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Explorative Study (explorative + study)
Selected AbstractsDiabetic persons with foot ulcers and their perceptions of hyperbaric oxygen chamber therapyJOURNAL OF CLINICAL NURSING, Issue 14 2009Hjelm Katarina Aim., To elucidate how diabetic patients with limb-threatening foot lesions perceive and evaluate content and organisation of treatment in a multi-place hyperbaric oxygen chamber. Background., To our knowledge there are no patients' evaluations of diabetes care in a high-technology area like the hyperbaric oxygen chamber. The burden on persons with diabetic foot complications might be increased if adjuvant therapy with hyperbaric oxygen therapy (HBOT) within a locked airtight vessel is given. Design., Explorative study. Participants., Participants were included in the HODFU study, a prospective randomised double-blind study, designed to evaluate whether HBOT heals more chronic foot ulcers than placebo treatment with hyperbaric air. Six females and 13 males, aged 44,83 years (median 70), with diabetic foot ulcers, participated. Method., Focus-group interviews by an external evaluator. Results., Management was perceived as well-functioning with competent staff delivering quick treatment in a positive manner and in good co-operation. HBOT sessions, in groups, were described as unproblematic and pleasant, through sharing experiences with others, although time-consuming and tiring. Recognising the responsible physician and communication with other physicians in the health-care chain was perceived as problematic. Placebo treatment, when given, did not reveal any problems; many perceived HBOT as the last resort and respondents had a negative view of future health and expressed fears of new wounds and amputation. Conclusions and relevance to clinical practice., From patients' perspective HBOT in the delivered health-care model was perceived as well-functioning, taking into consideration both technical and relational aspects of care in this high-technology environment. Communication with the patient and between different care givers, with a consistent message given and information about who is responsible and to whom one should turn, wherever treated, is the most crucial aspect of the model. Future fears need to be recognised and group interaction can be encouraged to share the burden of disease. [source] Soil-solution speciation of CD as affected by soil characteristics in unpolluted and polluted soilsENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 3 2005Erik Meers Abstract Total metal content by itself is insufficient as a measure to indicate actual environmental risk. Understanding the mobility of heavy metals in the soil and their speciation in the soil solution is of great importance for accurately assessing environmental risks posed by these metals. In a first explorative study, the effects of general soil characteristics on Cd mobility were evaluated and expressed in the form of empirical formulations. The most important factors influencing mobility of Cd proved to be pH and total soil content. This may indicate that current legislation expressing the requirement for soil sanitation in Flanders (Belgium) as a function of total soil content, organic matter, and clay does not successfully reflect actual risks. Current legal frameworks focusing on total content, therefore, should be amended with criteria that are indicative of metal mobility and availability and are based on physicochemical soil properties. In addition, soil-solution speciation was performed using two independent software packages (Visual Minteq 2.23 and Windermere Humic Aqueous model VI [WHAM VI]). Both programs largely were in agreement in concern to Cd speciation in all 29 soils under study. Depending on soil type, free ion and the organically complexed forms were the most abundant species. Additional inorganic soluble species were sulfates and chlorides. Minor species in solution were in the form of nitrates, hydroxides, and carbonates, the relative importance of which was deemed insignificant in comparison to the four major species. [source] Incidence of shoulder pain after neck dissection: A clinical explorative study for risk factorsHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 11 2001Pieter U. Dijkstra PhD Abstract Background It is the purpose of this study to determine the incidence of shoulder pain and restricted range of motion of the shoulder after neck dissection, and to identify risk factors for the development of shoulder pain and restricted range of motion. Methods Clinical patients who underwent a neck dissection completed a questionnaire assessing shoulder pain. The intensity of pain was assessed using a visual analog scale (100 mm). Range of motion of the shoulder was measured. Information about reconstructive surgery and side and type of neck dissection was retrieved from the medical records. Results Of the patients (n = 177, mean age 60.3 years [SD, 11.9]) 70% experienced pain in the shoulder. Forward flexion and abduction of the operated side was severely reduced compared to the non-operated side, 21° and 47°, respectively. Non-selective neck dissection was a risk factor for the development of shoulder pain (9.6 mm) and a restricted shoulder abduction (55°). Reconstruction was risk factor for a restricted forward flexion of the shoulder (24.5°). Conclusions Shoulder pain after neck dissection is clinically present in 70% of the patients. Non-selective neck dissection is a risk factor for shoulder pain and a restricted abduction. Reconstruction is a risk factor for a restricted forward flexion of the shoulder. © 2001 John Wiley & Sons, Inc. Head Neck 23: 947,953, 2001. [source] Towards a multi-criteria approach for priority setting: an application to GhanaHEALTH ECONOMICS, Issue 7 2006Rob Baltussen Abstract Background: Many criteria have been proposed to guide priority setting in health, but their relative importance has not yet been determined in a way that allows a rank ordering of interventions. Methods: In an explorative study, a discrete choice experiment was carried out to determine the relative importance of different criteria in identifying priority interventions in Ghana. Thirty respondents chose between 12 pairs of scenarios that described interventions in terms of medical and non-medical criteria. Subsequently, a composite league table was constructed to rank order a set of interventions by mapping interventions on those criteria and considering the relative weights of different criteria. Results: Interventions that are cost-effective, reduce poverty, target severe diseases, or target the young had a higher probability of being chosen than others. The composite league table showed that high priority interventions in Ghana are prevention of mother to child transmission in HIV/AIDS control, and treatment of pneumonia and diarrhoea in childhood. Low priority interventions are certain interventions to control blood pressure, tobacco and alcohol abuse. The composite league table lead to a different and more differentiated rank ordering of interventions compared to pure efficiency ratings. Conclusion: This explorative study has introduced a multi-criteria approach to priority setting. It has shown the feasibility of accounting for efficiency, equity and other societal concerns in prioritization decisions, and its potentially large impact on priority setting. Copyright © 2006 John Wiley & Sons, Ltd. [source] Developing a relativities approach to valuing the prevention of non-fatal work-related accidents and ill healthHEALTH ECONOMICS, Issue 11 2005Jonathan Karnon Abstract The aim of the current explorative study is to define and test a process for the valuation of the benefits associated with the prevention of non-fatal work-related accidents and ill health. A relativities approach is adopted, and monetary values for the prevention of three forms of work-related illness are estimated. The approach involves describing relevant attributes of alternative events (accidents or occurrences of ill health), their causes, the characteristics of the relevant working population, and the number of events that are avoidable, and asking respondents to make pair wise choices between alternatives options for prevention. Indirect monetary valuations are obtained against a peg event for which a reliable valuation exists (road deaths). A series of discussion groups were held to identify relevant factors affecting potential valuations and to test the presentation of information. The predicted magnitude of responses for three-case study events (and road deaths) was estimated in a pilot study. These preliminary stages informed the final survey instrument that described five attributes in addition to a statement of the event and occupation, and the likely intervention effect, which was administered by post. Based on a small sample, the results show that virtually all respondents passed the inserted consistency test. The median respondent altered their choice according to the number of events avoided for all three comparisons, such that the estimated valuations appear sensible. Potential amendments are suggested, but the general relativities approach warrants further investigation for the valuation of non-fatal work-related accidents and ill health. Copyright © 2005 John Wiley & Sons, Ltd. [source] Altered skin blood perfusion in areas with non blanchable erythema: an explorative studyINTERNATIONAL WOUND JOURNAL, Issue 3 2006Margareta Lindgren Abstract Non blanchable erythema, i.e. stage I pressure ulcer, is common in patients in acute and geriatric care and in nursing homes. Research has shown that this type of lesions is prone to develop into more severe pressure ulcers. The peripheral skin blood perfusion is of major importance for the development of pressure ulcers. The aim of this study was to explore the peripheral skin blood perfusion over time, in areas with non blanchable erythema and in corresponding undamaged areas on the opposite side of the body. A total of 19 measurements were performed, over time, using a laser Doppler perfusion imager. The blood flow distribution profiles over areas with non blanchable erythema and undamaged skin were found to be different. As the area of the non blanchable erythema decreased, the blood perfusion distribution profiles gradually became more heterogeneous; an area of high blood perfusion in the centre of the lesions was seen and the perfusion successively decreased closer to the edge. These results indicate that there are differences in blood perfusion between skin areas of non blanchable erythema and undamaged skin. The results also indicate that the visible redness in areas with non blanchable erythema is related to altered blood perfusion. The skin blood perfusion also seems to increase in relation to the size of the non blanchable erythema. [source] Individual quality of life of people with severe mental disordersJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2009A. PITKÄNEN mnsc People with mental disorders have been found to suffer from impaired quality of life (QoL). Therefore, the assessment of QoL has become important in psychiatric research. This explorative study was carried out in acute psychiatric wards. Thirty-five patients diagnosed with schizophrenia and related psychosis were interviewed. QoL was rated by the Schedule for Evaluation of Individual Quality of Life which is a respondent-generated QoL measure using semi-structured interview technique. Patients named five areas of life important to them and then rated their current status and placed relative weight on each QoL area. The data were analysed with qualitative content analysis and descriptive statistics. The most frequently named areas for QoL were health, family, leisure activities, work/study and social relationships, which represented 72% of all QoL areas named. Patients' average satisfaction with these QoL areas ranged 49.0,69.1 (scale 0,100). The mean global QoL score was 61.5 (standard deviation 17.4; range 24.6,89.6; scale 0,100). Awareness of patients' perceptions of their QoL areas can enhance our understanding of an individual patient's QoL and reveal unsatisfactory areas where QoL could be improved with individually tailored needs-based interventions. [source] Cerebral state index response to incision: a clinical study in day-surgical patientsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2006R. E. Anderson Background:, Inadequate anaesthesia, with somatic/autonomic response or awareness, is often revealed at intubation and surgical incision. Anaesthetic depth monitors should be able to prevent this risk. This explorative study examined the ability of the cerebral state monitor to predict autonomic/somatic responses to incision. Methods:, Forty-two ASA I,II day-surgical patients [19 men and 23 females; mean age 52 (29,79) years, mean weight 77 (50,118) kg] were induced clinically with fentanyl/propofol with sevoflurane after placement of the laryngeal mask airway. The cerebral state index (CSIÔ) was blindly recorded 4 min prior to and 4 min after incision. Results:, During the 4 min prior to incision, the mean CSIÔ was 45 (16,62) and increased by 9 (,13,40) when the mean value for the first 4 min after incision was subtracted from the value prior to incision, corresponding to a relative change of 21% (,21,118). The change in CSIÔ did not show any consistent relation to the value before incision. Five patients showed minor movements after incision and six patients had > 25% increase in blood pressure. Neither CSIÔ nor the change in index differed between patients who did or did not respond somatically or autonomically to incision. The last CSIÔ value just prior to incision was 44 for non-responders and 40 and 42 for somatic and autonomic responders, respectively. Conclusion:, The CSIÔ in the majority of patients was within acceptable ranges during clinically adjusted anaesthesia prior to incision but seems not to be able to reliably predict an autonomic or somatic response to incision. [source] Travel Insurance Claims Made by Travelers from AustraliaJOURNAL OF TRAVEL MEDICINE, Issue 2 2002Peter A. Leggat Background: Little is known about travel insurance claims made by travelers returning from abroad. This study was designed to investigate travel insurance claims made by travelers from Australia, particularly examining demographic factors, type of travel insurance coverage, nature and duration of travel, when treatment was sought during travel or when the problem arose, use of emergency assistance, nature of claim, and claim outcome, including cost. Methods: A random sample of approximately one in five claims reported during the period 1996 to 1998 to a major Australian travel insurance company were examined. Results: A total of 855 claims were examined, of which 42.6% (356/836) were made by male travelers and 57.1% (477/836) were made by female travelers. The majority of claimants were in the 55 years and over age groups (445/836, 53.2%). Medical and dental conditions accounted for 66.6% of claims (569/854), with the remainder associated with loss, theft, and damage (285/854, 33.4%). The most common medical conditions were respiratory (110/539, 20.4%), musculoskeletal (90/539, 16.7%), gastrointestinal (75/539, 13.9%), ear, nose, and throat (67/539, 12.4%), and dental conditions (39/539, 7.2%). Only one case of venous thrombosis was reported, secondary to a lower limb infection. Use of the travel insurance company's emergency telephone service was reported in 17.1% of claims (146/853). Almost two-thirds (559/853, 65.5%) of claims were fully accepted. Those who claimed medical treatment, assault, and theft were significantly more likely to have their claims accepted compared to those claiming dental conditions, cancellation, curtailment, loss and damage (,2= 127.78, df = 40, p < .00001). The majority of medical and dental conditions did not require further medical investigations (427/569, 75.0%). The mean cost of claim refunds was Australian dollars (AUD)991.31 (standard deviation [SD] ± AUD5400.76) for males and AUD508.90 (SD ± AUD1446.10) for females. Claims for assault, cancellation, and curtailment were significantly more expensive than other types of claims (Kruskal-Wallis one way analysis of variance [ANOVA]; ,2= 106.87, df = 8, p < .00001). Claims for treatment of gastrointestinal, cerebrovascular, cardiovascular, musculoskeletal conditions, and pyrexias of unknown origin were significantly more expensive than other medical and dental claims (Kruskal-Wallis one way ANOVA; ,2= 61.68, df = 15, p < .00001). Conclusions: This explorative study highlights the importance of travelers taking out appropriate travel insurance. Claims for medical and dental conditions represent the majority of travel insurance claims made by Australian travelers returning from abroad, although travel insurance also covers against such contingencies as loss, theft, and cancellation. The most common medical conditions claimed were respiratory, musculoskeletal, and gastrointestinal disorders. Travelers should be advised to take out appropriate travel insurance before departure overseas and to take care with preexisting medical and dental conditions, which may not be able to be claimed against travel insurance. [source] How multiple external representations are used and how they can be made more usefulAPPLIED COGNITIVE PSYCHOLOGY, Issue 9 2009Rolf Schwonke In two studies, students' difficulties in using multiple external representations were effectively addressed. In a first explorative study (N,=,16), we investigated the allocation of visual attention (as assessed by gaze data) on external representations, its relation to learning and learners' beliefs on the representations' functions. Results confirmed that students were not aware of the functions. In a subsequent experiment (N,=,30), we analysed effects of informing students about the function of diagrams in worked examples on learning, mediating effects of visual attention and moderating effects of prior knowledge. The instruction had strong effects on learning, which were partially mediated by visual attention. Prior knowledge moderated both, the effects of the instruction on visual attention and of visual attention on learning. Implications for research into multiple representations and instructional design are discussed. Copyright © 2008 John Wiley & Sons, Ltd. [source] Skin-to-skin contact of fullterm infants: an explorative study of promoting and hindering factors in two Nordic childbirth settingsACTA PAEDIATRICA, Issue 7 2010E Calais Abstract Aim:, To explore factors that promote or hinder skin-to-skin contact (SSC) during the first days after birth between parents and healthy fullterm infants. Methods:, A total of 117 postnatal mothers and 107 fathers/partners attending two childbirth settings, where Kangaroo mother care (KMC) was implemented as a standard routine of care, one in Sweden and one in Norway, were recruited consecutively and answered questionnaires two weeks postpartum. Results:, Satisfaction with support for SSC in postnatal care and being a mother in the Swedish setting was found to promote SSC during the first day postpartum; previous knowledge about SSC increased the practice also during the 2nd and 3rd days. Receiving visitors apart from partner and siblings emerged as a hindering factor. SSC was known of and practised to a larger extent in the Swedish setting, whereas parents in the Norwegian setting received more visitors and were more satisfied with the received information and support for SSC in postnatal care. Conclusions:, The results highlight the need for caregivers to give parents adequate support for practising SSC with their newborn healthy fullterm infants and indicate the importance of developing information routines during the antenatal period as well as in relation to the birth of the child, to effectively introduce and implement SSC. [source] | ||||||||||