15%) were in laparoscopy and three (15%) were in oncology; 25% of the participants were in large (>6 physicians), 25% in small (2,6 physicians) and 15% in solo practices; 70% of the participants were located in an urban setting. The majority of the participants (80%) had laparoscopic experience during residency training and had performed 20,60 laparoscopic cases prior to attending the M-R programme. Within 7.2 months after M-R (range 1,14 months), 95% of the participants were practising robot-assisted laparoscopic prostatectomy and 25% of the RALP M-R participants had also performed robotic-assisted laparoscopic pyeloplasty. Of the M-R participants, 38% availed themselves of the preceptor/proctor component of the programme; among these, 100% reported that they were performing RALP vs. only 92% of the MR participants who did not have a proctor experience. The 5 day length of the M-R was considered to be of satisfactory duration by 90% of the participants, while 1 participant considered it too brief and 1 considered it too long. All but one of the participants rated the M-R as a very or extremely valuable experience. All the M-R participants indicated that they would recommend this training programme to a colleague. Conclusions A 5 day intensive RALP M-R course seems to encourage postgraduate urologists, already familiar with laparoscopy, to successfully Copyright © 2006 John Wiley & Sons, Ltd. [source] Women's choice between sentinel lymph node biopsy and axillary clearanceANZ JOURNAL OF SURGERY, Issue 2 2002Steven Gan Purpose: To determine whether women would choose sentinel lymph node biopsy (SLNB) or axillary clearance (AC) for breast cancer treatment when they are given a single choice based on clear information about morbidity and mortality. Methods: The expected 5-year survival rate of women with breast cancer after either SLNB or AC was calculated using a utility analysis of established literature. The difference in survival was one in 1000. This and other detailed information on SLNB and AC was presented in a questionnaire, which provided subjects with a scenario and a choice between SLNB and AC. After a pilot study of 40 subjects, the questionnaire was mailed to 400 women (who had no mammographic abnormality) attending Breast Screen and handed to 100 women (who were over 40 years of age and had breast symptoms but not cancer) attending the rooms of two surgical specialists. Results: One hundred and twenty one of the 243 respondents to the mailed questionnaires (49.8%) chose SLNB and 35% of the 100 consulting room subjects chose SLNB rather than AC. Conclusions: Women faced with the possibility of having breast cancer seem to be very conservative in their choice of treatment, many choosing the increased morbidity of AC rather than the very small (one in 1000) increased risk of death at 5 years from SLNB. This raises questions about proposals to offer SLNB as standard treatment and demands that women are fully informed about any increased risk of death when making their choice between SLNB and AC. Abbreviations: AC, axillary clearance; SLNB, sentinel lymph node biopsy. [source] Thymus size and head circumference at birth and the development of allergic diseasesCLINICAL & EXPERIMENTAL ALLERGY, Issue 12 2001C. S. Benn Background The positive association between a large head circumference at birth and total serum IgE levels has been suggested to be due to negative associations between head circumference at birth and thymus development and between thymus development and total serum IgE levels. Objectives To examine the associations between head circumference and thymus size at birth and the development of allergic disease. Methods The size of the thymus was assessed by sonography during the first week of life in 149 healthy term infants. Information on birth characteristics and mode of delivery was collected at delivery. The presence of allergic disease was assessed 5 years later by mailed questionnaires, which were returned by 85% of the eligible families. Results At birth, head circumference was positively associated with thymus size (P < 0.001). In all, 27 (23%) of the children had developed at least one allergic disease. Multivariate analysis revealed that both parental allergy (Prevalence Ratio and 95% CI) = 3.18 (1.49,6.78)) and caesarean delivery (2.62 (1.48,4.64)) were independently correlated with allergic disease, whereas thymus size was not. Conclusions Our study does not support that a large head circumference is associated with a small thymus size, nor that a small thymus size is associated with allergic disease. Whether thymus size at birth is related to total serum IgE levels still remains to be elucidated. [source] Prevalence of recurrent complaints of pain among Greek schoolchildren and associated factors: A population-based studyACTA PAEDIATRICA, Issue 8 2006Chryssa Bakoula Abstract Aim: To determine the prevalence of recurrent complaints of pain (RCP) in Greek children, and to examine associations with socio-demographic characteristics and psychosocial factors. Methods: Cross-sectional study comprising a nationally representative population of 8130 7-y-old Greek schoolchildren. Data were collected by mailed questionnaires (response rate 89%). RCP was defined as present if at least one of the complaints of headache, abdominal pain or limb pain occurred at least once a week. Results: The RCP prevalence rate was 7.2%, with significant gender differences (8.8% of girls, 5.7% of boys; p<0.001). RCP was significantly positively associated with a chronic health problem among the children, frequent change of residence, poor school performance, often watching TV and rarely playing with other children. There were no statistically significant associations of RCP with family structure and socio-economic status. Conclusion: The results are indicative of the prevalence of RCP in Greek schoolchildren. This study enlightens the psychosocial component of RCP and emphasizes the importance of gathering information on children's social background in medical settings. [source] Factor structure of a conceptual model of oral health tested among 65-year olds in Norway and SwedenCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 2 2010Anne Nordrehaug Åstrøm Åstrøm AN, Ekbäck G, Ordell S. Factor structure of a conceptual model of oral health tested among 65-year olds in Norway and Sweden. Community Dent Oral Epidemiol 2010. © 2010 John Wiley & Sons A/S Abstract,,, Background:, No studies have tested oral health-related quality of life models in dentate older adults across different populations. Objectives:, To test the factor structure of oral health outcomes within Gilbert's conceptual model among 65-year olds in Sweden and Norway. It was hypothesized that responses to 14 observed indicators could be explained by three correlated factors, symptom status, functional limitations and oral disadvantages, that each observed oral health indicator would associate more strongly with the factor it is supposed to measure than with competing factors and that the proposed 3-factor structure would possess satisfactory cross-national stability with 65-year olds in Norway and Sweden. Methods:, In 2007, 6078 Swedish- and 4062 Norwegian adults borne in 1942 completed mailed questionnaires including oral symptoms, functional limitations and the eight item Oral Impacts on Daily Performances inventory. Results:, Model generation analysis was restricted to the Norwegian study group and the model achieved was tested without modifications in Swedish 65-year olds. A modified 3-factor solution with cross-loadings, improved the fit to the data compared with a 2-factor- and the initially proposed 3-factor model among the Norwegian [comparative fit index (CFI) = 0.97] and Swedish (CFI = 0.98) participants. All factor loadings for the modified 3-factor model were in the expected direction and were statistically significant at CR > 1. Multiple group confirmatory factor analyses, with Norwegian and Swedish data simultaneously revealed acceptable fit for the unconstrained model (CFI = 0.97), whereas unconstrained and constrained models were statistically significant different in nested model comparison. Conclusions:, Within construct validity of Gilbert's model was supported with Norwegian and Swedish 65-year olds, indicating that the 14-item questionnaire reflected three constructs; symptom status, functional limitation and oral disadvantage. Measurement invariance was confirmed at the level of factor structure, suggesting that the 3-factor model is comparable to some extent across 65-year olds in Norway and Sweden. [source] | |||||||||||||||||||||||||