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Postal Questionnaire (postal + questionnaire)
Terms modified by Postal Questionnaire Selected AbstractsPaediatric training for family doctors: principals and practiceMEDICAL EDUCATION, Issue 5 2002C Melville Background There is controversy as to how best to train general practitioners for the paediatric challenges they will meet in practice, in particular what should be included in training, what should be left out and how long should it last? Subjects and methods All 615 general practice principals referring to 6 hospitals were surveyed (40% response rate). Setting West Midlands region of England. Study design Postal questionnaire. Statistics Quantitative and qualitative assessment of responses. Quantitative responses were analysed by hospital, decade of qualification, and duration of paediatric training. Qualitative responses were analysed using grounded theory. Results Satisfaction with training was directly related to its duration, with low levels of satisfaction for less than 6 months paediatrics, moderate levels for 6,11 months, and high levels with 12 months or more. The most important item of training was recognition of the sick child. Acute and chronic paediatrics was generally well covered. Psychosocial aspects, public health and immunisation were poorly addressed. Neonatal resuscitation and first day checks were seen as relevant, but neonatal intensive care was not. Conclusions At least 6 months of paediatrics is necessary for GPs in training, but longer paediatric exposure further increases their satisfaction with training. GPs have a biopsychosocial rather than biomedical approach to their child patients, suggesting potential benefits from a greater emphasis on psychosocial and public health aspects at the expense of neonatal intensive care. Recognition of the sick child is essential, and acute and chronic organic illness should be covered in breadth. Possible future models for GP training in paediatrics are discussed. [source] Long-term follow up of uterine artery embolisation,an effective alternative in the treatment of fibroidsBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2006WJ Walker Objectives, To evaluate the long-term efficacy and complications of uterine artery embolisation (UAE) for treatment of symptomatic uterine fibroids. Design, A prospective observational study. Setting, A district general hospital and two private hospitals in the southeast of England. Population, Women with symptomatic fibroids who had been offered surgical options for treatment. Methods, Postal questionnaire follow up at 5,7 years to assess long-term clinical effects among women who had undergone UAE. Main outcome measures, The questionnaire was subdivided into sections dealing with menstrual flow, amenorrhoea and menopause, fibroid-related symptoms, fertility, vaginal discharge, sexual function, subsequent treatments for fibroids and satisfaction with the procedure. Results, A total of 258 women were identified as being between 5 and 7 years post-UAE and suitable for long-term follow up in October 2004. One hundred seventy-two completed questionnaires were analysed (67% response rate). Seventy-five percent of women still had either a return to normal or an improvement in menstrual flow compared with how they were prior to UAE. More than 80% of fibroid-related symptoms were still resolved or improved. Sixteen percent of women required further treatment for fibroids. Premature menopause directly following UAE occurred in only one woman in the study group. Eighty-eight percent of women were satisfied with the outcome of the procedure at 5,7 years and would choose it again or recommend it to others. Conclusions, These findings show that UAE is of benefit to women wishing to avoid hysterectomy and it carries a low risk of complications. [source] Women's perceived experiences of abuse in the health care system: their relationship to childhood abuseBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 12 2004Katarina Swahnberg Objectives The aim of this study was to determine whether there was an association between any lifetime experiences of emotional, physical and/or sexual abuse and perceived abuse in the health care system. Furthermore, we wanted to ascertain if adult victims of perceived abuse in the health care system reported exposure to childhood emotional, physical and/or sexual abuse more often than non-victims did. Design A cross sectional questionnaire study. The first hypothesis was tested in the total sample, and the second hypothesis in a case,control analysis. The cases were those women who reported perceived experiences of abuse in the health care system as adults. Exposure was defined as experience of emotional, physical and/or sexual abuse in childhood. Settings Three Swedish gynaecological clinics. Sample A total of 2439 gynaecology patients (response rate 81%). Methods Postal questionnaire. Main outcome measure Associations between experiences of emotional, physical and/or sexual abuse, and perceived abuse in the health care system; all operationalised in The NorVold Abuse Questionnaire (NorAQ). Results A general association was found between lifetime experiences of emotional, physical and/or sexual abuse and perceived abuse in the health care system. Adult victims of abuse in the health care system reported experiences of emotional, physical and/or sexual abuse in childhood more often than non-victims did. These findings also held after adjustment for age and educational level. Conclusions We found associations between experiences of any lifetime abuse and perceived abuse in the health care system. Adult victimisation in the health care system was associated with childhood exposure to emotional, physical and/or sexual abuse. These associations call for attention and need to be further investigated. [source] Acute Pain Teams in England: current provision and their role in postoperative pain managementJOURNAL OF CLINICAL NURSING, Issue 3 2003Ann Mcdonnell BSc Summary ,,This survey describes the current provision of multidisciplinary Acute Pain Teams (APTs) in acute English hospitals performing adult in-patient surgery (excluding maternity). Associations between the presence of an APT and a number of organizational and clinical initiatives for the management of postoperative pain are also explored. ,,Postal questionnaires were sent to the Clinical Director of Anaesthetics or head of the APT at every acute English hospital providing separate anaesthetic services. ,,After written and telephone reminders, the response rate was 86% (n = 226). ,,Eighty-four per cent (n = 190) of respondents had an APT in their hospital. The presence of an APT was associated (P,0.05) with higher estimates of patient controlled analgesia and epidural use, regular in-service training for nurses and junior doctors, written guidelines/protocols for management of postoperative pain, routine use of postoperative pain measurement systems and audit/research in relation to postoperative pain issues. ,,Acute Pain Teams, in which nurses play a major role, have a pivotal influence not only in relation to postoperative analgesia but also in wider service development. Since 1995, the number of hospitals offering in-patient surgery that are covered by an APT has risen. However, despite repeated endorsements from professional bodies, some acute hospitals still have no APT and recent evidence indicates that some APTs face financial problems and provide a ,token' service only. Recent policy recommendations may have little impact on the current situation. [source] Epidemic of Cesarean Section at the General, Private and University Hospitals in ThailandJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2000Dr. Boonsri Chanrachakul Abstract Objective: To undertake a survey of cesarean section in the general, private and university hospitals in Thailand. Methods: Postal questionnaires were sent to all the general, private and university hospitals with 200 beds or more. The questionnaires were prepared to find out the percentage, the indications and the trend of cesarean delivery, the measures taken to decrease cesarean section rate, and the practice of external cephalic version (ECV) and vaginal birth after cesarean section (VBAC) in the hospitals. Results: The overall response rate was 88%. Mean cesarean section rates were 24, 48, and 22% in the general, private and university hospitals, respectively. Cesarean section rates in most of the hospitals were increased in the past 5 years namely 78% in the general hospitals, 50% in the private hospitals, 66% in the university hospitals. However, only 38% of the hospitals had measures to regulate this operation. Repeated cesarean section was the most common indication in the private (63%) and the university hospitals (88%) while failure to progress was the most common indication in the general hospitals (55%). ECV and VBAC were performed in 26 and 12% of the hospitals. They were, however, not the standard practices. Conclusion: Rising of cesarean section rate without any measure to regulate it is the problem in the developing countries. Standardised labor management and reduction of unnecessary primary cesarean section will automatically reduce repeated operation and overall cesarean section. [source] Doctors' views about their first postgraduate year in UK medical practice: house officers in 2003MEDICAL EDUCATION, Issue 11 2006Trevor W Lambert Aim, To report house officers' views in 2003 of their first postgraduate year, and to compare their responses with those of house officers 2 and 3 years previously. Methods, Postal questionnaires to all house officers in 2003 who graduated from UK medical schools in 2002. Results, The response rate was 65.3% (2778/4257). The house officers of 2003 enjoyed the year more than those of 2000,1. A total of 78% of respondents in 2003 scored 7,10 in reply to the question ,How much have you enjoyed the house officer year overall?', scored from 0 (no enjoyment) to 10 (enjoyed it greatly), compared with 70% of 2000,1 house officers. They were more satisfied with leisure time available to them (51% scoring 6,10 in 2003; 35% in 2000,1). There were significant improvements in almost every aspect of doctors' experience. Hospital medical posts were rated more highly than surgical posts, and general practice posts higher still. Overall, 38% of respondents regarded their training as having been of a high standard, and 37% felt that they received constructive feedback on their performance. Differences between men and women in their views about their jobs were small. Discussion, The house officers of 2003 reported more positively on their experiences than did those of 2000,1. Although a substantial percentage were negative about specific aspects of clinical support and training, particularly in surgical posts, almost all the responses covering training and clinical support moved in a favourable direction over time. [source] The impact of formal education and training on urodynamic practice in the United Kingdom: A surveyNEUROUROLOGY AND URODYNAMICS, Issue 5 2006Julie Ellis-Jones Abstract Aim A previous survey of personnel performing urodynamics had shown that half of the respondents thought that their training had been inadequate. In order to address this the outcome of a 4-day practical course for teaching urodynamics, which has been running since 1995 at the Bristol Urological Institute, was reviewed. We were not aware of any published studies that have assessed the impact of formal urodynamic training on clinical practice. With this in mind we set out to determine whether the education and training we had given had changed urodynamic practice in the UK. Methods Postal questionnaires were sent out to 84 delegates who had attended the course over a 2-year period (2001,2003). Paired questionnaires were used to assess urodynamic practice before and after the course and also to establish whether their practice had changed as a direct result of attending the certificate course. Results The results suggested that 79% of those responders had changed their practice since completing the course. Significant changes to practice were observed in checking calibration, confidence in setting-up equipment, interpretation of urodynamic traces and ability to check the accuracy of the results. Conclusions The results of this survey suggest that attendance at a recognised urodynamic training course has had an impact on clinical practice in the UK. Training and education raises the level of confidence and ability to perform and interpret urodynamic investigations, which has wide implications for the accuracy, reliability and consistency of urodynamic investigations performed by those without formal training. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source] Relationship between menopausal symptoms and menopausal status in Australian and Japanese women: Preliminary analysisNURSING & HEALTH SCIENCES, Issue 3 2004Debra Anderson phd Abstract The main aim of the present study was to explore the midlife experience for women living in Australia and Japan. The specific objectives of the study included: (i) comparing menopausal symptoms between the two groups; and (ii) comparing the factor structure of symptoms and exploring their relationship to menopausal status. Postal questionnaires were distributed to two structured, random population based samples of midlife women aged 45,60 years; consisting of 712 women living in Australia and 1502 women living in Japan. Analysis showed significant differences in menopausal symptoms related to psychological symptoms (P < 0.001), including anxiety (P < 0.001) and depression (P < 0.001), somatic symptoms (P < 0.001), and vasomotor symptoms (P < 0.01). The analysis, which excluded hormone replacement therapy (HRT) users, found that there were significant differences seen across menopausal status in the following symptoms: difficulty in sleeping (P < 0.01), difficulty in concentrating (P < 0.01), feeling dizzy or faint (P < 0.001), loss of interest in most things (P < 0.01) and loss of feeling in hands or feet (P < 0.001). In the postmenopausal stage specifically, significant differences were seen in the areas of feeling tense or nervous (P < 0.01), feeling unhappy or depressed (P < 0.01), parts of body feeling numb or tingling (P < 0.05), headaches (P < 0.01), and sweating at night (P < 0.05). Our analysis revealed that the experience of menopause for women is different between Australian and Japanese women. [source] ORIGINAL RESEARCH,EPIDEMIOLOGY: Male Erectile Dysfunction: Its Prevalence in Western Australia and Associated Sociodemographic FactorsTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2008FRCPEdin, FRCPGlasg, Kew-Kim Chew MBBS ABSTRACT Introduction., This is a report of a population-based cross-sectional observational study in Western Australia (WA) on male erectile dysfunction (ED). Aim., To assess the prevalence of ED in WA and to examine its associated sociodemographic factors. Method., Postal questionnaires were sent to randomly selected age-stratified male population samples obtained from the WA Electoral Roll. Main Outcome Measures., In addition to items covering sociodemographic and clinical information, the Australian Standard Classification of Occupations (ASCO), the Socioeconomic Index for Area (SEIFA), and the 5-item International Index of Erectile Function (IIEF-5) were used. Results., One thousand seven hundred seventy (41.9%) of 4,228 questionnaires were returned. One thousand five hundred eighty (89.3%) were completed questionnaires from men aged 20.1 to 99.6 years (mean 57.9, median 59.1, standard deviation 18.5). The prevalences of any ED and of severe ED among adult males in WA, adjusted for age distribution, were 25.1 and 8.5%, respectively. Standardized to World Health Organization (WHO) World Standard Population, the corresponding prevalences were 23.4 and 7.4%. Prevalence, as well as severity, of ED increased with age. Thirty-eight percent of the participants who were married or had partners experienced ED (severe ED 19.1%). The prevalence of ED was not significantly different between "white-collar" and "blue-collar" workers. Despite the great majority of the affected participants having experienced ED for >1 year, only 14.1% reported having ever received any treatment for ED. Conclusions., The study has provided population-based epidemiological data on ED in Western Australian men covering a wide range of ages. The finding that ED is age related, highly prevalent, and grossly underdiagnosed and undertreated is pertinent to global population aging and a rapidly aging Australian population. To facilitate comparisons across populations with different age distributions, all future population-based studies on ED should be standardized to WHO World Standard Population. Chew K-K, Stuckey B, Bremner A, Earle C, and Jamrozik K. Male Erectile Dysfunction: Its Prevalence in Western Australia and Associated Sociodemographic Factors. J Sex Med 2008;5:60,69. [source] Smoking pattern during pregnancy in Hong Kong ChineseAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2008Grace W. S. KONG Background: While the prevalence of young female smokers is rising among the Hong Kong Chinese population, data on their smoking pattern during pregnancy are limited. Aims: To investigate the smoking habit of Hong Kong Chinese women and their partners during pregnancy. Methods: Postal questionnaires were sent to 479 couples to explore their smoking patterns during pregnancy at one to two years after the index delivery. Results: Questionnaires were completed by 247 subjects. Among 117 women who were ever-smokers, 26% had stopped smoking before the index pregnancy, while 60% stopped and 14% reduced smoking during the pregnancy. Most women stopped smoking in the first trimester (93%) and prior to the first antenatal visit (79%). Those who used to smoke fewer cigarettes before pregnancy were more likely to stop smoking during pregnancy but women with a history of recreational drug use were more likely to continue smoking during pregnancy. The post-partum smoking relapse rate was 59% in women who had stopped smoking before or during their pregnancy. Only 2.6% of the partners who were ever-smokers stopped smoking before the pregnancy while smoking habits remained unchanged in 52%. Conclusions: Approximately one-fifth of an unselected sample of Hong Kong mothers had a history of smoking prior to pregnancy. Pregnancy is an opportune time to implement smoking intervention programs for female smokers and their partners with an emphasis on the maintenance of post-partum smoking abstinence. [source] Most very low birth weight subjects do well as adultsACTA PAEDIATRICA, Issue 9 2009P-O Gäddlin Abstract Aim:, To study health, quality of life, educational level and occupation in very low birth weight (VLBW) children in early adulthood and the relationship of the findings to neonatal risk factors and later handicap. Methods:, This is a prospective long-term follow-up study of a regional cohort of 20-year-old VLBW subjects (n = 77) of all surviving VLBW children (n = 86) and 69/86 term controls born in 1987,1988 in the south-east of Sweden. Postal questionnaires were used: 1. A study-specific form, 2. Medical Outcomes Study, Short Form (SF-36), 3. Sense of Coherence. Results:, VLBW subjects did not differ significantly from their controls in self-perceived health, use of tobacco, education, occupation and way of living, or scoring on SF-36 and Sense of Coherence. Sixteen had cerebral palsy, attention deficit hyperactivity disorder or isolated mental retardation, and these subjects differed significantly from controls on SF-36 in physical functioning and physical health score, but not on Sense of Coherence. VLBW subjects were significantly lighter and shorter than their controls. Extremely low birth weight (ELBW), bronchopulmonary dysplasia and intraventricular haemorrhage were significantly associated with poorer scores on physical function. Conclusion:, The 20-year old VLBW subjects reported perceived health and managed transition to adulthood similar to controls. Handicapped subjects had poorer self-perceived physical function. ELBW and severe neonatal complications were associated with poorer self-perceived physical health. [source] Virtual colonoscopy vs conventional colonoscopy in patients at high risk of colorectal cancer , a prospective trial of 150 patientsCOLORECTAL DISEASE, Issue 2 2009T. J. White Abstract Objective, Virtual colonoscopy (VC)/CT colonography has advantages over the well-documented limitations of colonoscopy/barium enema. This prospective blinded investigative comparison trial aimed to evaluate the ability of VC to assess the large bowel, compared to conventional colonoscopy (CC), in patients at high risk of colorectal cancer (CRC). Method, We studied 150 patients (73 males, mean age 60.9 years) at high risk of CRC. Following bowel preparation, VC was undertaken using colonic insufflation and 2D-spiral CT acquisition. Two radiologists reported the images and a consensual agreement reached. Direct comparison was made with CC (performed later the same day). Interobserver agreement was calculated using the Kappa method. Postal questionnaires sought patient preference. Results, Virtual colonoscopy visualized the caecum in all cases. Five (3.33%) VCs were classified as inadequate owing to poor distension/faecal residue. CC completion rate was 86%. Ultimately, 44 patients had normal findings, 44 had diverticular disease, 11 had inflammatory bowel disease, 18 had cancers, and 33 patients had 42 polyps. VC identified 19 cancers , a sensitivity and specificity of 100% and 99.2% respectively. For detecting polyps > 10 mm, VC had a sensitivity and specificity (per patient) of 91% and 99.2% respectively. VC identified four polyps proximal to stenosing carcinomas and extracolonic malignancies in nine patients (6%). No procedural complications occurred with either investigation. A Kappa score achieved for interobserver agreement was 0.777. Conclusion, Virtual colonoscopy is an effective and safe method for evaluating the bowel and was the investigation of choice amongst patients surveyed. VC provided information additional to CC on both proximal and extracolonic pathology. VC may become the diagnostic procedure of choice for symptomatic patients at high risk of CRC, with CC being reserved for therapeutic intervention, or where a tissue diagnosis is required. [source] Fragrance contact allergic patients: strategies for use of cosmetic products and perceived impact on life situationCONTACT DERMATITIS, Issue 6 2009Susan Hovmand Lysdal Background: Fragrance ingredients are a common cause of contact allergy. Very little is known about these patients' strategies to manage their disease and the effect on their daily lives. Objectives: To investigate if patients with diagnosed fragrance contact allergy used scented products, how they identified tolerated products, and if fragrance allergy affected their daily living. Method: One hundred and forty-seven patients diagnosed with fragrance contact allergy in a 20-month period were included and received a postal questionnaire concerning the subjects of the study. One hundred and seventeen (79.6%) replied. Results: In total, 53/117 (45.3%) responded that they had found some scented products that they could tolerate. Thirty-seven (31.6%) had not tried to find any scented products and 26 (22%) had tried but could not find any. The methods most often used were trying different products and reading the ingredient label. Of the total respondents, 17.1% reported sick-leave due to fragrance allergy and 45.3% found that fragrance allergy significantly affected their daily living. Conclusion: Many patients with fragrance contact allergy succeeded in finding some scented products, which they could tolerate, e.g. by use of ingredient labelling, but a significant proportion had continued skin problems. Almost half of the patients perceived that fragrance allergy significantly affected their daily lives. [source] The current opinions and use of MTA for apical barrier formation of non-vital immature permanent incisors by consultants in paediatric dentistry in the UKDENTAL TRAUMATOLOGY, Issue 1 2008Gillian Catherine Mooney A semi-structured postal questionnaire was sent to all known consultants in paediatric dentistry in the UK. The response rate was 78.6% (44 of 56). Thity-eight consultants (86.3%) agreed that the use of this material was a good idea with 68.2% having used or arranged for its use in apical barrier formation. Forty-two consultants (95.5%) agreed that reduced number of visits was an advantage to the technique, with only 34.1% agreeing that this procedure was less likely to weaken the tooth and 63.6% agreed that material and equipment costs were a drawback and 50% agreed that lack of available evidence was a disadvantage to its use. The results from this study give an indication of the extent of MTA use by consultant-led services in paediatric dentistry in the UK and highlights the need for a multi-centre randomised controlled clinical trial. [source] Detecting language problems: accuracy of five language screening instruments in preschool childrenDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2007H M E Van Agt MA To identify a simple and effective screening instrument for language delays in 3-year-old children the reliability, validity, and accuracy of five screening instruments were examined. A postal questionnaire sent to parents of 11423 children included the Dutch version of the General Language Screen (GLS), the Van Wiechen (VW) items, the Language Screening Instrument for 3- to 4-year-olds, consisting of a parent form (LSI-PF) and a child test (LSI-CT), and parents' own judgement of their child's language development on a visual analogue scale (VAS). The response rate was 78% or 8877 children. Reliability (internal consistency) was found to be acceptable (,=0.67,0.72) for all instruments. Significant correlations between the screening instruments (r=0.29,0.55, p<0.01) indicated good concurrent validity. Accuracy was estimated by the sensitivity, specificity, and receiver operating characteristic (ROC) curves against two reference tests based on parent report and specialists' judgement. If the test would classify approximately 5% of the population as screen-positive, the mean sensitivity was 50%; assigning between 20% and 30% of the population as screen-positive, the mean sensitivity was 77%. The sensitivity was lowest for the LSI-CT (range 43,62%), whereas short instruments like the LSI-PF, VW, and the one-item VAS exhibited high levels of sensitivity (range 50,86%). The area under the ROC curves, ranged from 0.75 to 0.87. Apparently, short and simple parent report instruments like the LSI-PF and the one-item VAS perform remarkably well in detecting language delays in preschool children. [source] Characterization and comparison of health-related utility in people with diabetes with various single and multiple vascular complicationsDIABETIC MEDICINE, Issue 10 2006C. Ll. Abstract Aims To characterize and compare health-related utility in a large cohort of patients treated in hospital with diabetes and with single and multiple comorbidities. Methods The study was conducted in Cardiff and the Vale of Glamorgan, UK. Health-related utility was measured using the EQ5Dindex, a standardized instrument for measuring health outcome. Patients from the Health Outcomes Data Repository (HODaR) were surveyed by postal questionnaire 6 weeks post discharge for in-patients and during clinics for patients attending as out-patients between January 2002 and July 2005. Patients with diabetes were identified by a previous history of in-patient admission with diabetes or as an out-patient with diabetes recorded as a coexisting diagnosis. Results, We identified 4502 patients with diabetes. Mean ages were 65.4 and 64.2 years for males and females, respectively. Of these, 2003 (45%) had no recorded vascular complication. Overall, the EQ5Dindex was 0.584 (sd 0.325) for males and 0.533 (sd 0.351) for females. For those without any vascular complications the mean EQ5Dindex was 0.735 (sd 0.288). In a general linear model, the presence of single and multiple complications had a detrimental impact on the EQ5Dindex. Conclusion The results of this study provide an indication of the true impact of diabetes in terms of health-related utility. There was a decrease in the mean EQ5Dindex for those with vascular complications. Economic models of diabetes that have used additive or multiplicative methods to assess utility in individuals with several complications may be unreliable, and direct measurements, such as this, are recommended. [source] Binge drinking and depressive symptoms: a 5-year population-based cohort studyADDICTION, Issue 7 2009Tapio Paljärvi ABSTRACT Background Only few prospective population studies have been able so far to investigate depression and drinking patterns in detail. Therefore, little is known about what aspect of alcohol consumption best predicts symptoms of depression in the general population. Participants and design In this prospective population-based two-wave cohort study, a cohort of alcohol-drinking men and women (n = 15 926) were followed-up after 5 years. A postal questionnaire was sent in 1998 (response proportion 40%) and again in 2003 (response proportion 80% of the baseline participants) to Finnish adults aged 20,54 years at baseline. Measurements Alcohol consumption was measured by average intake (g/week) and by measures of binge drinking (intoxications, hangovers and alcohol-induced pass-outs). Depressive symptoms were assessed with the 21-item Beck Depression Inventory. In addition, information from hospital discharge register for depression and alcohol abuse were linked to the data. Findings This study found a positive association between baseline binge drinking and depressive symptoms 5 years later. Adjustment for several possible confounders attenuated the observed relationships only slightly, suggesting that binge drinking contributes independently to the occurrence of depressive symptoms. Binge drinking was related to symptoms of depression independently of average intake. Conclusions This study supports the hypothesis that heavy drinking, and in particular a binge pattern involving intoxications, hangovers or pass-outs, produces depressive symptoms in the general population. The frequency of hangovers was the best predictor for depressive symptoms. [source] The Influence of Comorbid Depression on Seizure SeverityEPILEPSIA, Issue 12 2003Joyce A. Cramer Summary:,Purpose: To determine the relation between depressive symptoms and seizure severity among people with epilepsy. Methods: A postal questionnaire was used to survey a nationwide community sample about seizures and depression. The Seizure Severity Questionnaire (SSQ) assessed the severity and bothersomeness of seizure components. The Centers for Epidemiological Studies-Depression scale categorized levels of depression. Results: Respondents categorized as having current severe (SEV, n = 166), mild,moderate (MOD, n = 74), or no depression (NO, n = 443) differed significantly in SSQ scores (all p < 0.0001). People with SEV or MOD reported significantly worse problems than did those with NO depression for overall seizure recovery (mean, 5.3, 4.9, 4.5, respectively); overall severity (5.0, 4.5, 4.2); and overall seizure bother (5.3, 4.8, 4.4) (all p < 0.005). Cognitive, emotional, and physical aspects of seizure recovery also were rated worse among people with SEV than with NO depression (all p < 0.05). Symptoms of depression were significantly correlated with higher levels of all components of generalized tonic,clonic seizure severity (r = 0.33,0.48; all p < 0.0001), and partial seizures (r = 0.31,0.38; all p < 0.01). Conclusions: Clinically depressed people with epilepsy reported higher levels of perceived severity and bother from seizures, as well as greater problems with overall seizure recovery than did nondepressed people experiencing similar types of seizures. The pervasive influence of depressive symptoms on reports of seizure activity suggests that people with epilepsy should be screened for depression. These data highlight the importance of detecting and treating depression among people with epilepsy. [source] An epidemiological study of risk factors associated with the recurrence of equine grass sickness (dysautonomia) on previously affected premisesEQUINE VETERINARY JOURNAL, Issue 2 2004J. R. Newton Summary Reasons for performing study: The reasons why equine grass sickness (EGS) recurs on premises are unknown and, consequently, practical methods for reducing the risk of recurrence are not available. Objectives: To identify risk factors associated with recurrence of EGS on premises and to gain possible insights into the pathogenesis of the disease. Methods: Data on disease history and risk factors were collected by postal questionnaire from premises with EGS cases between 1st January 1997 and 31st December 2001. Data on variation in rates of recurrence of EGS for different risk factors were analysed using Poisson regression analysis. Results: Of 509 premises contacted, 305 (60%) returned useable questionnaires and 100 of these (33%) were classified as ,recurrent' premises. An overall median incidence rate for EGS of 2.1 EGS incidents/100 horses/premises/year was recorded. There was an increased rate of recurrence with higher numbers of horses, presence of younger animals, stud farms and livery/riding establishments, loam and sand soils, rearing of domestic birds and mechanical droppings removal. The rate of recurrence decreased with chalk soil, cograzing ruminants, grass cutting on pastures and removal of droppings by hand. Several statistically significant interactions were identified. Conclusions: Many of the findings are consistent with the theory that EGS is a toxico-infectious form of botulism. Several of the significant factors identified may directly or indirectly relate to soil disturbance and consequent soil contamination of grass, thereby increasing the rate of exposure of grazing horses to Clostridium botulinum, which resides in soil. Potential relevance: Identification of potentially modifiable risk factors may, ideally following validation in appropriately designed, controlled and randomised intervention studies, lead to practical measures to reduce the incidence of EGS on previously affected premises. [source] The use of complementary therapy by men with prostate cancer in the UKEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2008S. WILKINSON The study aims were to determine the use of complementary therapies (CT) by men with prostate cancer, and to explore factors influencing CT use and attitudes toward CT use. A cross-sectional survey design was used in which a postal questionnaire was mailed to an eligible sample of 405 patients with prostate cancer receiving outpatient treatment in a London teaching hospital. The primary outcomes were the prevalence of CT use and the relationship between CT use and mental health status. Two hundred and ninety-four patients (73%) responded, of whom 25% were using CT. The most frequently used CTs were vitamins, low-fat diets, lycopene and green tea. Multivariate analyses revealed no differences in mental health scores between CT users and non-users. CT users were younger (OR 0.93, 95% CI 0.89,0.97) and were more likely to be receiving conservative management in the form of ,active surveillance' (OR 5.23, 95% CI 1.78,15.41) compared with non-users. Over half of the participants (55%) wanted to learn more about CT. Forty-three per cent of CT users had not informed any doctor about their CT use. Clinicians need to be aware of the prevalence of CT use amongst patients with prostate cancer, considering the potential harm that could be caused by interactions with conventional treatments. [source] A dental practice placement scheme: benefits for practitioners and undergraduatesEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 4 2001A. K. H. Pau Objectives: To report the feedback from general dental practitioners (GDPs) and dental undergraduates who participated in a general dental practice placement scheme. Methods:Subjects All 61 students in a year made 2 to 3 full day visits, individually or in pairs, to 44 general dental practices allocated to them. Thirty four GDPs completed and returned the questionnaire, representing a response rate of 77%. Data collection Formal feedback from the students and GDPs were obtained through 6 structured seminar sessions and a postal questionnaire respectively. Analysis Sifting, indexing and charting the data according to key issues and themes. Results: All 61 students attended the feedback sessions, 34 GDPs (response rate 77%) returned the questionnaire. The two most common themes that students reported having gained insight into were personal/professional development and practice management. The common positive aspects reported by the GDPs included exposure to the General Dental Service (GDS), motivation for undergraduate training and benefits for GDPs. These benefits included encouragement for the GDPs to reflect critically on their clinical practice, focus on their practice facilities and management, and stay in touch with developments in dental education. Through their visits and assignments, students gained skills in observation, interviewing, communication, relation-building and report writing. Conclusions: Placements of dental undergraduates in general dental practices enable students to gain insight into the GDS, develop key transferable skills and undergo professional socialisation. They are also beneficial and enjoyable for the GDPs who participated. [source] The relation of tobacco smoking to tooth loss among young adultsEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 2 2004Pekka Ylöstalo Earlier studies have associated smoking with a higher rate of dental caries, periodontal disease and tooth loss. The aim of this cross-sectional study was to determine whether smoking is associated with tooth loss among young adults. The data consist of the 1966 birth cohort of Northern Finland, which is an unselected general population birth cohort (n = 12 058). The data were collected using a postal questionnaire in 1997,98 (n = 8690). Prevalence odds ratios and confidence intervals were estimated by applying a logistic regression model. It was found that smoking was associated with tooth loss in an exposure-dependent manner. The odds for those who smoked 16 or more pack-years were 5.30 (CI = 2.35,11.2) after adjustment for socio-economic and behavioral factors. Differences in socio-economic or health behavior are not likely to explain the findings since an exposure-response pattern was seen even when data was stratified according to sex, education and health-oriented lifestyle. A possible explanation for this association is a combination of treatment decisions and dental diseases, which are most likely associated with smoking in an exposure-dependent manner. [source] Carrier testing in haemophilia A and B: adult carriers' and their partners' experiences and their views on the testing of young femalesHAEMOPHILIA, Issue 3 2008N. F. DUNN Summary., This is a descriptive study, which aims to report adult carriers' and their husbands/partners' experiences of carrier diagnosis and their views as to how these issues should be handled for the next generation. Following an initial pilot, 105 carriers and husbands/partners responded to a postal questionnaire. Most of the adult carriers had been tested because either they or their parents wanted to know their carrier status or they had a son diagnosed with haemophilia. The respondents agreed that the main reasons for testing young potential carriers should be either a family history of severe haemophilia or that the young person or her parents wanted to know her status. Forty per cent (35/87) believed the earliest age for carrier testing should be 0,9 years, 44% (38/87) 10,15 years and 16% (14/87) ,16 years. Respondents aged 18,39 years were more likely to be in favour of testing <2 years. If parents and teenagers disagreed, the majority of parents thought that a test should not be forced, consent refused or results withheld. Genetic counselling provides an important opportunity for parents, who want a very early genetic test, to explore their motivations and balance their desire to prepare and protect their daughter with her right to decide as a teenager. [source] Stakeholders' views on measuring outcomes for people with learning disabilitiesHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2006Anita F. Young PhD DipCOT Abstract What works and how do we know? These are recurring questions for health and social care professionals, although mediated through differing philosophies and historical perspectives. The aims of the study reported here were to discover views of managers and commissioners of services for people with learning disabilities in Scotland regarding (a) current approaches to service evaluation (as an indication of what is to be measured) and (b) healthcare outcome measurement (as an indication of preferences regarding how this should be measured). A postal questionnaire was used to survey 94 stakeholders from the NHS, Local Authorities, and non-statutory organisations across Scotland. Respondents' views were sought on current approaches to service evaluation within learning disabilities; outcome measurement; appropriateness of specified methods of measuring health outcomes; desired future methods of outcome measurement within learning disabilities; and service user involvement in care. A 77% (73/94) response rate to the questionnaire was achieved. Different methods of service evaluation were used by different stakeholders. Staff appraisal was the most frequently identified method (used by 85% of respondents). Specific outcome measures were used by 32% of respondents although there were differences of opinion as to what constitutes specific outcome measures. Overall there was strong support for goal-setting and reviewing (83%) and individualised outcome measures (75%) as appropriate methods for use with people with learning disabilities. The hypothetical question asking what outcome measures should be introduced for this client group had by far the lowest response rate (51/73). The overwhelming majority of all respondents, 68 (92%), reported user involvement in their service. Staff ambivalence to outcome measurement was evident in the research and respondents highlighted the complexity and multidimensional nature of outcomes for this service user group. Managers recognised that outcome measurement was expected but were uncertain how to go about it. [source] Carers and the digital divide: factors affecting Internet use among carers in the UKHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2005Clare Blackburn BA (Hons) DipHE RHV RGN Abstract This paper presents data from a cross-sectional survey of 3014 adult carers, examining use of the Internet and factors associated with it. Carers recruited from the databases of three local authorities and other carer organisations within their geographical boundaries and that of Carers UK, a national carers organisation, were sent a postal questionnaire (response rate: 40%). A comparison of our data with national data on carers suggests some under-representation of men and younger adult carers and some over-representation of those who had been caring for long periods and those with substantial caring responsibilities. Two measures of Internet use were used and are presented in this analysis: previous use (ever used vs never previously used) and frequency (less than once a week vs once a week or more). Bivariate analyses identified patterns of Internet use and socio-demographic and socio-economic factors and caring circumstances associated with them. Factors significantly associated with each measure of Internet use were entered into direct logistic regression analyses to identify factors significantly associated with each measure. Half (50%) of all carers had previously used the Internet. Of this group, 61% had used it once a week or more frequently. Factors significantly associated with having previously used the Internet were carer's age, employment status, housing tenure and number of hours per week they spent caring. Frequency of Internet use was significantly associated with carer's age, sex, employment status and number of hours spent caring. Our study suggests that a significant number of carers may not currently be Internet users and that age, gender, socio-economic status and caring responsibilities shape Internet use in particular ways. Given the targets set by government for the development of online services, it is important to address the digital divide among carers and to continue to develop other services and information systems to meet the needs of those who do not access the Internet. [source] Variables associated with attendance at, and the perceived helpfulness of, meetings for people with multiple sclerosisHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2003Tim J. Peters PhD Abstract People who have chronic disabling conditions are frequently advised by health or social care practitioners to attend meetings organised specifically for individuals who have the same or similar health problems. The purpose of the analyses described in the present paper was to ascertain the variables independently associated with attendance at meetings for people with multiple sclerosis (MS), and amongst those who did attend, variables related to the level of perceived helpfulness. A postal questionnaire was sent to a random sample of 471 people with MS in eight randomly selected health authorities/boards across England and Scotland with the general aim of eliciting their preferences for and views of health and social care. There were 318 respondents to this questionnaire (68%), 136 (43%) of whom had attended such a meeting. Logistic regression and proportional odds regression models were used to investigate the relationships with the two outcomes of attendance and helpfulness for 23 explanatory variables drawn from the questionnaire. The explanatory variables related to the following six broad areas: socio-demographic, illness-related, support, self-management, psycho-social factors and social function. Just under half of the respondents reported that they had attended a meeting. Half of these individuals found the last meeting that they had attended to be reasonably helpful, and one in five found it of no help. The individuals who were more likely to have attended were aged 45,64 years, had been in contact with a health professional in the past 12 months and felt that they had the ability and means to access MS-related information. The last meeting was considered more helpful by those who reported greater contentment with access to MS-related information and by those with mild depression. These findings should be useful to health professionals who may consider recommending meetings to people with MS, and also to those who are engaged in ensuring that meetings are both attractive and relevant to all potential attendees. [source] Sexual activity and risk-taking in later lifeHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2001C. Merryn Gott MA PhD Abstract The primary study objective was to identify the prevalence of sexual activity and sexual risk-taking behaviour among a sample of older community-based adults. Secondary objectives included gathering data about past experiences of consultations regarding sexual health issues with general practitioners (GPs) and at genitourinary medicine (GUM) clinics, and exploring participants' STI and HIV/AIDS-related information needs. Individuals over the age of 50 were identified from four electoral wards within Sheffield, UK by means of a postal screen based on the electoral register. Respondents self completed a short postal questionnaire. Three hundred and nineteen individuals aged over 50 years selected at random from the general population responded. Approximately 80% of respondents were currently sexually active and 7% engaged in behaviours that may place them at risk of contracting a sexually transmitted infection (STI). Risk takers were typically male, aged between 50 and 60 years and married. Being male was also related to reporting current or past sexual health concerns. In total, of 75 respondents reporting such concerns, two thirds had discussed these concerns with their GP or attended a GUM clinic. Levels of satisfaction with such consultations were generally high, but declined with increasing age. Overall, most participants felt they had not received very much information about STIs and HIV, and about one quarter reported that they would like to receive more information on these topics. These data have implications for all health and social care professionals who work with older people and indicate a potential need for education to help professionals meet the sexual health needs of their older patients/clients. Further implications for sexual health promotion and the need for additional research in this field are also discussed. [source] Social services and Primary Care Groups: a window of collaborative opportunity?HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2000Bob Hudson This paper reports on the findings of two investigations into the relationship between social services and Primary Care Groups (PCGs): a national postal questionnaire and a series of regional seminars. The key findings of both explorations are summarised and placed in the context of other available evidence on the development of PCGs. Issues covered include: the background and status of social services representatives; preparation and support for the board role; feedback and accountability, and early contributions. It is concluded that progress is being made in bringing together the agendas and activities of PCGs and social services, and to a lesser extent the wider local authority, but that important obstacles remain in place. The enduring significance of the resource dependency model needs to be a key factor in emerging partnerships. [source] Involving consumers successfully in NHS research: a national surveyHEALTH EXPECTATIONS, Issue 4 2007Rosemary Barber BA MSc MAppSci Abstract Objectives, To investigate how far and in what way consumers are involved in NHS research. Background, There is guidance from the UK Department of Health on involving consumers in research, but it is not known how these policies have been implemented. Design, A national postal survey was conducted of 884 researchers selected randomly from the National Research Register, 16 researchers registered on the INVOLVE database and 15 consumers nominated by researchers who collaborated in the same research projects. Setting, The survey participants were drawn from diverse settings including NHS organizations and universities. Participants, Researchers and consumers collaborating in the same projects. Main outcome measures, Details of how consumers were involved and the number of projects that met previously developed consensus-derived indicators of successful consumer involvement in NHS research. Results, Of the 900 researchers who were sent a postal questionnaire, 518 responded, giving a response rate of 58%. Nine of the 15 consumers responded. Eighty-eight (17%) researchers reported involving consumers, mainly as members of a project steering group, designing research instruments and/or planning or designing the research methods. Most projects met between one and four indicators. Conclusions, This national survey revealed that only a small proportion of NHS researchers were actively involving consumers. This study provides a useful marker of how far the Department of Health's policy on consumer involvement in NHS research has been implemented and in what way. [source] The information needs of doctors-in-training: case study from the Cairns Library, University of OxfordHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 3 2000Maureen Forrest The objective of this study was to find out more about the information needs of doctors-in-training and to identify their preferred sources of information. The methodology included interviews with consultants and administrators, a focus group discussion with library staff and a postal questionnaire sent to 347 doctors-in-training (there was a 43% return). The shortcomings of a questionnaire primarily composed of closed questions were addressed by the inclusion of one-to-one interviews which offered the opportunity for more in-depth commentary on specific issues highlighted in the questionnaire. Results indicated the frequency with which various types of information sources were consulted and how this related to the ,ease of access' of each information source. There was also the opportunity to comment on future information needs. It was clear from the interviews as well as comments made on the questionnaire that the two most important requirements for doctors-in-training were ,more time to find and obtain information' and ,better access to information sources when and where they are needed'. The results, although not surprising, included specific suggestions that have been used for the strategic planning of the library service to deliver the best possible support to users within the current framework of evidence-based medicine. [source] | |||||||||||||||||||||||||||||||||||||||||||