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Questionnaire Scores (questionnaire + score)

Distribution by Scientific Domains

Medical Sciences	85%
Psychology	9%

Distribution within Medical Sciences

Allergy & Clinical Immunology	16%
Nursing General	10%

Kinds of Questionnaire Scores

assessment questionnaire score

health assessment questionnaire score

Selected Abstracts

Adherence to the Mediterranean diet and fresh fruit intake are associated with improved asthma control

ALLERGY, Issue 7 2008
R. Barros
Background:, The traditional Mediterranean diet is claimed to possess antioxidant and immune-regulatory properties in several chronic diseases. Typical Mediterranean foods have recently been associated with improvement of symptoms of asthma and rhinitis in children. However the effect of adherence to Mediterranean diet on adult asthma outcomes is unknown. We aimed to investigate the association between adherence to Mediterranean diet and asthma control. Methods:, Cross sectional study of 174 asthmatics, mean (SD) age of 40 (15) years. The patients were defined as controlled, in contrast to noncontrolled, if they showed FEV1 , 80% of predicted, exhaled nitric oxide (NO) ,35 ppb, and Asthma Control Questionnaire score <1. Dietary intake was obtained by a food frequency questionnaire, and Mediterranean diet was assessed by alternate Mediterranean Diet (aMED) Score. Logistic regression models adjusting for confounders were performed to estimate the association between Mediterranean diet and asthma control. Results:, Controlled asthmatics (23%) had significantly higher aMED Score, intake of fresh fruit, and lower intake of ethanol compared to noncontrolled (77%). High adherence to Mediterranean diet reduced 78% the risk of noncontrolled asthma after adjusting for gender, age, education, inhaled corticosteroids and energy intake (OR = 0.22; 95% CI = 0.05,0.85; P -trend = 0.028). The higher intake of fresh fruit decreased the probability of having noncontrolled asthma (OR = 0.29; 95% CI = 0.10,0.83; P -trend = 0.015), while the higher intake of ethanol had the opposite effect (OR = 3.16; 95% CI = 1.10,9.11; P -trend = 0.035). Conclusion:, High adherence to traditional Mediterranean diet increased the likelihood of asthma to be under control in adults. The study introduces a novel link between diet and asthma control, as measured by symptoms, lung function and exhaled NO. [source]

Prevalence of incontinence and incontinence-specific quality of life impairment in women with cystic fibrosis,,

NEUROUROLOGY AND URODYNAMICS, Issue 8 2009
M. Vella
Abstract Aims Cystic fibrosis (CF) is the commonest autosomal recessive disorder in Caucasians. With advancing medical technology, the life expectancy has more than double in the last twenty years. This has led to new unforeseen health problems like urinary incontinence. The aim was to establish the prevalence, symptomatic typology, and quality of life impact of incontinence in a population of women with CF. Methods Women were recruited from two London tertiary referral centres for CF. They were asked to fill in a self- completed anonymous King's Health Questionnaire (KHQ) for assessment of symptoms and quality of life Impairment. Their age was also noted. Descriptive statistics are reported. Correlation was assessed using Pearson's Product Moment Correlation Coefficient (r). Results One hundred and forty six women were approached for enrolment. 98(67%) consented to take part in study. Their mean age was 28. Seventy three (74%) reported symptoms of urinary incontinence, which in all cases was perceived as stress urinary incontinence. Of these 44(60%) reported mild stress incontinence, 16(22%) moderate stress incontinence and 13(18%) severe stress incontinence. Continent and incontinent women perceived their general health to be similarly poor (mean score 40 vs 44 points). Strong positive correiations were found between age and stress urinary incontinence severity (r=0.742; P <0.001) and between age and total King's Health Questionnaire score (r=0.828; P <0.001). Conclusions Women with CF have a higher prevalence of stress urinary incontinence than the general population, with both the prevalence and associated quality of life impairment increasing with age. Neurourol. Urodynam. 28:986,989, 2009. © 2009 Wiley-Liss, Inc. [source]

Characteristics associated with discharge to home following prolonged mechanical ventilation: A signal detection analysis,

RESEARCH IN NURSING & HEALTH, Issue 6 2006
Yookyung Kim
Abstract The objective of study was to identify characteristics associated with being home at 6 months in 80 patients on prolonged mechanical ventilation (PMV) (,7 days). At 6 months, 47.5% were home, 13.8% institutionalized, and 38.8% deceased and classified "not home." Using signal detection methodology (SDM), four mutually exclusive groups at high and low probability of being home were identified. The best outcome (94.4% home) was achieved by patients with an admission Charlson Comorbidity Score ,3 and an Acute Physiology Score (APS) ,21 and the worst outcome (23.4% home) by patients with an admission Charlson Comorbidity Score >3 and Health Assessment Questionnaire score >2.7. SDM provided an effective means of identifying subgroups likely to be discharged home using available information. © 2006 Wiley Periodicals, Inc. Res Nurs Health 29: 510,520, 2006 [source]

Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: Results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry

ARTHRITIS & RHEUMATISM, Issue 1 2010
Merete Lund Hetland
Objective To compare tumor necrosis factor , inhibitors directly regarding the rates of treatment response, remission, and the drug survival rate in patients with rheumatoid arthritis (RA), and to identify clinical prognostic factors for response. Methods The nationwide DANBIO registry collects data on rheumatology patients receiving routine care. For the present study, we included patients from DANBIO who had RA (n = 2,326) in whom the first biologic treatment was initiated (29% received adalimumab, 22% received etanercept, and 49% received infliximab). Baseline predictors of treatment response were identified. The odds ratios (ORs) for clinical responses and remission and hazard ratios (HRs) for drug withdrawal were calculated, corrected for age, disease duration, the Disease Activity Score in 28 joints (DAS28), seropositivity, concomitant methotrexate and prednisolone, number of previous disease-modifying drugs, center, and functional status (Health Assessment Questionnaire score). Results Seventy percent improvement according to the American College of Rheumatology criteria (an ACR70 response) was achieved in 19% of patients after 6 months. Older age, concomitant prednisolone treatment, and low functional status at baseline were negative predictors. The ORs (95% confidence intervals [95% CIs]) for an ACR70 response were 2.05 (95% CI 1.52,2.76) for adalimumab versus infliximab, 1.78 (95% CI 1.28,2.50) for etanercept versus infliximab, and 1.15 (95% CI 0.82,1.60) for adalimumab versus etanercept. Similar predictors and ORs were observed for a good response according to the European League Against Rheumatism criteria, DAS28 remission, and Clinical Disease Activity Index remission. At 48 months, the HRs for drug withdrawal were 1.98 for infliximab versus etanercept (95% 1.63,2.40), 1.35 for infliximab versus adalimumab (95% CI 1.15,1.58), and 1.47 for adalimumab versus etanercept (95% CI 1.20,1.80). Conclusion Older age, low functional status, and concomitant prednisolone treatment were negative predictors of a clinical response and remission. Infliximab had the lowest rates of treatment response, disease remission, and drug adherence, adalimumab had the highest rates of treatment response and disease remission, and etanercept had the longest drug survival rates. These findings were consistent after correction for confounders and sensitivity analyses and across outcome measures and followup times. [source]

The relationship between focal erosions and generalized osteoporosis in postmenopausal women with rheumatoid arthritis

ARTHRITIS & RHEUMATISM, Issue 6 2009
Daniel H. Solomon
Objective Among rheumatoid arthritis (RA) patients who have had the disease for 10 years, more than half have focal erosions, and the risk of fracture is doubled. However, there is little information about the potential relationship between focal erosions and bone mineral density (BMD). The aim of this study was to determine whether lower BMD is associated with higher erosion scores among patients with RA. Methods We enrolled 163 postmenopausal women with RA, none of whom were taking osteoporosis medications. Patients underwent dual x-ray absorptiometry at the hip and spine and hand radiography, and completed a questionnaire. The hand radiographs were scored using the Sharp method, and the relationship between BMD and erosions was measured using Spearman's correlation coefficients and adjusted linear regression models. Results Patients had an average disease duration of 13.7 years, and almost all were taking a disease-modifying antirheumatic drug. Sixty-three percent were rheumatoid factor (RF) positive. The median modified Health Assessment Questionnaire score was 0.7, and the average Disease Activity Score in 28 joints was 3.8. The erosion score was significantly correlated with total hip BMD (r = ,0.33, P < 0.0001), but not with lumbar spine BMD (r = ,0.09, P = 0.27). Hip BMD was significantly lower in RF-positive patients versus RF-negative patients (P = 0.02). In multivariable models that included age, body mass index, and cumulative oral glucocorticoid dose, neither total hip BMD nor lumbar spine BMD was significantly associated with focal erosions. Conclusion Our results suggest that hip BMD is associated with focal erosions among postmenopausal women with RA, but that this association disappears after multivariable adjustment. While BMD and erosions may be correlated with bone manifestations of RA, their relationship is complex and influenced by other disease-related factors. [source]

Topiramate Treatment of Chronic Migraine: A Randomized, Placebo-Controlled Trial of Quality of Life and Other Efficacy Measures

HEADACHE, Issue 8 2009
Stephen Silberstein MD
Objective., To define yet more clearly the utility of topiramate in the treatment of chronic migraine, we evaluated prespecified secondary endpoints from a recent randomized, double-blind, placebo-controlled, multicenter clinical trial. Background., We previously reported that topiramate 100 mg per day produced a statistically significant reduction in mean monthly migraine/migrainous and migraine headache days compared with placebo treatment and that it was safe and generally well tolerated. Methods., Variables analyzed included between-treatment group differences in percent responders, change in the mean monthly rate of total headache days and headache-free days, change in average and worst daily headache severity, change in the mean monthly use of acute headache medications, and absolute change and percent change in a headache index. Additional analyses included evaluation of changes in: the associated symptoms of photophobia, phonophobia, and nausea; Migraine-Specific Quality of Life Questionnaire scores; Migraine Disability Assessment Scale scores; and Physician's and Subjects Global Impression of Change. Results., The intent-to-treat population consisted of 306 patients (topiramate, n = 153; placebo, n = 153). Categorical responder rates of reductions in mean monthly migraine/migrainous days for topiramate- vs placebo-treated subjects were as follows: for ,25% reduction: 68.6% vs 51.6% (P = .005); ,50%: 37.3% vs 28.8% (P = .093); and ,75%: 15.0% vs 9.2% (P = .061). The decrease in mean monthly total headache days and headache-free days for topiramate vs placebo treatment was 5.8 vs 4.7 days (P = .067). Compared with placebo, topiramate treatment resulted in statistically significant mean improvements in the Role Restrictive (P = .028) and Emotional Function (P = .036) domains of the Migraine-Specific Quality of Life Questionnaire, in the worst daily severity of migraine (P = .016), severity of photophobia (P = .032), frequency of vomiting (P = .018), photophobia (P = .038), phonophobia (P = .010), unilateral pain (P = .015), pulsatile pain (P = .023), and pain worsened because of physical activity (P = .047). In addition, there were trends observed (favoring topiramate) in average daily severity of migraine (P = .077), acute headache medication use (P = .127), severity of nausea (P = .098), frequency of nausea (P = .166), the Role Preventive domain of the Migraine-Specific Quality of Life Questionnaire (P = .061), and severity of phonophobia (P = .062). Conclusions., In addition to significantly reducing mean monthly migraine/migrainous and migraine headache days, treatment of chronic migraine with topiramate was effective with regard to several traditionally important and clinically relevant secondary outcomes in migraine prevention trials. Treatment with topiramate was well tolerated and not associated with serious adverse events. [source]

Cigarette dependence questionnaire: development and psychometric testing with male smokers

JOURNAL OF ADVANCED NURSING, Issue 10 2010
Chih-Ling Huang
huang c.-l., lin h.-h. & wang h.-h. (2010) Cigarette dependence questionnaire: development and psychometric testing with male smokers. Journal of Advanced Nursing,66(10), 2341,2349. Abstract Aim., This paper is a report of a study conducted to develop and test a theoretically derived Cigarette Dependence Questionnaire for adult male smokers. Background., Fagerstrom questionnaires have been used worldwide to assess cigarette dependence. However, these assessments lack any theoretical perspective. A theory-based approach is needed to ensure valid assessment. Methods., In 2007, an initial pool of 103 Cigarette Dependence Questionnaire items was distributed to 109 adult smokers in Taiwan. Item analysis was conducted to select items for inclusion in the refined scale. The psychometric properties of the Cigarette Dependence Questionnaire were further evaluated 2007,08, when it was administered to 256 respondents and their saliva was collected and analysed for cotinine levels. Criterion validity was established through the Pearson correlation between the scale and saliva cotinine levels. Exploratory factor analysis was used to test construct validity. Reliability was determined with Cronbach's alpha coefficient and a 2-week test,retest coefficient. Results., The selection of 30 items for seven perspectives was based on item analysis. One factor accounting for 44·9% of the variance emerged from the factor analysis. The factor was named as cigarette dependence. Cigarette Dependence Questionnaire scores were statistically significantly correlated with saliva cotinine levels (r = 0·21, P = 0·01). Cronbach's alpha was 0·95 and test,retest reliability using an intra-class correlation was 0·92. Conclusion., The Cigarette Dependence Questionnaire showed sound reliability and validity and could be used by nurses to set up smoking cessation interventions based on assessment of cigarette dependence. [source]

Embedded journalists in the Iraq war: Are they at greater psychological risk?

JOURNAL OF TRAUMATIC STRESS, Issue 2 2005
Anthony Feinstein
The current war in Iraq saw an alliance between the media and the military, a process called embedded journalism. The aim of this study was to explore whether this process affected the journalists' vulnerability to psychological distress. Eighty-five of 100 journalists approached agreed to participate; 38 (44.7%) were embedded. There were no differences between embedded and unilateral (nonembedded) journalists on demographic measures or in their exposure to traumatic events. Similarly, the two groups did not differ on indices of posttraumatic stress disorder, depression, psychological distress, and substance use. Based on General Health Questionnaire scores, one third of all journalists were psychologically distressed. There is no evidence from the recent war in Iraq suggesting that embedded journalists are at increased risk for psychological problems. [source]

Agreement of efficacy assessments for five-grass pollen sublingual tablet immunotherapy

ALLERGY, Issue 1 2009
A. Didier
Background:, The optimal dose of five-grass pollen sublingual tablet immunotherapy (SLIT) was established recently by the primary criteria Rhinoconjunctivitis Total Symptom Score (RTSS) from the first treatment season. Secondary and exploratory criteria, such as RTSS at peak pollen season, exploratory combined symptom and rescue medication use score, quality of life and immunological markers are calculated and described in this analysis. Methods:, Six hundred and twenty-eight patients with grass pollen rhinoconjunctivitis (,2 years duration) were randomized in a double-blind, placebo-controlled trial conducted in Europe. Patients received once-daily SLIT (Stallergenes, Antony, France) of 100IR, 300IR, 500IR or placebo, starting 4 months before grass pollen season and throughout the 2005 season. Patients were instructed to take rescue medication only if symptoms were severe and record symptom severity on using the RTSS. Results:, Both 300IR and 500IR doses significantly reduced mean RTSS at pollen peak (P = 0.0005 and P = 0.0014, respectively) and the exploratory combined score (P = 0.0001 and P = 0.0026, respectively) compared with placebo. Compared with patients in the placebo group, those who were taking the 300IR and 500IR doses reported significantly improved quality of life using the mean Rhinoconjunctivitis Quality of Life Questionnaire scores during the peak of the pollen season (P < 0.0001) and at the end of the pollen season (P = 0.0031 and P , 0.0001, respectively). Specific immunoglobulin G4 increased significantly depending on the SLIT dose (P < 0.0001). Conclusions:, All secondary efficacy criteria, including efficacy at pollen peak, combined score, quality of life and immunological changes, indicate that 300IR tablets represent the optimal dose and suggest it is appropriate for use in clinical practice. [source]

Treatment of early rheumatoid arthritis: A randomized magnetic resonance imaging study comparing the effects of methotrexate alone, methotrexate in combination with infliximab, and methotrexate in combination with intravenous pulse methylprednisolone,

ARTHRITIS & RHEUMATISM, Issue 12 2007
Patrick Durez
Objective To compare the effects of methotrexate (MTX), alone or in combination with intravenous (IV) methylprednisolone (MP) or infliximab, on magnetic resonance imaging (MRI),detected synovitis, bone edema, and erosive changes in patients with early rheumatoid arthritis (RA). Methods Forty-four patients with early RA were randomized to receive MTX alone (MTX group), MTX plus IV MP (IV MP group), or MTX plus infliximab (infliximab group), infused on day 0 and weeks 2, 6, 14, 22, 30, 38, and 46. Gadolinium-enhanced MRI scans of the metacarpophalangeal joints, wrists, and metatarsophalangeal joints were performed at baseline, week 18, and week 52. Results Scores for MRI-detected synovitis and bone edema improved over time in the 3 groups, with significantly lower synovitis scores in the infliximab group compared with the MTX group and significantly lower bone edema scores in the infliximab group compared with the MTX and the IV MP groups. Scores for MRI-detected erosion significantly increased over time in all groups. There were no differences in erosion scores between the MTX group and the other groups. It is of note that patients treated with IV MP showed more significant progression in MRI-detected erosions compared with patients treated with infliximab. At week 22, response rates according to the American College of Rheumatology 20% improvement criteria (ACR20), the ACR50, and the ACR70 were significantly higher in both the IV MP group and the infliximab group compared with the MTX group. At week 52, remission was achieved in 40% of patients in the MTX group and in 70% of patients in the IV MP and infliximab groups. Health Assessment Questionnaire scores improved significantly over time in all groups, with patients receiving IV MP experiencing significantly more improvement compared with patients treated with MTX alone. No severe side effects were observed, except 1 case of MTX-related pneumonitis. Conclusion The combination of MTX and infliximab is superior to MTX alone for reducing MRI-detected signs of synovitis and bone edema in patients with early RA. Progression of MRI-detected erosion was greater in patients treated with MTX plus IV MP compared with that in patients who received MTX plus infliximab. [source]

Randomised prospective single-blinded study comparing ,inside-out' versus ,outside-in' transobturator tapes in the management of urodynamic stress incontinence: 1-year outcomes from the E-TOT study

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 7 2010
M Abdel-fattah
Please cite this paper as: Abdel-fattah M, Ramsay I, Pringle S, Hardwick C, Ali H, Young D, Mostafa A. Randomised prospective single-blinded study comparing ,inside-out' versus ,outside-in' transobturator tapes in the management of urodynamic stress incontinence: 1-year outcomes from the E-TOT study. BJOG 2010;117:870,878. Objective, To compare the ,inside-out' versus ,outside-in' routes for transobturator tape insertion for urodynamic stress incontinence, and to identify independent risk factors for failure at 1 year. Design, Prospective single-blinded randomised trial. Setting, Tertiary urogynaecology centre. Population, A cohort of 341 women undergoing transobturator tape procedures between April 2005 and April 2007. Methods, Women were randomised to tension-free vaginal tape-obturator (TVT)-OÔ for the ,inside-out' route (n = 170) and transobturator tape (TOT)-ARIS® for the ,outside-in' route (n = 171). Participants completed validated symptom-severity, quality-of-life and sexual-function questionnaires before and after surgery. In addition, they completed the patient global impression of improvement questionnaire (PGI-I) and standard 1-hour pad test postoperatively. Main outcome measures, The primary outcome was the patient-reported success rate reported on the PGI-I scale. Secondary outcomes included objective cure rate and improvement in King's Health Questionnaire scores. Results, A total of 341 women were recruited: 171 women to the ,outside-in' (TOT-ARIS®) group and 170 to the ,inside-out' (TVT-OÔ) group; 299 completed the 1-year follow up. The patient-reported success rate was 80% with no statistically significant differences between the groups (,outside-in' 77.6% versus ,inside-out' 81.2%; OR 1.25; 95% CI 0.71, 2.20; P = 0.54). The objective cure rate was 91% with no statistically significant difference between the groups (,outside-in' 88% versus ,inside-out' 94%; OR 2.21; 95% CI 0.85, 5.75; P = 0.157). Previous incontinence surgery (OR 1.41; 95% CI 1.18, 1.91; P = 0.029) and preoperative urgency incontinence (OR 1.78; 95% CI 1.21, 3.91, P = 0.048) were significant risk factors for failure of transobturator tape at the 1-year follow up. Conclusions, There are no significant differences in patient reported and objective cure rates between ,inside-out' and ,outside-in' transobturator tapes. Quality of life and sexual function significantly improved following surgery. Both previous incontinence surgery and preoperative urgency incontinence are associated with significantly lower patient-reported cure rates. [source]

How should peripheral neuropathy be assessed in people with diabetes in primary care?

DIABETIC MEDICINE, Issue 5 2003
A population-based comparison of four measures
Abstract Aims To test the accuracy of four measures of peripheral diabetic neuropathy in a primary care population. Methods Type 2 diabetic (n = 544) and 544 non-diabetic participants aged 45,76 years were randomly selected from general practice registers. Neuropathy was assessed using vibration threshold (VT) and scores for light touch, thermal sense and modified Michigan Neuropathy Screening Instrument questionnaire. These measures were assessed for variation with diabetes status, age, diabetes duration, HbA1c, and presence of retinopathy and nephropathy. Light touch, thermal sense and questionnaire scores were assessed against VT using ROC curve analysis. Results Only VT and light touch were different between diabetic and non-diabetic groups (P = 0.02 and < 0.0001, respectively). All measures were significantly associated with diabetes duration and retinopathy, and all except questionnaire score (P = 0.14) with age. None was associated with nephropathy and only questionnaire score was associated with HbA1c (P = 0.033). VT varied as expected across scores of light touch (,2 = 41.65, P = 0.0001), thermal sense (,2 = 15.86, P = 0.015) and questionnaire (,2 = 21.22, P = 0.047). Area under the curve values for light touch, thermal and questionnaire scores were 0.72 (95% confidence interval (CI) 0.63, 0.82), 0.63 (95% CI 0.52, 0.73) and 0.64 (95% CI 0.53, 0.74), respectively. Conclusions All measures had associations with risk factors for neuropathy, but light touch score (monofilament) had the strongest association with vibration threshold (the chosen gold standard) and thus appeared the most appropriate tool for use in primary care, because of its validity and simplicity of use. Diabet. Med. 20, 368,374 (2003) [source]

Adenotonsillar Hypertrophy and Epstein-Barr Virus in Pediatric Organ Transplant Recipients,

THE LARYNGOSCOPE, Issue 6 2001
Nina L. Shapiro MD
Abstract Objectives/Hypothesis Epstein-Barr virus,related (EBV-related) lymphoid hyperplasia of the tonsils and adenoids is a precursor to post-transplantation lymphoproliferative disorder (PTLD). The incidence of post-transplantation adenotonsillar hypertrophy, a potential early sign of PTLD or EBV-related lymphoid hyperplasia, is not known. We sought to identify potential risk factors for adenotonsillar hypertrophy manifested as EBV-related hyperplasia and early PTLD in the pediatric solid organ transplant population. Study Design Cross-sectional analysis. Methods We developed a 65-point questionnaire concerning obstructive sleep disorder and upper respiratory tract infections and an 8-point focused physical examination, to identify prevalence of and risk factors for adenotonsillar hypertrophy in the pediatric transplant population. We evaluated 120 pediatric solid organ transplant recipients by parental questionnaire and focused adenotonsillar physical examination. Results Of the 120 patients, 62 had undergone liver transplantation and 58 had undergone kidney transplantation. Overall, the mean questionnaire score was 8.36 (range, 0,40) and the mean physical examination score was 3.86 (range, 1,8). Patients whose EBV serological test result was negative at the time of transplant had higher scores for both the questionnaire (mean score, 10.24) and the physical examination (mean score, 4.56) than those whose EBV serological test result was positive at the time of transplantation (scores of 7.38 and 3.30 for questionnaire and physical examination, respectively). The difference in examination scores was statistically significant (P <.003). Conclusions Epstein-Barr virus seronegativity at the time of organ transplantation is a known risk factor for PTLD, with associated risk of developing EBV-related lymphoid hyperplasia. Our results indicate a higher incidence of symptoms and signs consistent with adenotonsillar hypertrophy in the EBV seronegative population. Adenotonsillar hypertrophy may be a precursor to EBV-related lymphoid hyperplasia and PTLD and must be identified in this patient population. [source]

Bortezomib is associated with better health-related quality of life than high-dose dexamethasone in patients with relapsed multiple myeloma: results from the APEX study

BRITISH JOURNAL OF HAEMATOLOGY, Issue 4 2008
Stephanie J. Lee
Summary Health-related quality of life (HRQL) was prospectively measured during the phase III APEX trial of bortezomib versus dexamethasone in relapsed multiple myeloma patients. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire , Core (QLQ-C30) and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group,Neurotoxicity (NTX) side-effects questionnaires were administered at baseline and every 6 weeks up to 42 weeks. Patients receiving bortezomib (1·3 mg/m2, days 1, 4, 8 and 11 for eight 3-week cycles, then days 1, 8, 15 and 22 for three 5-week cycles; n = 296) demonstrated significantly better mean Global Health Status over the study versus patients receiving dexamethasone (40 mg/d, days 1,4, 9,12, and 17,20 for four 5-week cycles, then days 1,4 only for five 4-week cycles; n = 302), plus significantly better physical health, role, cognitive, and emotional functioning scores, lower dyspnoea and sleep symptom scores, and better NTX questionnaire score, using multiple imputation to account for missing data. Results were similar using available-data analyses. Sensitivity analyses suggested that improved HRQL with bortezomib is at least partially explained by improved survival. These results show that bortezomib was associated with significantly better multidimensional HRQL compared with dexamethasone, consistent with the better clinical outcomes seen with bortezomib. [source]

How should peripheral neuropathy be assessed in people with diabetes in primary care?

Urodynamics, the supine empty bladder stress test, and incontinence severity,,§

NEUROUROLOGY AND URODYNAMICS, Issue 7 2010
Charles W. Nager
Abstract Aims Determine whether urodynamic measures of urethral function [(valsalva leak point pressure (VLPP), maximum urethral closure pressure (MUCP), functional urethral length (FUL)] and the results of the supine empty bladder stress test (SEBST) correlate with each other and with subjective and objective measures of urinary incontinence (UI). Methods Data were collected preoperatively from subjects enrolled in a multicenter surgical trial of mid-urethral slings. Subjective measures included questionnaire scores from the Medical Epidemiological and Social Aspects of Aging Questionnaire, Urogenital Distress Inventory, and Incontinence Impact Questionnaire. Objective measures included a 24-hr pad weight test, incontinence episode frequency on a 3-day voiding diary, and a SEBST. Results Five hundred ninety-seven women enrolled. Three hundred seventy-two women had valid VLPP values; 539 had valid MUCP/FUL values. Subjective measures of severity had weak to moderate correlation with each other (r,=,0.25,0.43) and with objective measures of severity (r,=,,0.06 to 0.45). VLPP and MUCP had moderate correlation with each other (r,=,0.36, ,<,0.001). Urodynamic measures of urethral function had little or no correlation with subjective or objective measures of severity. Subjects with a positive SEBST had more subjective and objective severity measures compared to the negative SEBST group, but they did not have significantly different VLPP and MUCP values. Conclusions VLPP and MUCP have moderate correlation with each other, but each had little or no correlation with subjective or objective measures of severity or with the results of the SEBST. This data suggests that the urodynamic measures of urethral function are not related to subjective or objective measures of UI severity. Neurourol. Urodynam. 29:1306,1311, 2010. © 2010 Wiley-Liss, Inc. [source]

Self- and maternal representations, relatedness patterns, and problem behavior in middle childhood

PERSONAL RELATIONSHIPS, Issue 2 2008
ARIELA WANIEL
The present study investigated the association between children's representations of their mothers' and teachers' reports of children's problem behavior. The research team conducted semistructured narrative interviews with a community sample of 203 Israeli 9- to 11-year-old children. Ten months later, researchers collected teachers' reports of children's internalizing and externalizing problems. This study investigated whether children's self-representation narratives and their maladaptive relatedness stances questionnaire scores mediated this association. Results indicated that children reporting benevolent representations of their mothers exhibited lower levels of problem behavior. More positive self-representations and lower levels of skewness in children's relatedness stances to their mothers both mediated this association. This article includes a discussion of these results in light of factors contributing to maladjustment in middle childhood. [source]

Short-Term Effects of a Health Promotion Course for Taiwanese Nursing Students

PUBLIC HEALTH NURSING, Issue 1 2005
Ya-Chu Hsiao
Abstract, The purposes of this study were to (a) develop a teaching course on health promotion for nursing students in Taiwan, (b) evaluate the effects of this teaching course, and (c) understand students' appraisals of its effectiveness in helping them to change unhealthy behavior. A sample of 65 randomly selected female nursing students took an 18-week course developed by the investigators, which included 30 h of classroom lectures and 4 weeks of written reports by students chronicling the changes in their behavior. Health promotion questionnaires administered before and after the course and content analysis of the students' reports were used to evaluate the effects of the course. Students' questionnaire scores after course completion indicated significantly increased intent to adopt healthy lifestyles. Content analysis of students' reports on their personal behavior-changing experiences showed that they accepted the potential value of curriculum aspects such as "experiencing the struggle, suffering, and even abandonment of the process,""experiencing the benefits of change,""increasing self-confidence," and "empathizing with how difficult it is for clients to change behavior." These results support the value of teaching courses on health promotion to nursing students. The authors recommend including such a course as part of a regular nursing education. [source]

Clomiphene Citrate and Testosterone Gel Replacement Therapy for Male Hypogonadism: Efficacy and Treatment Cost

THE JOURNAL OF SEXUAL MEDICINE, Issue 1pt1 2010
Frederick Taylor MD
ABSTRACT Introduction., The efficacy of oral clomiphene citrate (CC) in the treatment of male hypogonadism and male infertility (MI) with low serum testosterone and normal gonadotropin levels has been reported. Aim., The aim of this article is to evaluate CC and testosterone gel replacement therapy (TGRT) with regard to biochemical and clinical efficacy and cost. Main Outcome Measures., The main outcome measures were change in serum testosterone with CC and TGRT therapy, and change in the androgen deficiency in aging male (ADAM) questionnaire scores with CC therapy. Methods., Men receiving CC or TGRT with either Androgel® 1% or Testim® 1% for hypogonadism (defined as testosterone < 300 ng/mL) or MI were included. Serum values were collected 1,2 months after treatment initiation and semi-annually thereafter. Retrospective data collection was performed via chart review. Subjective follow up of patients receiving CC was performed via telephone interview using the ADAM questionnaire. Results., A hundred and four men (65 CC and 39 TGRT) were identified who began CC (50 mg every other day) or TGRT (5 g). Average age (years) was 42(CC) vs. 57 (TGRT). Average follow up was 23 months (CC, range 8,40 months) vs. 46 months (TGRT, range 6,149 months). Average posttreatment testosterone was 573 ng/dL in the CC group and 553 ng/dL in the TGRT group (P value < 0.001). The monthly cost of Testim® 1% (5 gm daily) is $270, Androgel® 1% (5 gm daily) is $265, and CC (50 mg every other day) is $83. Among CC patients, the average pretreatment ADAM score was 4.9 vs. 2.1 at follow up (P < 0.05). Average pretreatment ADAM sexual function domain score was 0.76 vs. 0.23 at follow up (P < 0.05). There were no adverse events reported. Conclusion., CC represents a treatment option for men with hypogonadism, demonstrating biochemical and clinical efficacy with few side effects and lower cost as compared with TGRT. Taylor F, and Levine L. Clomiphene citrate and testosterone gel replacement therapy for male hypogonadism: Efficacy and treatment cost. J Sex Med 2010;7:269,276. [source]

The development and standardization of the Children Activity Scales (ChAS-P/T) for the early identification of children with Developmental Coordination Disorders

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2006
S. Rosenblum
Abstract Background Previous studies have emphasized the importance of early identification of children with Developmental Coordination Disorder (DCD) to prevent the development of secondary academic, emotional and social manifestations of the disorder. The aim of this study was to develop a valid parent and teacher questionnaire , the Children Activity Scales for parents (ChAS-P) and for teachers (ChAS-T) , to identify children aged 4,8 years at risk for DCD and to examine the reliability and validity of these questionnaires. Methods The questionnaires' content and face validity were established, and then cut-off scores were determined based on responses of 355 teachers and 216 parents. Internal consistencies were also calculated. Factor analyses were performed, and construct validity was determined by examining the questionnaires' ability to discriminate between 30 children aged 5,6.5 years diagnosed with DCD and 30 typically developing children. Concurrent validity was examined by comparing questionnaire scores with those of the Movement Assessment Battery for Children (M-ABC). Results High values were obtained for internal consistency (0.96,0.94) for the ChAS-T and the ChAS-P respectively. Factor analysis revealed four distinct factors within the ChAS-P and three within the ChAS-T, reinforcing the theoretical validity of the items selected and appropriateness for identifying DCD. Construct validity was indicated by finding significant differences between the groups' scores on the ChAS-T and the ChAS-P. Significant correlations between the children's scores on the questionnaires and those of the M-ABC confirmed their concurrent validity. Conclusions Initial results suggest that the ChAS-T and Chas-P are reliable tools to identify children at risk for DCD. [source]