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The undergraduate medical curriculum has been modified or even totally reorganized in many countries in recent years, and there are plans to make departmental budgets and the salaries of university professors partially dependent on the outcome of teaching. Questionnaires are often used in such situations as a means of curriculum evaluation. Based on our own experience such evaluations should be done not only during and immediately after a course in the curriculum, but also at later time points, e.g., at the end of the undergraduate and also the postgraduate phase. The clinical relevance of lectures and courses can only be graded adequately after some years of clinical experience. Gross anatomy was graded top at all time points evaluated and reached higher levels of 'clinical relevance' than other typical preclinical and even clinical subjects. Efforts should be made to obtain a high response rate for representative results. After modifying parts of a course detailed questionnaires should also include space for students' suggestions. The results of such evaluations are not only relevant to the head of department as feedback on the individual lecturers but also important for the curriculum committee and the dean. Anatomists should utilize these evaluations to improve teaching. PMID:11880942
BACKGROUND: This study examined the longitudinal stability of students' perceptions by comparing ratings on similar survey items in three sequential evaluations: end-of-clerkship (EOC), AAMC graduation questionnaire (GQ), and a postgraduate survey (PGY1).\\u000aMETHOD: For the classes of 2000 and 2001, ratings were compiled from EOC evaluations and comparable items from the GQ. For both cohorts, selected GQ items were included
Michele P. Pugnaire; Mary L. Zanetti; Michele M. Carlin
The purpose of this study was to identify the level of awareness among undergraduate students regarding medical informatics and to ascertain whether educational training has progressed with time in the Department of Health Sciences at Hirosaki University, Japan, which is a co-medical staff training institution that conducts a 4-year university course in medical informatics. The university accepts students who have completed the 3rd grade of medical licensing tests and who have attended the medical informatics lectures for 4 years (2007-2010). The ratio of first sight terminology percentage in any given fiscal year in all the 30 terminology categories varied widely from 0% to 80%, but the trend in various categories did not vary between fiscal years. The terminology of informatics under medical technology students obtained high scores of 52.5-77.3% after attending courses, which was higher compared with students from other classes. On the other hand, student nurses and occupational therapy students obtained 0-44.2%. Each class scored a high percentage of correct answers in the medical information-related terminology. Among the radiology students who attended the classes, the percentage of correct answers in categories of "digital imaging and communication in medicine" and "picture archiving and communication system" were lower than other medical terminology categories. These results reflect the gaps in educational curriculum of 1st and 2nd grades of medical licensing tests. PMID:23358336
High burnout levels have been observed in medical residents. The purpose of this study is to assess the burnout rates and potential determinants of burnout in a sample of medical residents. In total, 58 medical residents working in a Dutch teaching hospital, received questionnaires at home, including the Maslach Burnout Inventory (MBI). In addition, they were asked for an in-depth
Rik Ringrose; Saskia Houterman; Willem Koops; Guid Oei
This study aims to develop an assessment tool to evaluate multilingual questionnaires by categorizing the types of translation issues that can lead to measurement errors in crosscultural surveys. Based on the results of two multilingual projects that cogn...
|Reports on two studies investigating the utility of the Leeds Dependence Questionnaire (LDQ), which was developed to provide a brief evaluation instrument in drug abuse treatment centers. Results from both studies reveal that the LDQ possesses good internal consistency and reliability. (Author/GCP)|
Due to increasing pressures to document the effectiveness of educational programs, a project was undertaken to develop impact indicators and accompanying evaluationquestionnaires for four of seven Dietary Guidelines for Americans. The results of field testing a 12-item knowledge and 16-item behavior change evaluationquestionnaire for the “healthy weight” dietary guideline are presented. A pre-, post-, and 3- to 6-month
Linda S. Boeckner; Jacquelyn W. McClelland; Patricia Britten; Karen Chapman-Novakofski; David Mustian; Charles D. Clark; Kathryn S. Keim
BACKGROUND: The 14-item Treatment Satisfaction Questionnaire for Medication (TSQM) Version 1.4 is a reliable and valid instrument to assess patients' satisfaction with medication, providing scores on four scales – side effects, effectiveness, convenience and global satisfaction. In naturalistic studies, administering the TSQM with the side effects domain could provoke the physician to assess the presence or absence of adverse events
Murtuza Bharmal; Krista Payne; Mark J Atkinson; Marie-Pierre Desrosiers; Donald E Morisky; Eric Gemmen
Background There is no widely accepted objective evaluation for lumbar spine disorders. New outcome measures should be patient-oriented\\u000a and should measure symptoms and self-reported functional status in multiple dimensions. The aim of this study was to identify\\u000a items to be included in the disease-specific quality of life (QOL) questionnaire for the assessments of patients with lumbar\\u000a spine disorders.\\u000a \\u000a \\u000a \\u000a Methods The draft of
Surgical outcome can be optimized by anticipation and prevention of medical complications. General considerations that apply to all patients include evaluation for coagulation disorders, prior anesthetic complications and drug history. Evaluation for organ-specific risk factors allows identification of patients at high surgical risk, minimization of risk and anticipation of postoperative complications. Review of the recent literature and a practical guide to therapy is presented for the major medical considerations before surgical procedures: cardiac disease, hypertension, pulmonary disease, endocrine considerations and hepatic disease. Attention to these areas and communication among internists, anesthesiologists and surgeons should provide optimal treatment of surgical patients with medical disease.
Elliot, Diane L.; Linz, Douglas H.; Kane, Joseph A.
The number of physicians engaged in basic sciences and teaching is sharply decreasing in Japan. To alleviate this shortage, central government has increased the quota of medical students entering the field. This study investigated medical students' interest in basic sciences in efforts to recruit talent. A questionnaire distributed to 501 medical students in years 2 to 6 of Juntendo University School of Medicine inquired about sex, grade, interest in basic sciences, interest in research, career path as a basic science physician, faculties' efforts to encourage students to conduct research, increases in the number of lectures, and practical training sessions on research. Associations between interest in basic sciences and other variables were examined using ?(2) tests. From among the 269 medical students (171 female) who returned the questionnaire (response rate 53.7%), 24.5% of respondents were interested in basic sciences and half of them considered basic sciences as their future career. Obstacles to this career were their original aim to become a clinician and concerns about salary. Medical students who were likely to be interested in basic sciences were fifth- and sixth-year students, were interested in research, considered basic sciences as their future career, considered faculties were making efforts to encourage medical students to conduct research, and wanted more research-related lectures. Improving physicians' salaries in basic sciences is important for securing talent. Moreover, offering continuous opportunities for medical students to experience research and encouraging advanced-year students during and after bedside learning to engage in basic sciences are important for recruiting talent. PMID:23337622
As user experience studies move from laboratories to mobile context, we need tools for collecting data in natural settings. Based on the results from a pilot study, we present early guidelines for designing mobile questionnaires to be filled in on handheld, palm-sized mobile devices. We found that special attention needs to be paid to the clarity and simplicity of the
Which of the tort reforms enacted during the mid-1970s to alleviate the medical malpractice litigation crisis have succeeded? Under some circumstances, the frequency and disposition of claims may indicate how reforms affected key policy variables such as the number of injuries and costs of litigation. But potential pitfalls exist in using claims data to evaluate tort reforms. In this paper,
Questionnaires are often used to understand the quality of life of patients, treatment and disease burden and to obtain their feedback on the provided health care. However, a common problem with questionnaires is missing data. Some level of missing data is common and unavoidable. For example, patients may elect to leave one or more items unanswered either inadvertently or because
Justin Dauwels; Lalit Garg; Arul Earnest; Leong Khai Pang
OBJECTIVE--To review current knowledge of the effectiveness of medical audit programmes as a whole and of specific interventions within these programmes, as a means of changing clinical behaviour. CRITERIA FOR INCLUSION AND EXCLUSION OF PUBLISHED REPORTS--Articles listed on Medline from 1985-92 with key words "quality assurance" or "medical audit", and "evaluation" and relevant references from these articles, and from recently published reviews and reports on medical audit, were included. Excluded were simple descriptions of audit activity, replications of previous work, and publication in a language other than English. RESULTS--Evaluation of entire programmes of medical audit is unusual. Most reports concern specific interventions and focus particularly on the scientific and technical aspects of quality. These interventions may be classified by the means through which they attempt to achieve desired changes: patient characteristics; physician characteristics; administrative and organisational structures; and financial incentives. CONCLUSIONS--Knowledge about effective methods of bringing about specific changes in clinical behaviour is rudimentary. Impact is highly dependent on local factors, so generalisation of results to other settings is difficult. More qualitative research is needed to define the local factors which influence results.
EMS Administrators may sometimes determine a need to go beyond the evaluative requirements of the federal government in order to assess the impact of special programs which they have initiated. To facilitate the evaluation of a program or service, questio...
Objectives To evaluate the appropriateness of proton pump inhibitor (PPI) prescribing by conducting an audit of medical inpatients against recommended guidelines. Design Questionnaire-based study. All medical wards were audited and different information was documented by patients' medical records review (both hospital visit notes and general practitioner's letters) and short interview, where we asked them to name the clinical reason for using PPI. Setting This study was carried out in the setting of a regional hospital (537-bed, secondary care referral centre) in Ireland. Participants The study participants were all consecutive medical patients admitted to the medical wards at Waterford Regional Hospital, Waterford. Main outcome measures The appropriateness of PPI usage in our regional hospital by assessing the level of its prescribing against published guidelines (NICE, 2000). Results During the audit period, 205 consecutive medical inpatients were assessed. Seventy-nine percent (162 out of 205) of the studied patients were found to be using PPI. For 45% (n = 73) of patients, there was no documentation of valid indication for being on PPI. Overall, 64% of patients were prescribed PPI by hospital doctors, either during their current or previous admissions. We noted that 31% (n = 51) of patients were taking PPI for ?2 years and another 25% of patients were using PPI for about one year. Only 12% (n = 20) of patients had undergone endoscopy procedures. Conclusion Inappropriate use of PPI remains common in hospital practice. The risks of using long-term PPI must be weighed against the benefits.
Haroon, Muhammad; Yasin, Faiza; Gardezi, Syed K M; Adeeb, Fahd; Walker, Frank
|This paper discusses the importance of criteria in the evaluation of a teacher by his students and proposes a method of representing the results of the questionnaire in the form of one weighted average. The following points, emphasized in the construction of the questionnaire, are elaborated: a) the characteristics of a good teacher; b) the…
EMS Administrators may sometimes determine a need to go beyond the evaluative requirements of the federal government in order to assess the impact of the federal government in order to assess the impact of special programs which they have initiated. To fa...
The increased complexity of medical technology makes usability an important selection criterion when new equipment is purchased. However, this requires an understanding of what usability is in a medical technology context and what usability evaluation methods are suitable. A questionnaire was used to investigate what users of medical technology regard as the largest component of usability. The component ‘difficult to
The use of modern information technology (IT) offers tremendous opportunities such as reducing clinical errors and supporting health care professionals in providing care. Evaluation of user satisfaction is often seen as a surrogate for the success of an information systems. We will present the evaluation of a report writing system at the Innsbruck University Medical Center based on a standardized, validated psychometric questionnaire. The results show high reliability and validity of the questionnaire. They also show some interesting differences in user satisfaction between departments, due to differences in working processes and preconditions. Psychometric questionnaires can be seen as a reliable and valid method to measure certain psychological constructs. Their development requires, however, methodological rigour and sufficient time. Psychometric questionnaires allow only a limited interaction between researcher and user, their results may be very dependant on the time of measurement, and their interpretation often needs external knowledge. Those limitations have to be taken into account when preparing evaluation studies. PMID:14664060
Ammenwerth, Elske; Kaiser, Frieda; Wilhelmy, Immanuel; Höfer, Stefan
|Course evaluation is integral to medical education. We discuss (1) distinctive features of medical education that impact on course evaluation, (2) a framework for course evaluations, (3) details that shape the evaluation process, (4) key measurement issues important to data gathering and interpretation, and (5) opportunities for expanding the…
Course evaluation is integral to medical education. We discuss (1) distinctive features of medical education that impact on course evaluation, (2) a framework for course evaluations, (3) details that shape the evaluation process, (4) key measurement issues important to data gathering and interpretation, and (5) opportunities for expanding the…
The construct validity of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire was evaluated by examining its correlation to the Medical Outcomes Study Short Form-36 (SF-36). The study sample was 90 patients seen at the upper-extremity clinic of a university-based orthopedic practice. Patients were asked to complete a packet that included the DASH and SF-36 questionnaires. Pearson correlation coefficients of the DASH questionnaire to the SF-36 subscales ranged from -0.36 to -0.62. The DASH questionnaire had fewer ceiling and floor scores than most of the SF-36 subscales. These results support the DASH questionnaire as a valid measure of health status useful in patients with a wide variety of upper-extremity complaints. PMID:12015732
SooHoo, Nelson Fong; McDonald, Allen P; Seiler, John Gray; McGillivary, Gary R
The aim of this study was to determine the reliability, validity, and sensitivity of the Patient-rated Tennis Elbow Evaluation (PRTEE) Questionnaire in 78 tennis playing subjects who had chronic, unilateral, MRI-confirmed lateral elbow tendinopathy and who concomitantly participated in an outcome study. The PRTEE results were compared with results of the Visual Analog Scale (VAS); the Disabilities of the Arm,
Background Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. Methods A questionnaire, founded on the Minnesota Innovation Survey (MIS), was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. Results The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. Conclusions The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.
BACKGROUND: The objective of this study was to develop and psychometrically evaluate a general measure of patients' satisfaction with medication, the Treatment Satisfaction Questionnaire for Medication (TSQM). METHODS: The content and format of 55 initial questions were based on a formal conceptual framework, an extensive literature review, and the input from three patient focus groups. Patient interviews were used to
Mark J Atkinson; Anusha Sinha; Steven L Hass; Shoshana S Colman; Ritesh N Kumar; Meryl Brod; Clayton R Rowland
In many chronic diseases, objective gold standard measures such as blood pressure, cholesterol, and bone densitometry often provide most of the information used to establish a diagnosis and guide therapy. By contrast, in inflammatory rheumatic diseases, information from a patient history usually is considerably more prominent in clinical management. Patient history data can be recorded as standardized, quantitative scientific data through use of validated self-reported questionnaires. Patient questionnaires address the primary concerns of patients and their families. Questionnaire scores distinguish active from control treatments in clinical trials at similar levels to swollen and tender joint counts or laboratory tests. Patient questionnaire data are correlated significantly with joint counts, radiographic scores, and laboratory tests, but usually are far more significant than these measures in the prognosis of severe outcomes of rheumatoid arthritis (RA), including work disability, costs, and premature death. Limitations of patient questionnaires are based on cultural features involving variation in responses among ethnic groups, and a need for translation, although translated questionnaires can be as valuable as a translator. Patient questionnaires do not replace further medical history, physical examination, laboratory tests, and imaging data, and they require interpretation in a context of these standard sources of information at any clinical encounter. Patient questionnaires are useful to monitor patient status in usual clinical care, with almost no effort on the part of the physician and staff if distributed by the receptionist in the infrastructure of office practice. PMID:19962618
Pincus, Theodore; Yazici, Yusuf; Bergman, Martin J
The primary objective of this review was to identify and examine the literature on the association between medication adherence self-reported questionnaires (SRQs) and medication monitoring devices. The primary literature search was performed for 1980-2009 using PubMed, PubMed In Process and Non-Indexed, Ovid MEDLINE, Ovid MEDLINE In-Process, PsycINFO (EBSCO), CINAHL (EBSCO), Ovid HealthStar, EMBASE (Elsevier) and Cochrane Databases and using the
BACKGROUND: Drug abuse is hazardous and known to be prevalent among young adults, warranting efforts to increase awareness about harmful effects and to change attitudes. This study was conducted to assess the perceptions of a group of medical students from Pakistan, a predominantly Muslim country, regarding four drugs namely heroin, charas, benzodiazepines and alcohol. RESULTS: In total, 174 self-reported questionnaires
Majid Shafiq; Zaman Shah; Ayesha Saleem; Maham T Siddiqi; Kashif S Shaikh; Farah F Salahuddin; Rizwan Siwani; Haider Naqvi
The importance of academic advising has been established in part by its designation as an element in the American Association of Colleges of Nursing's Standards for Accreditation. In addition, academic advising plays an essential role in students' development, academic success, satisfaction, recruitment, and retention; therefore, access to valid and reliable evaluation tools is of considerable importance. The purpose of this study was to develop and pilot test the Faculty Advisor EvaluationQuestionnaire (FAEQ), which is an instrument developed from qualitative nursing research. The psychometric properties were explored using face and content validity, internal consistency reliability, and principle components factor analysis. The four-factor solution of the resulting 30-item questionnaire accounted for 81% of the variability. Cronbach's alpha values of the four factors ranged from 0.885 to 0.974. The FAEQ should elicit valid and reliable results, although further testing is needed to validate the findings in a larger and more diverse sample. PMID:22201275
Objectives: To determine what behaviors patients perceive as reflecting a physician’s humanistic qualities, to develop an instrument\\u000a for patients to use to assess the humanistic behaviors of their own physicians, and to compare patient assessment of residents’\\u000a humanistic behaviors with patient satisfaction and the assessment of attending physicians.\\u000a \\u000a \\u000a Design: Cross-sectional descriptive study, using patient interviews and questionnaires, and evaluations of
Michael J. Weaver; Cathy L. Ow; Debra J. Walker; Ernest F. Degenhardt
In the past, child bedtime routines have been examined through observation or sleep diaries. These methods are often expensive\\u000a and hinder study comparisons due to lack of consistent operational definitions of routines. This article describes the development\\u000a and psychometric evaluation of the Bedtime Routines Questionnaire (BRQ), a 31-item paper-and-pencil, parent-report measure\\u000a of children’s bedtime routines. The BRQ and related measures
We have developed and evaluated a self-administered questionnaire of knowledge about human immunodeficiency virus (HIV) infection for use in program evaluation. Formative work led to the development of the 62-item HIV-Knowledge Questionnaire (HIV-K-Q), which was administered to 409 women and 227 men. Item analyses resulted in the deletion of 17 items that were either too easy or did not correlate
Michael P. Carey; Dianne Morrison-Beedy; Blair T. Johnson
Given the rise of prescription stimulant misuse, examination of effect expectancies could prove helpful. The Prescription Stimulant Expectancy Questionnaire (PSEQ) was designed to explore positive and negative prescription stimulant-related expectancies. In 2006, 157 participants nationwide completed an Internet survey of prescription stimulant use, attention-deficit/hyperactivity disorder symptoms, and expectancies. Multiple regressions demonstrate that positive, but not negative expectancies, predicted frequency of use. Recreational and medical users were classified by hierarchical cluster analysis. Recreational users reported fewer positive and negative expectancies than medical users. Implications and limitations are discussed. Future research is warranted on prescription stimulant expectancies and the utility of the PSEQ. PMID:19938932
Study aims were to describe the development and validation of a Pediatric Epilepsy Medication Self-Management Questionnaire (PEMSQ) for caregivers of children 2-14years. It was expected that PEMSQ scales would have 1) factors with high internal consistency (e.g., Cronbach's alpha>0.70) and 2) moderate associations with adherence and seizures. Participants included caregivers of 119 children with epilepsy (Mage=7.2yrs, 36% female, 72% Caucasian)
Avani C. Modi; Sally Monahan; Dee Daniels; Tracy A. Glauser
The purpose of this investigation was to apply a validated curriculum evaluation instrument, the Science Curriculum Implementation Questionnaire (SCIQ), in an educational context in which a science curriculum review had recently been completed and, by so doing, ascertain the accuracy and potential value of the instrument as a curriculum delivery evaluative tool. The study begins by exploring the themes generated from an extensive case study attempting to identify the broad and complex factors influencing science program delivery at a large urban intermediate (Years 7 and 8) school in New Zealand. Following this, the results of the subsequent application of the SCIQ in the case study school are discussed. Responses to the SCIQ reaffirmed the themes identified in the case study and, by way of standard deviation analysis, gave a similar description of the variability in the staff perceptions pertaining to the factors influencing science program delivery. Limitations and recent practical applications of the SCIQ are also discussed.
The intention of this research project was to bridge the gap between social science research and application to the environmental domain through the development of a theoretically derived instrument designed to give educators a template by which to evaluate environmental education curricula. The theoretical base for instrument development was provided by several developmental theories such as Piaget's theory of cognitive development, Developmental Systems Theory, Life-span Perspective, as well as curriculum research within the area of environmental education. This theoretical base fueled the generation of a list of components which were then translated into a questionnaire with specific questions relevant to the environmental education domain. The specific research question for this project is: Can a valid assessment instrument based largely on human development and education theory be developed that reliably discriminates high, moderate, and low quality in environmental education curricula? The types of analyses conducted to answer this question were interrater reliability (percent agreement, Cohen's Kappa coefficient, Pearson's Product-Moment correlation coefficient), test-retest reliability (percent agreement, correlation), and criterion-related validity (correlation). Face validity and content validity were also assessed through thorough reviews. Overall results indicate that 29% of the questions on the questionnaire demonstrated a high level of interrater reliability and 43% of the questions demonstrated a moderate level of interrater reliability. Seventy-one percent of the questions demonstrated a high test-retest reliability and 5% a moderate level. Fifty-five percent of the questions on the questionnaire were reliable (high or moderate) both across time and raters. Only eight questions (8%) did not show either interrater or test-retest reliability. The global overall rating of high, medium, or low quality was reliable across both coders and time, indicating that the questionnaire can discriminate differences in quality of environmental education curricula. Of the 35 curricula evaluated, 6 were high quality, 14 were medium quality and 15 were low quality. The criterion-related validity of the instrument is at current time unable to be established due to the lack of comparable measures or a concretely usable set of multidisciplinary standards. Face and content validity were sufficiently demonstrated.
Purpose. To investigate the correlation between single limb support (SLS) phase (% of gait cycle) and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) questionnaire and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 Health Survey) in patients with knee osteoarthritis (OA). Method. A prospective observational study was employed with 125 adults with bilateral medial compartment symptomatic knee OA who underwent a physical and radiographic evaluation. Velocity, step length and SLS were assessed by a computerised mat (GAITRite). Patients completed the WOMAC and SF-36 Health Survey questionnaires. Results. Statistical analysis examined the correlations between SLS and both questionnaires, between Kellgren & Lawrence (K&L) scores and both questionnaires and between SLS correlations and K&L correlations. We found significantly stronger correlations between SLS and WOMAC-pain, WOMAC-function, the SF-36 pain sub-category, velocity and step length than between K&L scores and these parameters (Pearson's r— 0.50 vs. 0.26, 0.53 vs. 0.34, 0.50 vs. 023, 0.81 vs. 0.33, 0.77 vs. 0.37, respectively; all p 5 0.05). Significant differences in SLS were found over WOMAC-pain, WOMAC-function and SF-36 overall score quartiles (p 5 0.05 for all). Conclusion. We recommend integrating SLS as an objective parameter in the comprehensive evaluation of patients with knee OA.
Objective: The aim of this study was to determine the prevalence of needlestick injury (NSI) and the factors associated with it among medical and dental students in Kerman province during the 2006 year. Materials and Methods: A cross-sectional study was conducted among 269 medical and dental students to evaluate NSIs and practices regarding the protective strategies. These students were asked
Background Several studies from other countries have shown that bullying, harassment, abuse or belittlement are a regular phenomenon faced not only by medical students, but also junior doctors, doctors undertaking research and other healthcare professionals. While research has been carried out on bullying experienced by psychiatrists and psychiatry trainees in Pakistan no such research has been conducted on medical students in this country. Methodology/Principal Findings We conducted a cross-sectional questionnaire survey on final year medical students in six medical colleges of Pakistan. The response rate was 63%. Fifty-two percent of respondents reported that they had faced bullying or harassment during their medical education, about 28% of them experiencing it once a month or even more frequently. The overwhelming form of bullying had been verbal abuse (57%), while consultants were the most frequent (46%) perpetrators. Students who were slightly older, males, those who reported that their medical college did not have a policy on bullying or harassment, and those who felt that adequate support was not in place at their medical college for bullied individuals, were significantly more likely to have experienced bullying. Conclusion Bullying or harassment is faced by quite a large proportion of medical students in Pakistan. The most frequent perpetrators of this bullying are consultants. Adoption of a policy against bullying and harassment by medical colleges, and providing avenues of support for students who have been bullied may help reduce this phenomenon, as the presence of these two was associated with decreased likelihood of students reporting having being bullied.
|This article uses the case of designing a new course questionnaire to discuss the issues of validity, reliability and diagnostic power in good questionnaire design. Validity is often not well addressed in course questionnaire design as there are no straightforward tests that can be applied to an individual instrument. The authors propose the…
1. Medical audit is a philosophy in the field of medical science which has reached to an advanced stage of practice in Western World, but yet to reach and percolate into Indian medical community. 2. Of late, community is getting increasingly aware of its health rights, gradually community participation in health matters including quantum and quality of case, has started increasing. Thus community leaders have started demanding for quality of medical care and accountability of those, responsible for delivery of medical care at various levels. 3. Medical audit or Evaluation of medical care is an answer to ensure the quality of care. But there are misgivings and distrust about medical audit due to its terminology. 4. There is need to education the medical, nursing and paramedical staff regarding medical audit and its sole purpose of self education and improvement of patient care activity. The present paper spells out fundamentals of medical audit, its scope and limitations. PMID:10130922
Introduction: Physiological, anthropometrical and thermal perceptual are the most important factors affecting thermoregulation of men and women in workplaces. The purpose of this study was determining the validity of a questionnaire method for assessing women's heat strain in workplaces. Methods: This cross-sectional study was carried out on 96 healthy women. Data were continuously collected over a period of 3 months (July-September) in 2012. Mean ± (SD) of age was found to be 31.5 ± 7.48 years, of height 1.61 ± 0.05 m, of weight 61.55 ± 10.35 kg, and of body mass index 23.52 ± 3.75 kg/m2 in different workplaces. Heart rate and oral temperature were measured by heart rate monitoring and a medical digital thermometer, respectively. Subjects completed a draft questionnaire about the effective factors in the onset of heat strain. After collecting the questionnaires, the data were analyzed by applying Cronbach’sa calculation, factor analysis method, Pearson correlation and receiver operator characteristic curves using the SPSS 18 software. Results: The value for Cronbach's ? was found to be 0.68. The factor analysis method on items of draft questionnaire extracted three subscale (16 variables) which they explained 63.6% of the variance. According to the results of receiver operator characteristic curve analysis, the cut-off questionnaire score for separating people with heat strain from people with no heat strain was obtained to be 17. Conclusions: The results of this research indicated that this quantitative questionnaire has an acceptable reliability and validity, and a cut-off point. Therefore it could be used in the preliminary screening of heat strain in women in warm workplaces, when other heat stress evaluation methods are not available.
Dehghan, Habibollah; Habibi, Ehsanollah; Habibi, Peymaneh; Maracy, Mohammad Reza
|Since 2003, the Essential Skills Series training program developed by the Canadian Evaluation Society has been offered to more than 15 groups in the province of Quebec. The evaluations of these workshops were based on the participants' reactions collected by a Participant Feedback Questionnaire. This article describes the process used to assess…
Evaluating interactive question answering (QA) systems with real users can be challenging because traditional evaluation measures based on the relevance of items returned are difficult to employ since relevance judgments can be unstable in multi-user evaluations. The work reported in this paper evaluates, in distinguishing among a set of interactive QA systems, the effectiveness of three questionnaires: a Cognitive Workload Questionnaire (NASA TLX), and Task and System Questionnaires customized to a specific interactive QA application. These Questionnaires were evaluated with four systems, seven analysts, and eight scenarios during a 2-week workshop. Overall, results demonstrate that all three Questionnaires are effective at distinguishing among systems, with the Task Questionnaire being the most sensitive. Results also provide initial support for the validity and reliability of the Questionnaires.
Kelly, Diane; Kantor, Paul B.; Morse, Emile; Scholtz, Jean; Sun, Y.
Lecture evaluationquestionnaires have been carried out to students because they are the suitable ways to improve the classes. Though the purpose of lecture evaluationquestionnaires is to confirm whether it has fulfilled faculties' responsibility or not, we consider that our lectures should be evaluated from the three viewpoints, namely, by the students, the academic staffs and the society members. We proposed successfully the lecture evaluationquestionnaire items desired by the society members that are alumni of our faculty.
This paper aims to use the theory of service quality evaluation and the method of mathematical statistics, initially establishes a medical service evaluation index system based on the archival research, experts consultation and patients communication. According to the prepared index system, the authors use questionnaire survey method to explore the major considered factors when patients evaluate the medical service quality,
Expectancies influence the initiation and maintenance of substance use. Given the increasing literature devoted to the rise of prescription stimulant misuse, an examination of expectancy effects associated with prescription stimulant use appears warranted. This study employed a revised version of the Prescription Stimulant Expectancy Questionnaire (PSEQ) and examined its psychometric properties in a nationwide sample of 547 participants. An exploratory
Objective: To investigate the study skills and habits of Zanjan Medical students. Methods: in this descriptive cross-sectional study questionnaires were distributed among all the medical students of Zanjan University in spring 2005. A questionnaire containing 24 questions was designed to assess study skills and habits (time management, concentration, reading speed, note taking, study habits and comprehension). The questionnaires were distributed
Although numerous parental styles, practices, behaviors, and beliefs have been linked to childhood anxiety, specific parental\\u000a cognitions that are concurrently associated with parental and child anxiety have yet to be operationalized and measured in\\u000a a single instrument. This investigation describes the development of a parent-report questionnaire designed to assess parental\\u000a beliefs about their child’s anxiety, namely the Parental Beliefs about
This is the fifth volume of an evaluation report on the Nutrition Services for the Elderly program. It contains the questionnaires used by the researchers in executing the evaluation and is intended as a resource volume. The questionnaires derive from the...
ObjectivesQuestionnaires are used to estimate disease burden. Agreement between questionnaire responses and a criterion standard is important for optimal disease prevalence estimates. We measured the agreement between self-reported disease and medical record diagnosis of disease.
Yuji Okura; Lynn H. Urban; Douglas W. Mahoney; Steven J. Jacobsen; Richard J. Rodeheffer
|The purpose of this study was to develop a teaching quality assessment questionnaire and assess its reliability by using it with a sample of first-year medical students. Principal components analysis with varimax orthogonal rotation resulted in the development of a 12-item, two-component tool, adequate for use in lectures and small-group…
Gaspar, Maria Filomena; Pinto, Anabela Mota; da Conceicao, Hugo Camilo F.; da Silva, Jose Antonio Pereira
This study describes an initial psychometric evaluation of a new 15–item self-report instrument, the Family Rules from the Past questionnaire (FRP), which measures perceived dysfunctional rules from the past. Reliability and validity tests were conducted including a factor analysis to determine the underlying dimensions of the FRP. A sample of 943 young adults completed the FRP, a demographic questionnaire, and
Jeffry H. Larson; Amy A. Parks; James M. Harper; Vaughn A. Heath
The intention of this research project was to bridge the gap between social science research and application to the environmental domain through the development of a theoretically derived instrument designed to give educators a template by which to evaluate environmental education curricula. The theoretical base for instrument development was provided by several developmental theories such as Piaget's theory of cognitive
Fourth in a series of volumes designed to develop an evaluation design for the Urban Development Action Grant (UDAG) program, this volume consists of a set of data collection instruments to be administered to various public officials, agency staff, and pr...
D. Culp L. Haydon G. Reigeluth N. Rockler J. Tilney
The National Medical Care Utilization and Expenditure Survey (NMCUES) was designed to collect data about the U.S. civilian noninstitutionalized population during the 1980. Information was obtained on health, access to and use of medical services, associat...
Medical post-graduate residency training and medical student training increasingly utilize electronic systems to evaluate trainee performance based on defined training competencies with quantitative and qualitative data, the later of which typically consists of text comments. Medical education is concomitantly becoming a growing area of clinical research. While electronic systems have proliferated in number, little work has been done to help manage and analyze qualitative data from these evaluations. We explored the use of text-mining techniques to assist medical education researchers in sentiment analysis and topic analysis of residency evaluations with a sample of 812 evaluation statements. While comments were predominantly positive, sentiment analysis improved the ability to discriminate statements with 93% accuracy. Similar to other domains, Latent Dirichlet Analysis and Information Gain revealed groups of core subjects and appear to be useful for identifying topics from this data. PMID:23304426
Medical post-graduate residency training and medical student training increasingly utilize electronic systems to evaluate trainee performance based on defined training competencies with quantitative and qualitative data, the later of which typically consists of text comments. Medical education is concomitantly becoming a growing area of clinical research. While electronic systems have proliferated in number, little work has been done to help manage and analyze qualitative data from these evaluations. We explored the use of text-mining techniques to assist medical education researchers in sentiment analysis and topic analysis of residency evaluations with a sample of 812 evaluation statements. While comments were predominantly positive, sentiment analysis improved the ability to discriminate statements with 93% accuracy. Similar to other domains, Latent Dirichlet Analysis and Information Gain revealed groups of core subjects and appear to be useful for identifying topics from this data.
The aims of the study were to assess theagreement between data from personal interviews andmedical records on selected medical conditions, toevaluate the validity of each source of information, andto estimate the prevalence of these conditions inpancreatobiliary pathology. Between 1992 and 1995, 602patients with pancreatobiliary diseases were included inthe PANKRAS II Study. Information from interview and medical records was available in
M. Soler; N. Malats; M. Porta; E. Fernandez; L. Guarner; A. Maguire; J. L. Pinol; J. Rifa; A. Carrato
This contract extension was to continue to generate data from Maine's EMS management system for the purpose of evaluating EMS effectiveness. This study suggests support for the hypothesis that there is no significant difference in patient outcome between ...
Background To care for terminally ill and dying patients requires a thorough medical education, encompassing skills, knowledge, and attitudes in the field of palliative care. Undergraduate medical students in Germany will receive mandatory teaching in palliative care in the near future driven by recent changes in the Medical Licensure Act. Before new curricula can be implemented, the knowledge of medical students with respect to palliative care, their confidence to handle palliative care situations correctly, their therapeutic attitude, and their subjective assessment about previous teaching practices have to be better understood. Method We designed a composite, three-step questionnaire (self estimation of confidence, knowledge questions, and opinion on the actual and future medical curriculum) conducted online of final - year medical students at two universities in Germany. Results From a total of 318 enrolled students, 101 responded and described limited confidence in dealing with specific palliative care issues, except for pain therapy. With regard to questions examining their knowledge base in palliative care, only one third of the students (33%) answered more than half of the questions correctly. Only a small percentage of students stated they had gained sufficient knowledge and experience in palliative care during their studies, and the vast majority supported the introduction of palliative care as a mandatory part of the undergraduate curriculum. Conclusion This study identifies medical students' limited confidence and knowledge base in palliative care in 2 German universities, and underlines the importance of providing a mandatory palliative care curriculum.
Background Spirituality has become a subject of interest in health care as it is was recognized to have the potential to prevent, heal or cope with illness. There is less doubt that values and goals are important contributors to life satisfaction, physical and psychological health, and that goals are what gives meaning and purpose to people's lives. However, there is as yet but limited understanding of how patients themselves view the impact of spirituality on their health and well-being, and whether they are convinced that their illness may have "meaning" to them. To raise these questions and to more precisely survey the basic attitudes of patients with severe diseases towards spirituality/religiosity (SpR) and their adjustment to their illness, we developed the SpREUK questionnaire. Methods In order to re-validate our previously described SpREUK instrument, reliability and factor analysis of the new inventory (Version 1.1) were performed according to the standard procedures. The test sample contained 257 German subjects (53.3 ± 13.4 years) with cancer (51%), multiple sclerosis (24%), other chronic diseases (16%) and patients with acute diseases (7%). Results As some items of the SpREUK construct require a positive attitude towards SpR, these items (item pool 2) were separated from the others (item pool 1). The reliability of the 15-item the construct derived from the item pool 1 respectively the 14-item construct which refers to the item pool 2 both had a good quality (Cronbach's alpha = 0.9065 resp. 0.9525). Factor analysis of item pool 1 resulted in a 3-factor solution (i.e. the 6-item sub-scale 1: "Search for meaningful support"; the 6-item sub-scale 2: "Positive interpretation of disease"; and the 3-item sub-scale 3: "Trust in external guidance") which explains 53.8% of variance. Factor analysis of item pool 2 pointed to a 2-factor solution (i.e. the 10-item sub-scale 4: "Support in relations with the External life through SpR" and the 4-item sub-scale 5: "Support of the Internality through SpR") which explains 58.8% of variance. Generally, women had significantly higher SpREUK scores than male patients. Univariate variance analyses revealed significant associations between the sub-scales and SpR attitude and the educational level. Conclusions The current re-evaluation of the SpREUK 1.1 questionnaire indicates that it is a reliable, valid measure of distinct topics of SpR that may be especially useful of assessing the role of SpR in health related research. The instrument appears to be a good choice for assessing a patients interest in spiritual concerns which is not biased for or against a particular religious commitment. Moreover it addresses the topic of "positive reinterpretation of disease" which seems to be of outstanding importance for patients with life-changing diseases.
Bussing, Arndt; Ostermann, Thomas; Matthiessen, Peter F
Background A new self-administered questionnaire as an outcome measure for patients with cervical myelopathy was drawn up in Part 1 (Japanese\\u000a Orthopaedic Association Cervical Myelopathy EvaluationQuestionnaire, JOACMEQ). Because a question with regard to driving\\u000a a car (C-41) was not suitable for this patient group, the authors composed an alternative question related to neck motion\\u000a (C-41-2). The purposes of the present
Background: The focus of this review is on methods that are currently being used to evaluate the behavioural effects of medication for individuals with intellectual disabilities. First we describe what has been identified as the ideal criteria for conducting clinical trials and how these criteria may be adapted to do less controlled evaluations.…
1. This program evaluation case example describes changes made to a medical/health surveillance program that resulted in cost savings while increasing services to employees. 2. An integrated computerized recordkeeping system provided immediate feedback to nurse and employee when testing was conducted at distant locations. 3. By offering voluntary health promotion activities simultaneously with a regulatory mandated health/medical surveillance program, employees were able to do "one stop shopping" for programs that had previously been offered separately. PMID:10025250
Compared to other life periods, adolescence is characterized by a heightened potential for risky behaviors. This study reports the systematic development and psychometric evaluation of a comprehensive Adolescent Risk-Taking Questionnaire (ARQ). It was developed using reports of 570 adolescents and was psychometrically evaluated with a sample of 925 adolescents between 11 and 18 years of age. Principal components analyses yielded
Eleonora Gullone; Susan Moore; Simon Moss; Candice Boyd
Objective Test the psychometric properties of the Persian version of the Perception of Psychiatry Survey questionnaire, which is being used in a large multi-site international study, of which we were part. This instrument was designed to measure the attitudes of medical educators to psychiatry. Method We used World Health Organization guideline as the methodological model for Persian translation. The Persian version of Perception of Psychiatry Survey questionnaire was administered to a convenience sample of 100 medical teachers at Tehran University of Medical Sciences and Azad University. The content validity, internal consistency, and test-retest reliability of the instrument were assessed. Results No item changed completely during the process of translation and cultural adaptation. The content validity of translation and back translation was 0.74 and 0.86 according to Feliss Kappa Statistic. The Cronbach's ? coefficient was 0.76 for the Persian version and for its subdivisions ranged from 0.59 to 0.81. The inter class correlation (ICC) coefficient for test-retest reliability of the whole instrument was 0.89. Conclusion The Persian version of Perception of Psychiatry Survey questionnaire could be considered as a good cross-cultural equivalent for original English version. The instrument is a reliable instrument in terms of internal consistency and test-retest reliability.
Non-prescribed use of stimulant medication among college students has become a public health concern. Although it has been well-established that outcome expectancies play a prominent role in initiation and maintenance of drinking behaviors it is unknown if and how outcome expectancies influence non-prescribed use of stimulant medication among college students. The aim of this study was to develop a valid
The medical records system of an upcoming teaching hospital in a developing nation was evaluated for its accessibility, completeness, physician satisfaction, presence of any lacunae, suggestion of necessary steps for improvisation and to emphasize the importance of Medical records system in education and research work. The salient aspects of the medical records department were evaluated based on a questionnaire which was evaluated by a team of 40 participants-30 doctors, 5 personnel from Medical Records Department and 5 from staff of Hospital administration. Most of the physicians (65%) were partly satisfied with the existing medical record system. 92.5% were of the opinion that upgradation of the present system is necessary. The need of the hour in the present teaching hospital is the implementation of a hospital-wide patient registration and medical records re-engineering process in the form of electronic medical records system and regular review by the audit commission. PMID:21409398
Kumar, B Deepak; Kumari, C M Vinaya; Sharada, M S; Mangala, M S
Objectives: This study aimed to determine attitudinal and self reported behavioural variations between medical students in different years to scenarios involving academic misconduct. Design: A cross-sectional study where students were given an anonymous questionnaire that asked about their attitudes to 14 scenarios describing a fictitious student engaging in acts of academic misconduct and asked them to report their own potential behaviour. Setting: Dundee Medical School. Participants: Undergraduate medical students from all five years of the course. Method: Questionnaire survey. Main measurements: Differences in medical students' attitudes to the 14 scenarios and their reported potential behaviour with regards to the scenarios in each of the years. Results: For most of the scenarios there was no significant difference in the response between the years. Significant differences in the responses were found for some of the scenarios across the years, where a larger proportion of year one students regarded the scenario as wrong and would not engage in the behaviour, compared to other years. These scenarios included forging signatures, resubmitting work already completed for another part of the course, and falsifying patient information. Conclusion: Observed differences between the years for some scenarios may reflect a change in students' attitudes and behaviour as they progress though the course. The results may be influenced by the educational experience of the students, both in terms of the learning environment and assessment methods used. These differences may draw attention to the potential but unintentional pressures placed on medical students to engage in academic misconduct. The importance of developing strategies to engender appropriate attitudes and behaviours at the undergraduate level must be recognised.
Objectives To assess the safety culture in an acute medical admissions unit (AMAU) of a teaching hospital in order to benchmark results\\u000a against international data and guide a unit-based, integrated, risk management strategy.\\u000a \\u000a \\u000a \\u000a Methods The safety attitudes questionnaire (SAQ), a validated instrument for the measurement of safety culture was applied to an AMAU.\\u000a All AMAU healthcare staff (n = 92) were surveyed: doctors, nurses,
Background Mental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3rd year of medical school, considering personality and study conditions measured at 1st year. Methods Questionnaires were sent to 127 first year medical students who were then followed-up at 3rd year of medical school. Eighty-one of 3rd year respondents participated in a diagnostic interview. Personality (HP5-i) and Performance-based self-esteem (PBSE-scale) were assessed at first year, Study conditions (HESI), Burnout (OLBI), Depression (MDI) at 1st and 3rd years. Diagnostic interviews (MINI) were used at 3rd year to assess psychiatric morbidity. High and low burnout at 3rd year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender. Results 98 (77%) responded on both occasions, 80 (63%) of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1st year and Financial concerns at 1st year. When controlling for 3rd year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27%) had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1st year, only the later remained significant in the adjusted analysis. Conclusion Psychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students should be encouraged to seek help and adequate facilities should be available.
Generic drugs are not as widely used in Japan as they are in the West. The objective of this study was to survey the awareness of generic drugs among outpatients and medical staff and propose methods of promoting the use of generic drugs. Our survey showed that 86.7% of respondents were aware of generic drugs. This is a higher awareness
In many areas of medicine, an intervention can be evaluated using the same measures and terms as are used to describe it. What is good - that is, what is effective in producing medical benefit -can be characterized as specifiable amounts of particular actions or substances delivered under specifiable conditions. Research that develops a more precise description of the intervention
|This set of guidelines was written to provide a systematic explanation of the process of evaluation applied to Regional Medical Programs, as required by Public Law 89-239. Goals of the programs are the improvement of health care of patients suffering from heart disease, cancer, stroke and related diseases and improvement in the practice of health…
Objective Delayed sleep phase disorder (DSPD) is a condition in which patients often fall asleep some hours after midnight and have difficulty waking up in the morning. Circadian chronotype questionnaires such as Horne-Östberg Morningness-Eveningness Questionnaire (MEQ) and Basic Language Morningness (BALM) scale have been used for screening for DSPD. This study was to evaluate these two chronotype questionnaires for screening of DSPD. Methods The study samples were 444 DSPD and 438 controls. Cronbach's alpha coefficient was calculated to evaluate for internal consistency. An exploratory factor analysis was conducted using principal-axis factoring. The diagnostic performance of a test was evaluated using Receiver Operating Characteristic (ROC) curve analysis. A discriminant function analysis was also performed. Results For internal consistency, Cronbach's alpha of 0.898 for BALM was higher than the 0.837 for MEQ, though both have acceptable internal consistency. BALM has better construct validity than the MEQ because some MEQ items measure different dimensions. However, when we evaluated the efficiency of two questionnaires for DSPD diagnosis by using the ROC curve, the BALM was similar to the MEQ. In a discriminant analysis with the BALM to classify the two groups (DSPD vs. normal), 6 items were identified that resulted in good classification accuracy. Upon examination of the classification procedure, 94.2% of the originally grouped cases were classified correctly. Conclusion These findings suggest that the BALM has better psychometric properties than the MEQ in screening and discriminating DSPS.
|Despite advances in child maltreatment research, accurate measurement of exposure remains a key issue. In this study, we evaluated a short form (CEVQ-SF) of the Childhood Experiences of Violence Questionnaire (CEVQ) in a sample of adolescents involved with child protection services in an urban city in Ontario, Canada. Focusing on the two most…
Clinical observation, systematic research and popular anecdote indicate that, when confronted by death, people change the criteria by which they evaluate their lives. Questionnaires used routinely to assess quality of life in people with poor-prognosis cancer tend to be symptom-based and do not assess factors which become important when confronted by fatal illness, such as the meaning of life and
Objective: The Pain Response Preference Questionnaire (PRPQ) assesses preferences regarding pain-related social support. The initial factor analytic study of the PRPQ conducted with a nonclinical sample identified scales labeled Solicitude, Management, Suppression, and Encouragement. The first aim of the current study was to evaluate whether these scales would be appropriate for use with chronic pain patients. The construct validity of
Lachlan A. McWilliams; Bruce D. Dick; Kristen Bailey; Michelle J. Verrier; John Kowal
|The purpose of this pilot study was to develop and evaluate an instrument for measuring Greek elementary physical educators' knowledge of student assessment. A multiple-choice questionnaire comprised of items about concepts, methods, tools, and types of student assessment in physical education was designed and tested. The initial 35-item…
Emmanouilidou, Kyriaki; Derri, Vassiliki; Aggelousis, Nicolaos; Vassiliadou, Olga
A brief, 10-item version of the Questionnaire of Smoking Urges (QSU; Tiffany & Drobes, 1991) was administered to 221 active cigarette smokers in a laboratory setting (Study 1) and to 112 smokers entering a comprehensive smoking cessation program (Study 2). In the laboratory setting, craving to smoke was evaluated in response to neutral- and smoking-related stimuli. In the clinical setting,
Background The prognosis for glioma remains dismal, and little is known about the final disease phase. To obtain information about this period, we surveyed caregivers of patients who were registered in the German Glioma Network and who died from the disease. Methods A questionnaire with 15 items, focusing on medical, logistic, and mental health support and symptom control during the final 4 weeks, was sent to caregivers. For some of the questions, a scale from 1 (inadequate) to 10 (excellent) was used. Results Of 1655 questionnaires, 605 were returned (36.6%) and evaluated. We found that 67.9% of the patients were taken care of at home for the last 4 weeks; 47.7% died at home, 22.6% died in hospitals, and 19.3% died in hospice facilities. Medical support was provided by general practitioners in 72.3% of cases, by physicians affiliated with a nursing home or hospice in 29.9%, and by general oncologists in 17%. Specialized neuro-oncologists were involved in 6%. The caregivers ranked the medical support with a mean of 7.2 (using a 10-point scale), nursing service with 8.1, and mental health support with 5.5. In 22.9% of cases, no support for the caregivers themselves was offered by medical institutions. Conclusions Although these data reflect the caregivers' subjective views, they are useful in understanding and improving current patterns of care. While patients and their caregivers are supported mainly by neuro-oncologists for most of the disease phase, the end-of-life phase is managed predominantly by general practitioners and specialists in palliative care. Close cooperation between these specialties is necessary to meet the specific needs of glioma patients. PMID:23814266
Purpose The Institute of Medicine (IOM) report on social and behavioral sciences (SBS) indicated that 50% of morbidity and mortality in the United States is associated with SBS factors, which the report also found were inadequately taught in medical school. A multischool collaborative explored whether the Association of American Medical Colleges Graduation Questionnaire (GQ) could be used to study changes in the six SBS domains identified in the IOM report. Method A content analysis conducted with the GQ identified 30 SBS variables, which were narrowed to 24 using a modified Delphi approach. Summary data were pooled from nine medical schools for 2006 and 2007, representing 1,126 students. Data were generated on students’ perceptions of curricular experiences, attitudes related to SBS curricula, and confidence with relevant clinical knowledge and skills. The authors determined the sample sizes required for various effect sizes to assess the utility of the GQ. Results The 24 variables were classified into five of six IOM domains representing a total of nine analytic categories with cumulative scale means ranging from 60.8 to 93.4. Taking into account the correlations among measures over time, and assuming a two-sided test, 80% power, alpha at .05, and standard deviation of 4.1, the authors found that 34 medical schools would be required for inclusion to attain an estimated effect size of 0.50 (50%). With a sample size of nine schools, the ability to detect changes would require a very high effect size of 107%. Conclusions Detecting SBS changes associated with curricular innovations would require a large collaborative of medical schools. Using a national measure (the GQ) to assess curricular innovations in most areas of SBS is possible if enough medical schools were involved in such an effort.
Carney, Patricia A.; Rdesinski, Rebecca; Blank, Arthur E.; Graham, Mark; Wimmers, Paul; Chen, H. Carrie; Thompson, Britta; Jackson, Stacey A.; Foertsch, Julie; Hollar, David
The objective of this study was to develop a quantitative method of evaluating the user interface for medication system software. A detailed task analysis provided a description of user goals and essential activity. A structural fault analysis was used to develop a detailed description of the system interface. Nurses experienced with use of the system under evaluation provided estimates of failure rates for each point in this simplified fault tree. Means of estimated failure rates provided quantitative data for fault analysis. Authors note that, although failures of steps in the program were frequent, participants reported numerous methods of working around these failures so that overall system failure was rare. However, frequent process failure can affect the time required for processing medications, making a system inefficient. This method of interface analysis, called Software Efficiency Evaluation and Fault Identification Method, provides quantitative information with which prototypes can be compared and problems within an interface identified. PMID:17625402
Pingenot, Alleene Anne; Shanteau, James; Pingenot, James D F
Background Achieving asthma control is a major challenge in children, otherwise symptoms perception remain poor especially at this age. The aim of this study is to evaluate the relationship between Asthma Control Test (ACTTM), Asthma Therapy Assessment Questionnaire (ATAQTM) and exercise-induced bronchospasm (EIB). Methods We studied 80 asthmatic children. Airways hyperresponsiveness (AHR) was assessed by exercise-induced bronchospasm (Balke Protocol). Asthma control was evaluated using two questionnaires in all subjects: ACT (composed by Childhood-ACT and ACT) and ATAQ. In addition the use of short acting beta 2 agonist agents (SABAs) was assessed for each patient. Non-parametric variables were compared by Chi Square Test. Binomial logistic regression was performed to estimate the two questionnaires Odds Ratio (OR) in finding AHR. Results We have found that ATAQ has a sensitivity and a specificity of 0.72 and 0.45 respectively; instead, ACT has a sensitivity and a specificity of 0.5 and 0.39 respectively in evaluating AHR. Patients with uncontrolled asthma according to ATAQ revealed a significant higher percentage of AHR compared with ACT (72% vs 50%, p < 0.01). Confirming this finding, patients declaring uncontrolled asthma to ATAQ have a significantly higher percentage (34%) of frequent SABAs use than the group with uncontrolled asthma to ACT (21%) (p <0.01). Binomial logistic regression shows how a test revealing uncontrolled asthma is associated with the increasing odds of having AHR according to ATAQ (OR = 3.8, p = 0.05), not to ACT (OR = 0.2, p = 0.1). Conclusions Our results show that ATAQ reflects AHR and asthma control better than ACT. Children with uncontrolled asthma according to ATAQ have higher odds of having AHR and use of rescue medications (SABAs) compared to patients declaring uncontrolled asthma according to ACT. However both questionnaires are not sufficient alone to fully evaluate asthma control in children and it is always necessary to perform functional tests and investigate patients lifestyle, drug use and other important data that a simple questionnaire is not able to point out
BackgroundTo assess the effect of sociodemographic characteristics, perceived health, chronic disease, and country of birth on use of medicines and the validity of a questionnaire survey on the use of medicines.MethodsA questionnaire was handed out to all 1776 patients aged 16 years or over who had attended Jordbro Health Center, Haninge municipality, Sweden, during the preceding 6 months (response rate 81%), and
The prevalence of Parkinson's disease (PD) is low among Indians, except in the Parsis. Data for Indians come from studies using different screening tools and criteria to detect PD. An epidemiological study in India, which has nearly a billion people, more than 18 spoken languages, and varying levels of literacy, requires development and validation of a screening tool for PD. The objectives of this study are to (1) validate a modified version of a widely used screening questionnaire for PD to suit the needs of the Indian population; (2) compare the use of a nonmedical assistant (NMA) with the use of a medical person during screening; and (3) compare the effect of literacy of participants on the validity of the screening tool. The validity of the questionnaire was tested on 125 participants from a home for the elderly. NMAs of similar background and medical personnel administered the modified screening questionnaire. A movement disorder neurologist blind to the responses on the questionnaire, examined participants independently and diagnosed if participants had PD. The questionnaire was validated in the movement disorders clinic, on known PD patients and their family members without PD. In the movement disorders clinic, sensitivity and specificity of the questionnaire were 100% and 89%, respectively. Fifty-seven participants were included for analysis. The questionnaire had a higher sensitivity when NMAs (75%) rather than the medical personnel (61%) administered it, and its specificity was higher with the medical personnel (61%) than with NMAs (55% and 25%). The questionnaire had a higher specificity in literates than illiterates, whereas sensitivity varied considerably. The modified questionnaire translated in a local Indian language had reasonable sensitivity and can be used to screen individuals for PD in epidemiological studies in India. This questionnaire can be administered by NMAs to screen PD and this strategy would reduce manpower costs. Literacy may influence epidemiological estimates when screening PD. PMID:16078206
Sarangmath, Nagaraja; Rattihalli, Rohini; Ragothaman, Mona; Gopalkrishna, Gururaj; Doddaballapur, Subbakrishna; Louis, Elan D; Muthane, Uday B
...2012-10-01 2012-10-01 false Medical, psychiatric, and social evaluations...HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL...Plan of Care Requirements Â§ 456.482 Medical, psychiatric, and social...
...2012-10-01 2012-10-01 false Medical, psychological, and social evaluations...HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL...Control: Intermediate Care Facilities Medical, Psychological, and Social...
...2012-10-01 2012-10-01 false Medical, psychiatric, and social evaluations...HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Medical, Psychiatric, and Social...
|First-year Australian and international medical students self-evaluated their medical communication skills during two interviews with a standardized patient. Self-evaluations were compared with clinical tutors' evaluations. Students' evaluations showed moderate, significant correlations with the tutor's. Students improved their medical…
We examined the validity and reliability of the modified Cigarette EvaluationQuestionnaire (mCEQ) that assesses the degree to which subjects experience the reinforcing effects of smoking. Data came from three phase II clinical trials (n=626, n=627, n=312) on varenicline for smoking cessation. Comparative fit indexes and non-normed fit indexes from a confirmatory factor analysis exceeded 0.90. Cronbach's alpha for internal
Joseph C. Cappelleri; Andrew G. Bushmakin; Christine L. Baker; Elizabeth Merikle; Abayomi O. Olufade; David G. Gilbert
Objective: To evaluate a food frequency questionnaire (FFQ) used to assess the dietary intake of iodine.Design: The iodine intake determined by the FFQ was compared with 4-day dietary records and with iodine excretion in 24 h urine samples in a subgroup of participants in a cross-sectional study of iodine intake and thyroid diseases in Denmark. Furthermore, the intake of fish
LB Rasmussen; L Ovesen; I Bülow; T Jørgensen; N Knudsen; P Laurberg; H Perrild
Although every food frequency questionnaire (FFQ) requires a nutrient database to produce nutrient intake estimates, it is often unclear how a particular database has been generated. Moreover, alternative methods for constructing a database have not been rigorously evaluated. Using 24-hour recalls from the 1994-1996 Continuing Survey of Food Intake by Individuals, the authors categorized 5,261 individual foods reported by 10,019
Amy F. Subar; Douglas Midthune; Martin Kulldorff; Charles C. Brown; Frances E. Thompson; Victor Kipnis; Arthur Schatzkin
Objective:Despite increasing use of the Eating Disorder Examination-Questionnaire (EDE-Q) in bariatric surgery patients, little is known about the utility and psychometric performance of this self-report measure in this clinical group. The primary purpose of the current study was to evaluate the factor structure and construct validity of the EDE-Q in a large series of bariatric surgery candidates.Methods and Procedures:Participants were
Joshua I. Hrabosky; Marney A. White; Robin M. Masheb; Bruce S. Rothschild; Carolyn H. Burke-Martindale; Carlos M. Grilo
Background Most medical schools in Japan have incorporated mandatory courses on medical ethics. To this date, however, there is no established means of evaluatingmedical ethics education in Japan. This study looks 1) To develop a brief, objective method of evaluation for moral sensitivity and reasoning; 2) To conduct a test battery for the PIT and the DIT on medical students who are either currently in school or who have recently graduated (residents); 3) To investigate changes in moral sensitivity and reasoning between school years among medical students and residents. Methods Questionnaire survey: Two questionnaires were employed, the Problem Identification Test (PIT) for evaluation of moral sensitivity and a portion of the Defining Issues Test (DIT) for moral reasoning. Subjects consisted of 559 medical school students and 272 residents who recently graduated from the same medical school located in an urban area of Japan. Results PIT results showed an increase in moral sensitivity in 4th and 5th year students followed by a decrease in 6th year students and in residents. No change in moral development stage was observed. However, DIT results described a gradual rising shift in moral decision-making concerning euthanasia between school years. No valid correlation was observed between PIT and DIT questionnaires. Conclusion This study's questionnaire survey, which incorporates both PIT and DIT, could be used as a brief and objective means of evaluatingmedical students' moral sensitivity and reasoning in Japan.
Introduction. Restless legs syndrome (RLS) is a common sensory- motor condition, characterised by the irresistible need to move the legs while sitting or lying down, usually presenting late in the day, from the end of the afternoon into the night. Objective. To describe the translation process to Spanish of three different research RLS tools: the diagnosis criteria, the Practitioner Screening Questionnaire and the Basic Set of Questions for Epidemiological Studies. A procedure is proposed for the translation of these tools into other languages. Methods. The back translation method was employed. Five translators took part: two translated into their mother tongue and two into their foreign tongue, and once the translations were completed, a fifth independent translator introduced the changes using his mother tongue. Two expert analysts determined the equivalence between the original questionnaire and the translation. The clarity of the translated questionnaires was evaluated in a sample of students, who completed these themselves, and in RLS patients, for whom the doctor(s) or another authorised person filled them out. Results. The procedure undertaken varied according as to how each instrument were to be used either by health care professionals (diagnosis criteria) or to obtain information from patients (the questionnaire being directly completed by the patient directly or indirectly by a health care professional). No significant differences between the original and the translation of the practitioner screening questionnaire and the basic set of questions for epidemiological studies were found. The translators aimed to maintain concept equivalence function and validity of the original instrument were preserved in the trans lation. The same terminology was employed in the di fferent translations to make sure they were all consistent should they be used together. The Spanish version of the practitioner screening questionnaire has added terms to the first item by providing examples of sensations to ensure its understanding by patients from different parts of Spain. Conclusions. Spanish translated versions of three different questionnaires have been obtained to be used for RLS assessment in Spain, following appropriate psychometric validation. The instrument translated in the third place showed the closest equivalence with original. PMID:20340058
García-Borreguero, D; Lahuerta-Dal Ré, Jm; Albares, J; Zaragoza, S; de Gracia, M
Abstract The need for validated outcome measures is increasing. The purpose is to translate and validate the Patient Rated Wrist Evaluation (PRWE) in Danish. Translation was done by an expert panel followed by evaluation of a lay panel and a field test on 10 patients. Sixty patients with wrist fractures were included. Both lay panel comments and field test revealed issues not dealt with by the expert panel, and a final version of the Danish PRWE was made. The validation process then continued and reliability results. were presented as Cronbach's alpha = 0.94, describing the homogeneity and the intraclass correlation coefficient = 0.88 and difference of mean = 5.7 (CI = 1.12-10.37, p = 0.017), describing the concordance of the results. Convergent validity at first and last control was for pain, 0.51 and 0.46, and physical mobility, 0.56 and 0.64, respectively, describing the correlation with a gold standard questionnaire. A minor floor effect was noticed, but not enough to indicate a lack of sensitivity of the PRWE. Effect size, the ability to measure sensitivity to change, was 0.62, also described as responsiveness. The translation resulted in a questionnaire that represents correct easy-understandable Danish. It is concluded that the modified Danish version is a valid questionnaire for patients with wrist fractures. PMID:23596992
The occurrence of patients with gastrointestinal symptoms attributed either to food allergy or intolerance has significantly increased. Nevertheless, an accurate and detailed case history, a systematic evaluation and the outcomes of specific allergy tests to identify the offending foods, including "in vivo" and "in vitro" allergy tests, are often negative for food allergy and may indicate a lactose intolerance, which is a recurrent condition affecting about 50% of adults. The aims of our study were the following: (1) What is the real incidence of the food hypersensitivity and the primary lactose intolerance in patients with gastrointestinal symptoms, initially referred to allergy or food intolerance? (2) Does lactose intolerance affect the quality of life and compliance to the therapy program? We investigated 262 consecutive patients, 72 men and 190 women. An accurate and detailed history and clinical examination were completed to investigate the offending foods. The evaluation in each patient included: allergy tests, lactose H2 breath test (LHBT) and the HRQoL questionnaire. Five years after the diagnosis of lactose intolerance, a questionnaire on the persistence of gastrointestinal symptoms after lactose ingestion and the diet compliance was distributed. Our results demonstrate an high prevalence of lactose intolerance, more frequent in women; in these patients, bloating and diarrhea are the most reported symptoms. We observe only a significant positive correlation between adverse drug reaction (ADR) and LHBT+ patients, but not an augmented prevalence of food allergy and a negative impact on the HRQoL questionnaire of lactose intolerance. PMID:21614464
Background A standardized instrument for recording the specific cognitive psychopathology of chronically depressed patients has not yet been developed. Up until now, preoperational thinking of chronically depressed patients has only been described in case studies, or through the external observations of therapists. The aim of this study was to develop and evaluate a standardized self-assessment instrument for measuring preoperational thinking that sufficiently conforms to the quality criteria for test theory. Methods The "Luebeck Questionnaire for Recording Preoperational Thinking (LQPT)" was developed and evaluated using a german sample consisting of 30 episodically depressed, 30 chronically depressed and 30 healthy volunteers. As an initial step the questionnaire was subjected to an item analysis and a final test form was compiled. In a second step, reliability and validity tests were performed. Results Overall, the results of this study showed that the LQPT is a useful, reliable and valid instrument. The reliability (split-half reliability 0.885; internal consistency 0.901) and the correlations with other instruments for measuring related constructs (control beliefs, interpersonal problems, stress management) proved to be satisfactory. Chronically depressed patients, episodically depressed patients and healthy volunteers could be distinguished from one another in a statistically significant manner (p < 0.001). Conclusion The questionnaire fulfilled the classical test quality criteria. With the LQPT there is an opportunity to test the theory underlying the CBASP model.
The aim of this research was to investigate the opinions and attitudes of medical staff towards schizophrenic patients. The research included three groups of examinees, 200 physicians of various specialties, 200 nurses and technicians working in Zagreb city hospitals, and 200 3rd and 4th year students of the School of Medicine in Zagreb. Previously validated anti-stigma questionnaire was used, consisting of 25 questions divided into three thematic groups, structured and adapted to the specific requirements of this study. The results were mutually compared and statistically analyzed by applying the chi 2-test. Significant difference (p < 0.01) between the answers of physicians and those of medical students was found in questions 2, 4, 5, 6, 11, 13, 15, 16, 18, 22, 23, 25, and between physicians and nurses/technicians in answers to questions 4, 15, 22, 23. Significant difference (p < 0.01) between the answers given by nurses/technicians and medical students was found in questions 10, 13, 22, 23. The results point to the existence of prejudices and stigmatizing attitudes in all three investigated groups. The most frequent reasons for stigmatizing attitude of students are based on fear and insufficient knowledge about mental patients and schizophrenia as a disease, while there are a high percentage of positive answers to the questions on rehabilitation and resocialization. The nurses/technicians also show a high degree of mistrust towards schizophrenic patients and mostly answer with "I don't know", thus presenting insufficiently formed attitudes about the mentioned problems. The physicians in their answers confirm fear, mistrust and stigmatizing attitudes towards schizophrenic patients found in general population in Croatia. The consequences of such attitudes are the low quality of life of schizophrenic patients, and slow, often incomplete, resocialization. PMID:12974160
This study evaluated the psychometric properties of two parallel questionnaires (for the supervisor and supervisee, respectively). Ninety supervisees and 37 supervisors from different parts of Germany took part in the study. The three dimensions of clarifying, problem solving, and relationship were confirmed, but for both supervisor and supervisee versions of the scale medium intercorrelations also allowed a combined scale to be formed. In exploratory regression analysis, the relationship dimension related to both perspectives (i.e., supervisor and supervisee) served as the best predictor for overall supervision satisfaction. Despite the fact that general session satisfaction correlated in the medium range between supervisor and supervisee, there was no correlation between the perspectives as measured by the questionnaires. Possible reasons for this unexpected correlational pattern are discussed. PMID:19396650
Zarbock, Gerhard; Drews, Marko; Bodansky, Alexander; Dahme, Bernhard
Microsuction toilet of debris from the ear canal is a commonly performed procedure within the ENT outpatient clinic. This department has received two complaints from patients following microsuction aural toilet over the past year. These cases will be discussed. We wish to assess the frequency of side effects following aural microsuction in our department. A prospective questionnaire studied 164 patients undergoing aural microsuction over a 3 month period. From the total of 164 patients surveyed, only 74 (45%) did not report any adverse effects. Patients with mastoid cavities reported higher levels of vertigo when compared to those with normal ears (p < 0.001). A high proportion of patients have reported adverse side effects following aural microsuction. Medical staff should also be aware that certain patient subgroups are more prone to adverse effects. It would be appropriate to ensure that patients are counselled before suction takes place. PMID:20607265
|Psychometrically sound evaluation measures are vital for examining the contribution of professional training to organizational success in a reliable manner. As training evaluations tend to be both time-consuming and labor-intensive, there is an increasing demand for economic evaluation inventories. Simultaneously, evaluation measures have to meet…
Measures of psychological trauma are rarely evaluated for validity with disadvantaged populations. The authors used three qualitative methods to assess the cultural validity of the Stressful Life Events Screening Questionnaire (SLESQ) with low-income African American women. Focus groups (n = 17), cognitive interviews (n = 20), and videotape reviews of SLESQ interviews were conducted (n = 16). Focus group participants spontaneously used similar language to the SLESQ items and tended to identify SLESQ events as traumatic. Most items were well understood in the interviews, with some criticism of wording. Tape reviews indicated little wording modification by interviewers. One item showed consistent problems. The interview was revised accordingly. PMID:17090693
As more Spanish speaking immigrants participate in and become the focus of research studies, questions arise about the appropriateness of existing research tools. Questionnaires have often been adapted from English language instruments and tested among college- educated Hispanic-Americans. Little has been written regarding the testing and evaluation of research tools among less educated Latino immigrants. The purpose of this study was to revise and evaluate the appropriateness of a battery of existing Spanish-language questionnaires for a physical activity intervention for immigrant Hispanic women. A three-step process was utilized to evaluate, adapt and test Spanish versions of the Self-Efficacy and Exercise Habits Survey, an abbreviated version of the Hispanic Stress Inventory-Immigrant version and the Latina Values Scale. The revised tools demonstrated acceptable validity and reliability. The adaptations improved the readability of the tools, resulting in a greater response rate, less missing data and fewer extreme responses. Psychometric limitations to the adaptation of Likert scales are discussed.
Although medical ethics has become a part of the curriculum of almost every medical school, medical students' perceptions of the value of medical ethics have not been documented. This paper reports the evaluations given by 137 preclinical and 216 clinical medical students to different levels of medical ethics teaching at the College of Human Medicine and the College of Osteopathic Medicine of Michigan State University. The results indicate (1) that students' satisfaction with medical ethics teaching is directly linked to how much they receive, (2) that students overwhelmingly prefer the input of both ethicists and doctors to teaching by either alone, and (3) that a preclinical medical ethics course followed by explicit medical ethics teaching in clinical training is a promising model for achieving an adequate level of medical ethics teaching within medical education. PMID:3626902
Resources made available by DCEG for use in developing study questionnaires. Includes questionnaires reviewed and approved by DCEG’s Technical Evaluation Committee, as well as non-reviewed questionnaire modules to be used as starting points for development.
Objective. To modify the traditional heuristic evaluation method of assessing software usability so that it can be applied to medical devices and used to evaluate the patient safety of those devices through the identification and assessment of usability problems.Design. Heuristic evaluation, a usability inspection method commonly used for software usability evaluation, was modified and extended for medical devices. The modified
Jiajie Zhang; Todd R. Johnson; Vimla L. Patel; Danielle L. Paige; Tate Kubose
Introduction: This study evaluated the factor structure of the Brief Questionnaire of Smoking Urges (QSU-Brief) within a sample of Black light smokers (1–10 cigarettes per day). Methods: The QSU-Brief was administered to 540 (mean age = 46.5; 66.1% women) urban Black light smokers upon entering a smoking cessation clinical trial. An exploratory factor analysis (EFA) was conducted to evaluate the factor structure of this 10-item measure. Results: An EFA indicated that as in other samples, the construct of craving in a Black sample is defined by 2 factors; 1 factor emphasizing the positive reinforcement of smoking and the other factor emphasizing the negative reinforcement properties of smoking. Conclusions: Findings largely replicate a 2-factor structure of craving seen in smokers from other racial/ethnic groups, demonstrating the clinical utility of the QSU-Brief in measuring craving in Black light smokers.
Clausius, Rebecca L.; Krebill, Ron; Mayo, Matthew S.; Bronars, Carrie; Martin, Laura; Ahluwalia, Jasjit S.
Study Objectives: The objective was to psychometrically evaluate the Insomnia Symptom Questionnaire (ISQ), a self-report instrument designed to establish a clinically relevant case definition of insomnia consistent with widely used insomnia classification criteria, using methods from classical test theory and item response theory (IRT). Methods: The ISQ was evaluated using IRT algorithms in a cohort of 362 pre-, peri- and post-menopausal women recruited for the SWAN (Study of Women's Health Across the Nation) Sleep Study. This yielded a dichotomous outcome consistent with the presence/absence of insomnia. The internal consistency and criterion validity of the dichotomized ISQ were compared to traditional measures of sleep from sleep diaries, polysomnography, and the Pittsburgh Sleep Quality Index using kappa statistics, and indices of sensitivity, specificity, positive and negative predictive value (PPV), and likelihood ratio tests (LRs). Results: The ISQ identified 9.8% of the sample as meeting insomnia, consistent with established diagnostic criteria. Reliability was established with Cronbach ? (? = 0.89). The ISQ had high specificity (> 90%), but sensitivity, PPV, NPV, and LRs varied according to which sleep measure was used. Concurrent validity was not confirmed with any of the traditional sleep summary measures (kappas < 0.30). Conclusions: The ISQ captures the multidimensionality of insomnia better than traditional sleep measures as it ascertains symptoms of insomnia that are based on DSM-IV and RDC criteria. The high specificities suggest that the ISQ has a high probability of correctly identifying those without insomnia and would be a cost-effective tool in large observational studies in which the prevalence of insomnia is likely to be about 10%. Further evaluation of the ISQ, including validation against clinical interviews, is warranted. Citation: Okun ML; Kravitz HM; Sowers MF; Moul DE; Buysse DJ; Hall M. Psychometric evaluation of the insomnia symptom questionnaire: a self-report measure to identify chronic insomnia. J Clin Sleep Med 2009;5(1):41–51.
Okun, Michele L.; Kravitz, Howard M.; Sowers, Mary Fran; Moul, Douglas E.; Buysse, Daniel J.; Hall, Martica
Searching for medical information on the Web is popular and important. However, medical search has its own unique requirements that are poorly handled by existing medical Web search engines. This paper presents iMed, the first intelligent medical Web search engine that extensively uses medical knowledge and questionnaire to facilitate ordinary Internet users to search for medical information. iMed introduces and
Background Despite the achievements of previous research, caregiving assessments in severe mental illness should be crossculturally validated in order to define risk groups or to evaluate family work. This study reports on the psychometric properties of the European version of the Involvement EvaluationQuestionnaire (IEQ-EU) in Portugal. Methods A Portuguese translation of the IEQ-EU was developed according to the 'European Psychiatric Services: Inputs Linked to Outcome Domains and Needs' (EPSILON) group guidelines. We then studied 194 caregivers who were related to patients with schizophrenia spectrum disorders in psychiatric outpatient services. All relatives were assessed using the IEQ-EU. In order to describe the corresponding patients' sample, the majority (n = 162) was evaluated with the World Health Organization Disability Assessment Schedule (WHO-DAS II); 108 patients were also assessed with the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF). Results The factor structure of the Portuguese version of the questionnaire was similar to the original; internal consistency was good, with Cronbach's ? ranging from 0.71 to 0.87 in the IEQ-EU scales (total score and domains: tension, supervision, worrying, urging); test-retest reliability yielded intraclass correlation coefficients (ICCs) from 0.80 to 0.94, concerning the same scores. Ecological validity was confirmed. Most caregiving consequences were reported on the worrying domain of the IEQ-EU. Conclusions Validity and reliability of the Portuguese IEQ-EU translation were established. Specifically the four IEQ-EU subscale domains seem to be valid in Portugal.
A critical aspect of air pollution exposure models is the estimation of the air exchange rate (AER) of individual homes, where people spend most of their time. The AER, which is the airflow into and out of a building, is a primary mechanism for entry of outdoor air pollutants and removal of indoor source emissions. The mechanistic Lawrence Berkeley Laboratory (LBL) AER model was linked to a leakage area model to predict AER from questionnaires and meteorology. The LBL model was also extended to include natural ventilation (LBLX). Using literature-reported parameter values, AER predictions from LBL and LBLX models were compared to data from 642 daily AER measurements across 31 detached homes in central North Carolina, with corresponding questionnaires and meteorological observations. Data was collected on seven consecutive days during each of four consecutive seasons. For the individual model-predicted and measured AER, the median absolute difference was 43% (0.17 h?1) and 40% (0.17 h?1) for the LBL and LBLX models, respectively. Additionally, a literature-reported empirical scale factor (SF) AER model was evaluated, which showed a median absolute difference of 50% (0.25 h?1). The capability of the LBL, LBLX, and SF models could help reduce the AER uncertainty in air pollution exposure models used to develop exposure metrics for health studies.
This study aimed to validate the Child's and Parent's Questionnaire about Teeth Appearance and to evaluate concerns relative to fluorosis among 213 pairs of parents and 12-year-old children from two regions of Brazil. Reliability was assessed by Cronbach's alpha and intraclass correlation coefficient, and construct and criterion validity by Spearman's correlations. Student t-test was used to compare the two regions and to assess parent/child agreement. Internal consistency was acceptable, and test-retest reliability was moderate to excellent. Perception of moderate to severe fluorosis and clinical data were significantly correlated, as were perception of fluorosis and subjects' concerns. Although parents from Rafael Arruda, Ceará State, showed a higher perception of fluorosis, parental concern was greater in Piracicaba, São Paulo State. Parents were more worried and dissatisfied with their children's dental appearance than the children themselves. This version of the questionnaire proved to be valid and reliable for assessing children's and parents' perceptions of dental fluorosis. PMID:22892969
Furtado, Gabriela Eugênio de Sousa; Sousa, Maria da Luz Rosário de; Barbosa, Taís de Souza; Wada, Ronaldo Seichi; Martínez-Mier, Esperanza de los Angeles; Almeida, Maria Eneide Leitão de
Background Available data suggest that body dissatisfaction is common during pregnancy and may even be a precursor to post-natal depression. However, in order to accurately identify at-risk women, it is essential to first establish that body image measures function appropriately in pregnant populations. Our study examines the suitability of the Body Attitudes Questionnaire (BAQ) for measuring body dissatisfaction among pregnant women by comparing the psychometric functioning of the BAQ: (1) across key phases of pregnancy, and (2) between pregnant and non-pregnant women. Methods A total of 176 pregnant women from Melbourne, Victoria filled out a questionnaire battery containing demographic questions and the Body Attitudes Questionnaire at 16, 24, and 32 weeks during pregnancy. A comparison group of 148 non-pregnant women also completed the questionnaire battery at Time 1. Evaluations of the psychometric properties of the BAQ consisted of a series of measurement invariance tests conducted within a structural equation modelling framework. Results Although the internal consistency and factorial validity of the subscales of the BAQ were established across time and also in comparisons between pregnant and non-pregnant women, measurement invariance tests showed non-invariant item intercepts across pregnancy and also in comparison with the non-pregnant subgroup. Inspection of modification indices revealed a complex, non-uniform pattern of differences in item intercepts across groups. Conclusions Collectively, our findings suggest that comparisons of body dissatisfaction between pregnant and non-pregnant women (at least based on the BAQ) are likely to be conflated by differential measurement biases that serve to undermine attempts to accurately assess level of body dissatisfaction. Researchers should be cautious in assessments of body dissatisfaction among pregnant women until a suitable measure has been established for use in this population. Given the fact that body dissatisfaction is often associated with maladaptive behaviours, such as unhealthy eating and extreme weight loss behaviours, and with ante-and post-natal depression, that have serious negative implications for women’s health and well-being, and potentially also for the unborn foetus during pregnancy, developing a suitable body image screening tool, specific to the perinatal period is clearly warranted.
The main and additional criteria used in evaluation (in percent) of loss of professional working capacity are characterized. Criteria common for forensic medical and medical social expert evaluations and differences between them are discussed. These differences are due to the fact that forensic medical expert evaluations are based on the Civil and Civil Processual Codes of the Russian Federation but not on the departamental norm-setting documents. PMID:11186952
Kapustin, A V; Tomilin, V V; Ol'khovik, V P; Panfilenko, O A; Serebriakova, V G
The 1987 National Medical Expenditure Survey Public Use Tape 5 contains data from the facility questionnaire supplement of the Institutional Population Component (IPC). The National Medical Expenditure Survey (NMES) is a nationwide survey sponsored by the...
The 1987 National Medical Expenditure Survey Public Use Tape 5 contains data from the facility questionnaire supplement of the Institutional Population Component (IPC). The National Medical Expenditure Survey (NMES) is a nationwide survey sponsored by the...
The 1987 National Medical Expenditure Survey Public Use Tape 5 contains data from the facility questionnaire supplement of the Institutional Population Component (IPC). The National Medical Expenditure Survey (NMES) is a nationwide survey sponsored by the...
The objective of this study was to evaluate a computerized food frequency questionnaire (FFQ) that estimates calcium intake among Asian, Hispanic, and non-Hispanic white youth. A computerized FFQ based on a list of 80 foods with corresponding food photos was evaluated for 4 consecutive weeks. The evaluation study consisted of computerized FFQs during weeks 1 and 4, and 24-hour dietary
Siew Sun Wong; Carol J. Boushey; Rachel Novotny; Deborah R. Gustafson
The present study reports an evaluation of the factor structure of the Norwegian version of the Adolescent Stress Questionnaire (ASQ-N) among 723 students. Principal components analysis (PCA) revealed nine internally consistent dimensions of adolescent stress. Scales constructed from this PCA correlated positively with measures of depression and anxiety and negatively with self-esteem. Girls reported higher stress levels than boys in seven of the nine scales and age was also positively correlated with the scale scores of adolescent stress. The results revealed that the instrument has potential for measuring adolescent stress. The stability of the ASQ-N needs to be tested repeatedly, across cohorts and over time, to establish the adequacy for use in Norwegian adolescent studies. PMID:20149144
Moksnes, Unni Karin; Byrne, Don G; Mazanov, Jason; Espnes, Geir Arild
|The medicalevaluation of children with suspected sexual abuse includes more than just the physical examination of the child. The importance of taking a detailed medical history from the parents and a history from the child about physical sensations following sexual contact has been emphasized in other articles in the medical literature. The…
Over a 12-year period, the Birmingham implantation otology unit has implanted more than 300 patients with bone-anchored hearing aids (BAHA). The Entific Medical Systems questionnaire was administered to these patients to evaluate the day to day use of the BAHA, professional needs, after-care, wear and tear concerns and service related issues. Data analysis revealed that most patients used their BAHA for more than eight hours a day (90 per cent of BAHA users) and every day of the week (93 per cent of BAHA users). A high degree of satisfaction was expressed as regards sound amplification, listening to radio or television news, listening to music, speech perception in quiet conditions, during conversation with one person in noisy surroundings and conversation with family at home. Some degree of difficulty was expressed with the use of the BAHA during conversation with two or more people in noisy surroundings. A slow process of perceptual acclimatization was noticed with the majority of the patients. The majority of patients were pleased with the service as regards care of the wound, BAHA nursing clinics, device repairs and other service-related issues. PMID:12138788
Dutt, Sunil N; McDermott, Ann-Louise; Jelbert, Anwen; Reid, Andrew P; Proops, David W
...Medical Criteria for Evaluating Cystic Fibrosis AGENCY: Social Security Administration...to evaluate claims involving cystic fibrosis in adults and children under...Information for individuals with cystic fibrosis who apply for Social...
In 1991, the NRC, Division of Industrial and Medical Nuclear Safety, began a program to evaluate the use of probabilistic risk assessment (PRA) in regulating medical devices. This program represents an initial step in an overall plant to evaluate the use of PRA in regulating the use of nuclear by-product materials. The NRC envisioned that the use of risk analysis
In 1991, the NRC, Division of Industrial and Medical Nuclear Safety, began a program to evaluate the use of probabilistic risk assessment (PRA) in regulating medical devices. This program represents an initial step in an overall plant to evaluate the use ...
New system design and evaluation methodologies are being developed to address social, organizational, political, and other non-technological issues in medical informatics. This paper describes a social interactionist framework for researching these kinds of organizational issues, based on research within medical informatics and other disciplines over the past 20 years. It discusses how effective evaluation strategies may be undertaken to address
The thesis describes some aspects of a computer system for doing medical diagnosis in the specialized field of kidney disease. Because such a system faces the spectre of combinatorial explosion, this discussion concentrates on heuristics which control the...
The aim of this project was to cross-culturally adapt and validate the American English version of the Childhood Health Assessment Questionnaire (CHAQ) and of the Child Health Questionnaire (CHQ) in the 32 different member countries of the Paediatric Rheumatology International Trials Organisation (PRINTO). This effort forms part of an international study supported by the European Union to evaluate the health-related quality of life in children with juvenile idiopathic arthritis (JIA) as compared to their healthy peers. A total of 6,644 subjects were enrolled from 32 countries: Argentina, Austria, Belgium, Brazil, Bulgaria, Chile, Croatia, the Czech Republic, Denmark, Finland, France, Georgia, Germany, Greece, Hungary, Israel, Italy, Korea, Latvia, Mexico, the Netherlands, Norway, Poland, Portugal, Russia, Slovakia, Spain, Sweden, Switzerland, Turkey, the United Kingdom, and Yugoslavia. A total of 3,235 patients had JIA (20% systemic onset, 33% polyarticular onset, 17% extended oligoarticular subtype, and 30% persistent oligoarticular subtype) while 3,409 were healthy children. This introductory paper describes the methodology used by all the participants. The results and the translated version of both the CHAQ and the CHQ for each country are fully reported in the following papers. The results of the present study show that cross-cultural adaptation is a valid process to obtain reliable instruments for the different socio-economic and socio-demographic conditions of the countries participating in the project. PMID:11510308
Self-efficacy is associated with health behavior and medication adherence in persons living with HIV infection (PLWH). This paper describes self-efficacy, medication adherence, and quality of life (QOL), and it examines the relationships among these variables in PLWH in China. A cross-sectional survey of 199 patients was completed using the HIV Self-Efficacy Questionnaire and the QOL for Chinese HIV-Infected Questionnaire. Medication adherence was measured through direct questioning of pill-taking behavior. Results showed that self-efficacy for disease management was moderate, with a mean score of 6.61. Of the 199 patients, 157 (78.9%) reported that medication adherence was higher than 90%. The scores for dimensions of QOL ranged from 33.1 to 81.4, with six dimensions lower than 60. Stepwise regression analyses showed that self-efficacy, medication adherence, and drug use were significant predictors of QOL. These results suggest a need for intervention programs to improve self-efficacy and quality of life in Chinese PLWH. PMID:22770801
A questionnaire-based study was undertaken to assess women's satisfaction with the home medical abortion service. Over a 15-month period, questionnaires were conducted at 24 h and 2 weeks following the procedure. A total of 127 women took part in the study and filled in a questionnaire at 24 h, with 77 completing the questionnaire at 2 weeks. At 24 h, over 95% of women who responded, agreed or strongly agreed that they felt prepared for the pain and bleeding that they experienced at home. At 2 weeks, 97.3% of respondents felt that they had had enough information and knew what to expect, and were therefore satisfied with the procedure. Only 15% of women were lost to clinical follow-up at 2 weeks. The majority of women are satisfied with the home medical abortion service. These high satisfaction rates are maintained at 2 weeks. Telephone follow-up 2 weeks after the abortion was safe and effective. PMID:23919859
|In a pilot study, two methods of identifying problems in the evaluation of third- and fourth-year medical students' clinical skills were tested. The two types of materials, questionnaires and a problem-case analysis, were found to be complementary, both identifying some of the same problems and each identifying some different problems. (MSE)|
An analysis of the four scales from Buss and Perry's (1992, Journal of Personality and Social Psychology, 63, 452–459) Aggression Questionnaire was conducted. Examined was the internal consistency, test-retest reliability, the influence of social desirability, and the interrelationships with other measures of aggression. The results suggest that the four scales of The Aggression Questionnaire have moderate to high internal consistencies
Aims. To validate the Italian version of the 'depression attitude questionnaire' (DAQ), to assess its psychometric properties and to evaluate the primary care physicians' (PCPs) opinion and attitude towards depression. Methods. An Italian version of the DAQ was created and then administered to a representative sample of PCPs working in the Emilia-Romagna region. Results. The findings derived from the Italian version of the DAQ indicated a three-factor solution (professional confidence, negative viewpoint and biological stance), broadly similar to previous studies and with acceptable fit indices. Our results showed that the PCPs consider depression as an increasingly important issue for their daily clinical practice. A large majority of them believed in the effectiveness of antidepressants and considered psychopharmacological treatment as appropriate for the PCPs to undertake. However, most PCP respondents thought that psychotherapy should be left to the specialists. Our findings suggest a prevalent orientation to the biochemical aspects of depression and the use of antidepressant treatment. Conclusions. The PCPs' attitude and opinion towards depression is an important aspect of their understanding and response to this common and disabling condition. The Italian version of the DAQ appears to be an appropriate and useful instrument to assist the understanding of the PCPs' views and potential need for further professional development. PMID:22793494
Sighinolfi, C; Norcini Pala, A; Casini, F; Haddad, M; Berardi, D; Menchetti, M
A brief, 10-item version of the Questionnaire of Smoking Urges (QSU; Tiffany & Drobes, British Journal of Addiction 86:1467-1476, 1991) was administered to 221 active cigarette smokers in a laboratory setting (Study 1) and to 112 smokers enrolled in a comprehensive smoking cessation program (Study 2). In the laboratory setting, craving to smoke was evaluated in response to neutral and smoking-related stimuli. In the clinical setting, craving was assessed prior to cessation and again during treatment. Factor analyses revealed that a two-factor solution best described the item structure of the QSU-Brief across conditions. Factor 1 items reflected a strong desire and intention to smoke, with smoking perceived as rewarding for active smokers. Factor 2 items represented an anticipation of relief from negative affect with an urgent desire to smoke. The findings were consistent with the expressions of craving found in the 32-item version of the QSU (Tiffany & Drobes, 1991). Regression analyses demonstrated stronger baseline mood intensity and self-reported tendency to smoke to achieve pleasurable effects and to experience the desire to smoke when cigarettes are unavailable were predictive of general levels of craving report in active smokers in the laboratory and clinical setting. The findings supported a multidimensional conceptualization of craving to smoke and demonstrated the utility of a brief multidimensional measure of craving. PMID:11260806
ObjectiveThe authors evaluated the use of the Unified Medical Language System (UMLS) as a medical knowledge source for the representation of medical procedures in the MAOUSSC system.DesignMAOUSSC, a multiaxial coding system, was used for the representation of 1500 procedures from 15 clinical specialties, using UMLS concepts (augmented by full sources for three new vocabularies being added to the UMLS) and
Oliver Bodenreider; Anita Burgun; Geneviève Botti; Marius Fieschi; Pierre Le Beux; François Kohler
57 former clients (parents) of a school psychologist completed an eight-item questionnaire, which was mailed to them, asking about their satisfaction with the counseling, based on the German translation of the CSQ-8 (Larsen et al. 1979). 38 of the respondents had been prepared for the arrival of the questionnaire through a telephone call asking for their cooperation. The remainder (n = 19) had not been phoned or otherwise prepared. The problem of response rate is mentioned. The results of the parents questionnaire are described and their meaning with regard to improvement of the work and the comparability of counseling institutions are discussed. PMID:1570274
Questionnaires were sent out to the staffs (13 physicians, 52 nurses and 5 medical engineers) of the ICU/CCU at the University of Tokyo Hospital, to evaluate pharmaceutical services by analyzing problems in the services offered. Four components of pharmaceutical services were evaluated: inventory control of drugs, check of drug usage and doses, mixing of injections, and offering drug information. Almost all responses from medical staffs evaluated pharmaceutical services overall as "good". The high response rate (96%) from the nursing staff was attributed to the fact that they were familiar with the pharmacist's role with drug inventory, and mixing injections, when nursing was not available for these tasks. Although 50% of physicians rated the pharmaceutical services of providing drug information as "good", this value was lower than responses on other items of the questionnaires, which suggests some dissatisfaction. The occurrences of drug information obtained by passive offering (121 subjects) was 4 times as common as drug information obtained by active offering (30 subjects). From this finding, and comments on the questionnaires from physicians, it suggests that physicians require more drug information for dosage regimens, and prefer the drug information to be provided more actively. Further, an important comment from physicians and nurses was that the services of pharmacists are not available on all shifts/all days of the week to provide consultation for drug information and mixing of injections. Although having a pharmacist available daily around the clock is desirable and ideal to the medical team, the number of pharmacists under the present system cannot support this. As a solution, we think that it is crucial that pharmacists educate medical staff when they are present to in order to optimize therapy and patient care over time. PMID:15118240
BACKGROUND: The need for Complementary and Alternative Medicine (CAM) and holistic approaches in allopathic medical school curricula has been well articulated. Despite increased CAM instruction, feasible and validated instruments for measuring learner outcomes in this content area do not widely exist. In addition, baseline attitudes or beliefs of medical students towards CAM, and the factors that may have formed them,
OBJECTIVE: To evaluate the psychometric properties of the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) and Visual Function Questionnaire Utility Index (VFQ-UI) in patients with non-infectious intermediate and posterior uveitis. METHODS: Secondary analysis of pooled data from a 26-week, multicenter, masked, randomized, sham-controlled Phase 3 clinical trial. Health-related quality of life was assessed using the NEI VFQ-25, the EQ-5D, and SF-36. Internal consistency reliability, reproducibility, convergent validity, and known groups of BCVA and vitreous haze severity were assessed. Clinically significant difference was assessed using anchor-based and distribution-based methods. RESULTS: The study included 224 subjects with non-infectious intermediate (80.4 %) or posterior uveitis (19.6 %). The NEI VFQ-25 and the VFQ-UI demonstrated good internal consistency (Cronbach's alpha 0.87-0.94) and test-retest reliability (ICCs 0.58-0.88). Spearman's product-moment rank correlations between the NEI VFQ-25 and VFQ-UI scores and the SF-6D, EQ-5D, and BCVA ranged from small to moderate. There was a significant association between visual functioning and known groups of visual acuity (p < 0.05). Clinical significance, using the anchor-based method (difference between visual acuity groups ?10-<15 letter better and no change), was 10.2 for change from baseline to week 26 for the NEI VFQ-25 composite score and 0.05 for the VFQ-UI. Using the distribution-based method, the clinical significance was 3.86 for the composite score and 0.04 for the VFQ-UI. CONCLUSION: The NEI VFQ-25 and the VFQ-UI are reliable and valid measures of vision-related functioning and preference-based status in patients with non-infectious intermediate and posterior uveitis. PMID:23645458
Naik, Rupali K; Gries, Katharine S; Rentz, Anne M; Kowalski, Jonathan W; Revicki, Dennis A
Activities during the reporting period include test and evaluation of nuclear powered pacemakers; test, evaluation, and design of transcutaneous transformers to supply power for implanted blood pumps; and two exploratory projects aimed toward developing p...
In an effort to collect information on the status of quality control procedures and the use of pay adjustment factors, a questionnaire was distributed to all state agencies, the District of Columbia, and the Federal Highway Administration. Each agency was...
R. M. Moore J. E. Wilson J. P. Mahoney R. G. Hicks
This paper reviews the use of economic evaluations in the Swedish health care system. The most important actors are defined and examples are given how economic evaluations have played a role in the decision making process. The introduction of extracorporal shock-wave lithotripsy (ESWL) is used as an example on how economic evaluation was used for recommendations to the county councils
LEARNING OUTCOME: To evaluate the clinical effectiveness and costs of providing medical nutrition therapy (MNT) to outpatients with non-insulin dependent diabetes mellitus in order to improve nutrition services.Clinical effectiveness and operating efficiency are essential components of nutrition services in an era of managed care. Although a number of studies have shown that medical nutrition therapy improves outcomes in patients with
C. Williams; J. Walter; M. Ruocco; LTC M. Applewhite
Annual Medicago species (medics) have characteristics that may make them a valuable addition to agricultural systems in the Upper Midwest, USA, but few genotypes have been evaluated. The objective of this research was to identify medic germplasm exhibiting traits that are desirable for cultivars int...
Fly biting describes a syndrome in which dogs appear to be watching something and then snapping at it. Medical work-up of fly biting in dogs has never been reported. The aims of this case series were to characterize fly biting and perform a complete medicalevaluation of dogs displaying fly biting.
Frank, Diane; Belanger, Marie C.; Becuwe-Bonnet, Veronique; Parent, Joane
The article describes and discusses the use of focus groups and questionnaires to evaluate educational printed material for high school level art teachers prior to publication. The material consisted of "The Notebook of the Investigative Teacher," created by the Instituto Itau Cultural to help teachers develop critical skills in discussing…
Almeida, Adriana Mortara; Martins, Maria Helena Pires
|Surprisingly, little is known about how IPV perpetrators perceive the consequences of their violent behavior. This article describes the development and evaluation of the Perceived Consequences of Domestic Violence Questionnaire (PCDVQ). The PCDVQ is a 27 item self report instrument designed to assess the consequences of intimate partner violence…
Walker, Denise D.; Neighbors, Clayton; Mbilinyi, Lyungai F.; O'Rourke, Allison; Zegree, Joan; Roffman, Roger A.; Edleson, Jeffrey L.
This article describes the use of two linked instruments, the Instructor Effectiveness Check Sheet (IEC) and Instructor Effectiveness Questionnaire (IEQ). The use of an evaluation instrument during a course can enable improvements to be made--even with experienced instructors. Detail can be taken from the IEC and IEQ to find obvious and not so…
Phipps, Maurice L.; Hayashi, Aya; Lewandowski, April; Padgett, Allison H.
|Background: African-American and Latino children living in neighborhoods with a low-socioeconomic index are more at risk of obesity-associated metabolic disease than their higher socioeconomic index and/or white peers. Currently, consistent and reliable questionnaires to evaluate nutrition and physical activity knowledge in these children are…
Roberts, Lindsay S.; Sharma, Sushma; Hudes, Mark L.; Fleming, Sharon E.
The study outlines the evaluation of an intellectual disability screening tool, the "Child and Adolescent Intellectual Disability Screening Questionnaire" ("CAIDS-Q"), with two age groups. A number of aspects of the reliability and validity of the "CAIDS-Q" were assessed for these two groups, including inter-rater reliability, convergent and…
McKenzie, Karen; Paxton, Donna; Murray, George; Milanesi, Paula; Murray, Aja Louise
The objectives of the study were to identify perceived difficulty and reduction of difficulty when using assistive devices and altered working methods in performing daily activities and to detect which activities were unaffected by interventions. Twenty-one women aged 29–65 years with rheumatoid arthritis answered the Evaluation of Daily Activity Questionnaire (EDAQ), which contains 102 items divided into 11 dimensions of
Objective: Evaluatemedical students' communication and professionalism skills from the perspective of the ambulatory patient and later compare these skills in their first year of residency. Methods: Students in third year neurology clerkship clinics see patients alone followed by a revisit with an attending neurologist. The patient is then asked to complete a voluntary, anonymous, Likert scale questionnaire rating the student on friendliness, listening to the patient, respecting the patient, using understandable language, and grooming. For students who had completed 1?year of residency these professionalism ratings were compared with those from their residency director. Results: Seven hundred forty-two questionnaires for 165 clerkship students from 2007 to 2009 were analyzed. Eighty-three percent of forms were returned with an average of 5 per student. In 64% of questionnaires, patients rated students very good in all five categories; in 35% patients selected either very good or good ratings; and <1% rated any student fair. No students were rated poor or very poor. Sixty-two percent of patients wrote complimentary comments about the students. From the Class of 2008, 52% of students received "better than their peers" professionalism ratings from their PGY1 residency directors and only one student was rated "below their peers." Conclusion: This questionnaire allowed patient perceptions of their students' communication/professionalism skills to be evaluated in a systematic manner. Residency director ratings of professionalism of the same students at the end of their first year of residency confirms continued professional behavior. PMID:22723790
Davis, Larry E; King, Molly K; Wayne, Sharon J; Kalishman, Summers G
Objective: Evaluatemedical students’ communication and professionalism skills from the perspective of the ambulatory patient and later compare these skills in their first year of residency. Methods: Students in third year neurology clerkship clinics see patients alone followed by a revisit with an attending neurologist. The patient is then asked to complete a voluntary, anonymous, Likert scale questionnaire rating the student on friendliness, listening to the patient, respecting the patient, using understandable language, and grooming. For students who had completed 1?year of residency these professionalism ratings were compared with those from their residency director. Results: Seven hundred forty-two questionnaires for 165 clerkship students from 2007 to 2009 were analyzed. Eighty-three percent of forms were returned with an average of 5 per student. In 64% of questionnaires, patients rated students very good in all five categories; in 35% patients selected either very good or good ratings; and <1% rated any student fair. No students were rated poor or very poor. Sixty-two percent of patients wrote complimentary comments about the students. From the Class of 2008, 52% of students received “better than their peers” professionalism ratings from their PGY1 residency directors and only one student was rated “below their peers.” Conclusion: This questionnaire allowed patient perceptions of their students’ communication/professionalism skills to be evaluated in a systematic manner. Residency director ratings of professionalism of the same students at the end of their first year of residency confirms continued professional behavior.
Davis, Larry E.; King, Molly K.; Wayne, Sharon J.; Kalishman, Summers G.
Increasing numbers of medical practitioners and medical students are using online social and business-related networking websites such as Facebook, Doc2doc and LinkedIn. These rapidly evolving and growing social media have potential to promote public health by providing powerful instruments for communication and education. However, evidence is emerging from studies, legal cases, and media reports that the use of these new technologies is creating several ethical problems for medical practitioners as well as medical students. Improper online activities may harm not only individual reputations and careers, but also the medical profession as a whole, for example by breach of patient confidentiality, defamation of colleagues and employers, undisclosed conflict of interests that bias the medical practitioner?s medical advice, posting of advice/information without an evidence base, and infringement of copyright. We developed a self-evaluation checklist for medical practitioners using social media. The checklist addresses three key elements in the use of social media: personal information and accessibility, connections, and postings. It contains questions specifically formulated to evaluate a medical practitioner?s social media profile, to prevent unintended, improper online activities and to promote professional online behaviour. PMID:23099596
Visser, Benjamin J; Huiskes, Florian; Korevaar, Daniel A
The physician who examines a patient for impairment to driving must consider the welfare of the community which will be exposed to the patient's driving in addition to the welfare of the patient himself. The medical opinion on physical and mental fitness to drive should be based upon consideration of: 1. Extent and nature of driving exposure. 2. Relation of organ system involved to medical requirements of the driving task. 3. Duration of condition and nature of adaptability. 4. Predicted speed of onset of medical crisis. 5. Evaluation of the patient and his environment as a totality. An informed medical society traffic safety committee can be of great assistance to the practicing physician and to the Department of Motor Vehicles in evaluatingmedical hazards in driving in special cases. Most regulations concerning impairment to driving are currently based upon consensus of expert opinion since statistically valid data are not yet available.
There are no disease-specific questionnaires to measure patient sensitive outcomes in arrhythmia patients. We report the development and preliminary psychometric testing of the Patient Perception of Arrhythmia Questionnaire (PPAQ). The PPAQ was developed using formative research, exploratory factor analysis, expert review, pilot study, and regression. The PPAQ measures frequency and duration of episodes, symptoms, impact on daily activities, and restricted activity days. After preliminary content validation, the responsiveness of the PPAQ was tested in 103 arrhythmia patients. The measures showed good sensitivity and reliability. Preliminary construct validation was supported by significant differences (p<.001) among groups of arrhythmia patients consistent with clinical patterns. Preliminary evidence from patients with supraventricular arrhythmias suggests that the questionnaire has acceptable psychometrics and could be useful in future studies of arrhythmia patients.
Wood, Kathryn A.; Stewart, Anita L.; Drew, Barbara J.; Scheinman, Melvin M.; Froelicher, Erika S.
Background Negative affect and difficulties in its regulation have been connected to several adverse psychological consequences. While several questionnaires exist, it would be important to have a theory-based measure that includes clinically relevant items and shows good psychometric properties in healthy and patient samples. This study aims at developing such a questionnaire, combining the two Gross  scales Reappraisal and Suppression with an additional response-focused scale called Externalizing Behavioral Strategies covering clinically relevant items. Methods The samples consisted of 684 students (mean age?=?23.3, SD?=?3.5; 53.6% female) and 369 persons with mixed mental disorders (mean age?=?36.0 SD?=?14.6; 71.2% female). Items for the questionnaire were derived from existing questionnaires and additional items were formulated based on suggestions by clinical experts. All items start with “When I don’t feel well, in order to feel better…”. Participants rated how frequently they used each strategy on a 5-point Likert scale. Confirmatory Factor Analyses were conducted to verify the factor structure in two separate student samples and a clinical sample. Group comparisons and correlations with other questionnaires were calculated to ensure validity. Results After modification, the CFA showed good model fit in all three samples. Reliability scores (Cronbach’s ?) for the three NARQ scales ranged between .71 and .80. Comparisons between students and persons with mental disorders showed the postulated relationships, as did comparisons between male and female students and persons with or without Borderline Personality Disorder. Correlations with other questionnaires suggest the NARQ’s construct validity. Conclusions The results indicate that the NARQ is a psychometrically sound and reliable measure with practical use for therapy planning and tracking of treatment outcome across time. We advocate the integration of the new response-focused strategy in the Gross’s model of emotion regulation.
The Multnomah EMCRO (MEMCRO) is characterized by three medical care appraisal projects: (1) criteria development; (2) concurrent on-site evaluation and review (CONSERVE); (3) development of an ambulatory care data base for quality of care review. Optimal ...
The internet has become one of the most popular and frequently used sources of information in Taiwan, where over one-third of the population has online access (at total of 8.8 million users). Health and medical Websites have become important information sources for professional care providers, but few evaluations have been made of the more commonly used medical Websites in Taiwan. Evaluation criteria for assessing accuracy based on critical thinking skills is required to reduce the amount of misleading information that might be transmitted. The purpose of this paper is to make suggestions for medical Website evaluation. Concepts include access, author status, content, information structure and design, and links quality. It is hoped that this information will help Taiwanese medical professionals better assess the quality of currently available healthcare-related Websites. PMID:15211775
\\u000a Objective To summarize the psychometric properties of the PHQ2 and PHQ9 as screening instruments for depression.\\u000a \\u000a \\u000a \\u000a Interventions We identified 17 validation studies conducted in primary care; medical outpatients; and specialist medical services (cardiology,\\u000a gynecology, stroke, dermatology, head injury, and otolaryngology). Electronic databases from 1994 to February 2007 (MEDLINE,\\u000a PsycLIT, EMBASE, CINAHL, Cochrane registers) plus study reference lists have been used for this
Simon Gilbody; David Richards; Stephen Brealey; Catherine Hewitt
An Italian version of the patient-rated wrist/hand evaluation (PRWHE) questionnaire was obtained through the standardized process of cross-cultural adaptation. The PRWHE-Italian (IT) was tested on 63 patients in order to evaluate comprehension, reliability and validity as correlated to the validated version of the disabilities of the arm shoulder and hand (DASH)-IT and SF-36. No patients had difficulty completing the PRWHE-IT questionnaire. Psychometric testing demonstrated high reliability (Cronbach's alpha coefficient = 0.9607) and internal and external validity (Pearson correlation coefficient r = 0.927 with PRWHE, r < 0.810 with DASH and r < -0.476 with SF-36). The Italian version of the PRWHE has equivalent evaluation capacities to the original English version and is a reliable functional outcome measurement instrument for wrist and hand disorders. PMID:22719008
Fairplay, T; Atzei, A; Corradi, M; Luchetti, R; Cozzolino, R; Schoenhuber, R
In this article we analyze the variables of anxiety and depression in two different situations: a combat situation and taking an exam. We used the Hospital Anxiety and Depression Scale questionnaire with a sample of 621 subjects, divided in four groups, two groups of soldiers, one of them in situation of combat (SBH) and the other one on the military
Background: In this paper we tested the hypothesis that persons with eating disorders (EDs) are affected by disturbances of the way they experience their own body (embodiment) and shape their personal identity, assuming that the various kinds of anomalies of eating behavior are consequences thereof. Sampling and Methods: We developed and validated a new self-reported questionnaire named IDEA (IDentity and
Giovanni Stanghellini; Giovanni Castellini; Patrizia Brogna; Carlo Faravelli; Valdo Ricca
The Children's Social Behavior Questionnaire (CSBQ) contains items referring to behavior problems seen in children with milder variants of PDD. Data of large samples of children diagnosed as having high-functioning autism, PDDNOS, ADHD, and other child-psychiatric disorders were gathered. Besides the CSBQ, parents completed the Autism Behavior Checklist (ABC) and the Child Behavior Checklist (CBCL). The data provided the basis
Ellen Luteijn; Frans Luteijn; Sandy Jackson; Fred Volkmar; Ruud Minderaa
Perceived self-efficacy (SE) for eating fruit and vegetables (FV) is a key variable mediating FV change in interventions. This study applies item response modeling (IRM) to a fruit, juice and vegetable self-efficacy questionnaire (FVSEQ) previously validated with classical test theory (CTT) procedur...
The economic evaluation of medical technology has evolved as a key element in supporting health budget allocation decisions. Among suppliers of innovation, the medical device industry is one of the most dynamic fields of medical progress with thousands of new products marketed every year. Accordingly, the broad variety of technologies covered by the umbrella term 'medical devices' have come under increasing scrutiny regarding their cost effectiveness. In the process, a number of device-specific factors have become apparent, each of which can complicate a thorough economic evaluation and limit its informative value. Some of these factors relate to specific characteristics of device functioning. Examples of such factors include the fact that most technologies require, or form part of, a procedure and that many devices have multiple indications or purposes. Others in turn reflect external conditions and are more general in character, such as the regulatory framework that a medical device manufacturer faces prior to market approval and the structure of the medical device industry. Drawing on the available literature, these complicating factors and their practical implications are discussed and used as a basis to elaborate on the emerging challenges for the economic evaluation of medical devices. PMID:23329383
OBJECTIVE: To develop a reliable, valid measure of patient satisfaction with out of hours care suitable for large scale service evaluation. DESIGN: Focus group meetings and semistructured interviews with patients to identify issues of importance to patients and possible questionnaire items; interviews and two pilot studies to test and identify new questionnaire items; modification or removal of items to eliminate ambiguity and reduce non-response and skewed responses; questionnaire survey of out of hours care. SETTING: Greater Manchester and Leicester. SUBJECTS: 11 general practice patients participated in the focus groups and 28 in the semistructured interviews; 41 in the preliminary interviews; 41 and 378 in the postal pilots; and 1466 in the survey of out of hours care. RESULTS: A 32 item questionnaire was developed. Component analysis indicated seven scales (satisfaction with communication and management, doctor's attitude, continuity of care, delay until visit, access to out of hours care, initial contact person, telephone advice) related to overall satisfaction and containing issues identified as important to patients. Levels of reliability were satisfactory, Cronbach's alpha correlation coefficient exceeding 0.60 for all scales. CONCLUSION: A reliable, valid measure of patient satisfaction has been developed, suitable for large scale evaluation of out of hours care.
McKinley, R. K.; Manku-Scott, T.; Hastings, A. M.; French, D. P.; Baker, R.
In order to evaluate the impact WIISARD technology has on disaster response we have defined a set of quantitative measures which can be applied at drills and disasters. The measures were found through ethnographic study of responders, especially team leaders and incident commanders, and we tested their viability in simulation models. Our site metrics are victim flow rate per node,
Pain management is an important aspect of providing quality health care, and monitoring patient-related outcomes is a recommended quality improvement practice. Valid and reliable tools are needed for this purpose. The American Pain Society Patient Outcome Questionnaire (APS-POQ) is widely used to measure quality of pain management. The APS-POQ was recently revised to reflect advances in pain management. The purpose of this study was to test the psychometric properties of the revised version in Icelandic patients in the hospital setting. The questionnaire was translated according to an adaptation of Brislin's model. Data were collected from 143 patients on 23 wards in a university hospital. Participants were ?18 years old, hospitalized for >24 hours, alert, not too ill to participate, and in pain ?1 on a 0-10 scale in the past 24 hours. Mean (SD) age was 66 (18) years, 51.4% were women, 48.6% men. Principal component analysis with varimax rotation confirmed a five-component structure, but four items lowered reliability and were removed from the scales. The final version consists of four components, with Cronbach ? >.70, explaining 64.2% of the variance. Participants had little difficulty in answering the questionnaire, but two additional items about participation in decisions and pain medications were added in response to patients' comments and suggestions. Administering the Icelandic version of the APS-POQ-R was found to be feasible, and the questionnaire has acceptable construct validity and reliability. The results support the use of the APS-POQ-R-I to evaluate the quality of pain management in hospitals in Iceland. PMID:23318415
Background Good communication is a crucial element of good clinical care, and it is important to provide appropriate consultation skills teaching in undergraduate medical training to ensure that doctors have the necessary skills to communicate effectively with patients and other key stakeholders. This article aims to provide research evidence of the acceptability of a longitudinal consultation skills strand in an undergraduate medical course, as assessed by a cross-sectional evaluation of students' perceptions of their teaching and learning experiences. Methods A structured questionnaire was used to collect student views. The questionnaire comprised two parts: 16 closed questions to evaluate content and process of teaching and 5 open-ended questions. Questionnaires were completed at the end of each consultation skills session across all year groups during the 2006-7 academic year (5 sessions in Year 1, 3 in Year 2, 3 in Year 3, 10 in Year 4 and 10 in Year 5). 2519 questionnaires were returned in total. Results Students rated Tutor Facilitation most favourably, followed by Teaching, then Practice & Feedback, with suitability of the Rooms being most poorly rated. All years listed the following as important aspects they had learnt during the session: • how to structure the consultation • importance of patient-centredness • aspects of professionalism (including recognising own limits, being prepared, generally acting professionally). All years also noted that the sessions had increased their confidence, particularly through practice. Conclusions Our results suggest that a longitudinal and integrated approach to teaching consultation skills using a well structured model such as Calgary-Cambridge, facilitates and consolidates learning of desired process skills, increases student confidence, encourages integration of process and content, and reinforces appreciation of patient-centredness and professionalism.
The objective of this survey was to identify the importance placed by Croatian-based surgeons on writing scientific manuscripts and publishing them internationally, as well as their awareness of and attitudes toward medical writing. A link to an online survey was sent to 327 Croatian-based orthopedic and trauma surgeons. The electronic questionnaire consisted of rating scales, multiple choice questions and free text reply boxes. A total of 61 surgeons based in Croatia replied to the survey, yielding a response rate of 19% (61/327). The survey results indicate that surgeons in Croatia are active in both research and the writing of manuscripts. There is also a high level of interest among them to publish internationally in English to further their careers. While 68% (38/56) of respondents initially claimed to know about medical writing, further questioning on the subject revealed a reduced level of familiarity with the concept. Only 19% (11/58) of respondents had ever engaged the services of a medical writer and they were generally satisfied with the work done across the three areas of language, editing and scientific knowledge. Medical writers are advised to increase awareness of their services among Croatian-based orthopedic and trauma surgeons who may well have a need for their expertise. PMID:23697268
De Faoite, Diarmuid; Bakota, Bore; Staresini?, Mario; Kopljar, Mario; Cvjetko, Ivan; Dobri?, Ivan
Due to organ shortage and difficulties for availability of cadaveric donors, living donor transplantation is an important choice for having allograft. Live donor surgery is elective and easier to organize prior to starting dialysis thereby permitting preemptive transplantation as compared to cadaveric transplantation. Because of superior results with living kidney transplantation, efforts including the usage of “Medically complex living donors” are made to increase the availability of organs for donation. The term “Complex living donor” is probably preferred for all suboptimal donors where decision-making is a problem due to lack of sound medical data or consensus guidelines. Donors with advanced age, obesity, asymptomatic microhematuria, proteinuria, hypertension, renal stone disease, history of malignancy and with chronic viral infections consist of this complex living donors. This medical complex living donors requires careful evaluation for future renal risk. In this review we would like to present the major issues in the evaluation process of medically complex living kidney donor.
This study aims to explore the knowledge and beliefs of Chronic Kidney Disease (CKD) patients about the role of diet in their disease presentation and management. Focus Groups (FG) with nephrology and dialysis patients informed the development of a questionnaire. A sixty percent response rate was achieved (115/190) with 100 complete questionnaires available for analysis. 80 respondents said they would like to receive dietary advice as soon as they know they have renal damage. In most cases this would have been months or years sooner than they were referred to a dietitian. Group work and 'expert patient' assistance offer the means of delivering this service in a patient-centred way. It is also essential that doctors have access to accurate dietary advice so they can support patients appropriately to change their dietary behaviour. PMID:18786081
Perceived self-efficacy (SE) for eating fruit and vegetables (FV) is a key variable mediating FV change in interventions. This study applies item response modeling (IRM) to a fruit, juice and vegetable self-efficacy questionnaire (FVSEQ) previously validated with classical test theory (CTT) procedures. The 24-item (five-point Likert scale) FVSEQ was administered to 1578 fourth graders from 26 Houston schools. The IRM
The Dutch translation of the OM8-30 questionnaire, originally developed in the UK on a large clinical sample, has been applied\\u000a for validation in an ENT sample, with the aim of assessing otitis media impact and identifying treatment needs in children\\u000a suffering from chronic otitis media (OM) and\\/or upper respiratory tract infections (URTI). Caregivers of 246 children completed\\u000a the OM8-30 and
Angelique A. Timmerman; Cor M. G. Meesters; Lucien J. C. Anteunis; Michelene N. Chenault; Mark P. Haggard
There is growing demand for translations of health status questionnaires for use in multinational drug therapy studies and for population comparisons of health statistics. The International Quality of Life Assessment (IQOLA) Project is conducting a three-stage research program to determine the feasibility of translating the SF-36 Health Survey, widely used in English-speaking countries, into other languages. In stage 1, the
Ware John E. Jr; Susan D. Keller; Barbara Gandek; John E. Brazier; Marianne Sullivan
BACKGROUND: The aim of this study is to validate the questionnaire ECOS-16 (Assessment of health related quality of life in osteoporosis) for the evaluation of health related quality of life (HRQoL) in post-menopausal women with osteoporosis. METHODS: An observational, prospective and multi-centre study was carried out among post-menopausal women with osteoporosis in primary care centres and hospital outpatient clinics. All
Background Asthma is one of the most common chronic diseases in women of reproductive age, occurring in up to 8% of pregnancies. Objective Assess the prevalence of asthma medication use during pregnancy in a large diverse cohort. Methods We identified women aged 15 to 45 years who delivered a live born infant between 2001 and 2007 across 11 U.S. health plans within the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). Using health plans’ administrative and claims data, and birth certificate data, we identified deliveries for which women filled asthma medications from 90 days before pregnancy through delivery. Prevalence (%) was calculated for asthma diagnosis and medication dispensing. Results There were 586,276 infants from 575,632 eligible deliveries in the MEPREP cohort. Asthma prevalence among mothers was 6.7%, increasing from 5.5% in 2001 to 7.8% in 2007. A total of 9.7% (n=55,914) of women were dispensed asthma medications during pregnancy. The overall prevalence of maintenance-only medication, rescue-only medication, and combined maintenance and rescue medication was 0.6%, 6.7%, and 2.4% respectively. The prevalence of maintenance-only use doubled during the study period from 0.4% to 0.8%, while rescue-only use decreased from 7.4% to 5.8%. Conclusions In this large population-based pregnancy cohort, the prevalence of asthma diagnoses increased over time. The dispensing of maintenance-only medication increased over time, while rescue-only medication dispensing decreased over time.
Hansen, Craig; Joski, Peter; Freiman, Heather C.; Andrade, Susan; Toh, Sengwee; Dublin, Sascha; Cheetham, T. Craig; Cooper, William O.; Pawloski, Pamala A.; Li, De-Kun; Beaton, Sarah J.; Scott, Pamela E.; Hammad, Tarek; Davis, Robert
ObjectiveGiven the need for continuing education in medical informatics for mid-career professionals, the authors aimed to implement and evaluate distance learning courses in this area.DesignThe authors performed a needs assessment, content and technology planning, implementation, and student evaluation.MeasurementsThe needs assessment and student evaluations were assessed using a combination of Likert scale and free-form questions.ResultsThe needs assessment indicated much interest in
William R Hersh; Katherine Junium; Mark Mailhot; Patricia Tidmarsh
BACKGROUND: The Medical Student Research Programme is a national education and grant scheme for medical students who wish to carry out research in parallel with their studies. The purpose of the programme is to increase recruitment of people with a standard medical degree to medical research. The Research Programme was established in 2002 and underwent a thorough evaluation during the
Steinar Hunskaar; Jarle Breivik; Maje Siebke; Karin Tømmerås; Kristian Figenschau; John-Bjarne Hansen
Aim To assess physicians’ knowledge and practices for obtaining patients’ informed consent to medical procedures. Methods An anonymous and voluntary survey of knowledge and practices for obtaining informed consent was conducted among 470 physicians (63% response rate) working in 6 hospitals: 93 specialists in anesthesiology, 166 in internal medicine, and 211 in surgery. Results Only 54% physicians were acquainted with the fact that the procedure for obtaining consent was regulated by the law. Internists and surgeons were better informed than anesthesiologists (P?=?0.024). More than a half of respondents (66%) were familiar with the fact that a law on patient rights was passed in Croatia; there were no differences among different specialties (P?=?0.638). Only 38% of the physicians were fully informed about the procedure of obtaining consent. Internists and surgeons provided detailed information to the patient in 33% of the cases and anesthesiologists in 16% of the cases (P?0.050). Internists reported spending more time on informing the patient than anesthesiologists and surgeons (P?0.001). There were no differences in knowledge and practices for obtaining informed consent between physicians working in university and those working in community hospitals (P???0.05 for all questions). Conclusion Physicians in Croatia have no formal education on informed consent and implement the informed consent process in a rather formal manner, regardless of the type of hospital or medical specialty. Systemic approach at education and training at the national level is needed to improve the informed consent process.
Background The aim of this study is to validate the questionnaire ECOS-16 (Assessment of health related quality of life in osteoporosis) for the evaluation of health related quality of life (HRQoL) in post-menopausal women with osteoporosis. Methods An observational, prospective and multi-centre study was carried out among post-menopausal women with osteoporosis in primary care centres and hospital outpatient clinics. All patients attended 2 visits: at baseline and at 6 months. In addition, the subgroup of outpatients attended another visit a month after the baseline to assess the test-retest reliability. The psychometric properties of the questionnaire were evaluated in terms of feasibility, validity (content validity and construct validity) and internal consistency in baseline, and in terms of test-retest reliability and responsiveness to change in visit at month and visit at 6 months, respectively. In all visits, ECOS-16, EUROQoL-5D (EQ-5D) and four 7-point items about health status (general health status, back pain, limitation in daily activities and emotional status) were administered, whereas only outpatients were given MINI-OQLQ (Mini Osteoporosis Quality of Life Questionnaire), besides all clinical variables; and sociodemographic variables at baseline. Results 316 women were consecutively included, 212 from primary care centres and 104 from hospital outpatient clinics. Feasibility: 94.3% of patients answered all items of the questionnaire. The mean administration time was 12.3 minutes. Validity: factor analysis suggested that the questionnaire was unidimensional. In the multivariate analysis, patients with vertebral fractures, co-morbidity and a lower education level showed to have worse HRQoL. Moderate to high correlations were found between the ECOS-16 score and the other health status questionnaires (0.47–0.82). Reliability: internal consistency (Cronbach's ?) was 0.92 and test-retest reliability (ICC) was 0.80. Responsiveness to change: ECOS-16 scores increased according to change perceived by the patient, as well as the effect size (ranges between 1.35 to 0.43), the greater the perception of change in patients' general health status, the greater the changes in patients' scores. The Minimal Clinically Important Difference (MCID) suggested a change of 0.5 points in the ECOS-16 score, representing the least improvement in general health status due to their osteoporosis: "slightly better". Conclusion ECOS-16 has been proven preliminarily to have good psychometric properties, so that it can be potentially a useful tool to evaluate HRQoL of post-menopausal women with osteoporosis in research and routine clinical practice.
The Tridimensional Personality Questionnaire (TPQ) is a 100-item true-false self-questionnaire proposed by R. Cloninger and based on a three independent dimensions model of personality. These three dimensions, each with four sub-scales, are Novelty Seeking (NS), Harm Avoidance (HA) and Reward Dependence (RD). Recently, several groups have used the TPQ to study clinical samples, and other have reported normative data in the general population but, up to date, no result has been published on the French TPQ version. The aims of this study were therefore to assess the psychometric properties of this questionnaire and also to research an eventual relationship between dimensions of personality and anxiety and depression mood, measured by mood and anxiety scales in out-patients. A population of 165 subjects was included in this study and assessed with the TPQ. In this sample, 119 patients completed also the Hospital Anxiety and Depression (HAD) scale. The factor analysis with a Varimax rotation suggests three possible solutions with 3, 4 or 5 factors for the TPQ. These all three analysis indicate that the dimensions NS and HA load consistently unto the first two factors, and seem therefore two robust and independent dimensions. Contrastly, the RD dimension seems definitely heterogeneous, even if the RD2 sub-scale (persistence) is treated separately from the other as proposed by Cloninger. Analysis of correlations between TPQ dimensions and HAD sub-score show that only the HA dimension is related to anxiety sub-score (r = 0.34), depression subscore (r = 0.52) and total HAD score (r = 0.47).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7875109
Lépine, J P; Pelissolo, A; Téodorescu, R; Téhérani, M
Law on promotion of renovation for earthquake-resistant structures was revised in 2006. Since then administrative agencies have been promoting seismic diagnosis and retrofit of houses. But citizens living in densely built-up areas cannot rebuild their houses because of their economic reasons and Building Standards Act regulations. Therefore, we conducted questionnaire surveys of construction companies located in Ishikawa Prefecture and citizens living in Kanazawa City. The results of surveys show that many construction companies are not in favor of simple method of seismic retrofit, and that width of roads hardly influence the citizens' consciousness to renovation for earthquake-resistant structures.
Background The internet is increasingly being used worldwide in imparting medical education and improving its delivery. It has become an important tool for healthcare professionals training but the data on its use by medical students in developing countries is lacking with no study on the subject from Pakistan. This study was, therefore, carried out with an aim to evaluate the pattern of internet access and utilization by medical students in Pakistan. Methods A structured pre-tested questionnaire was administered to a group of 750 medical students in clinical years studying at various public and private medical colleges in Lahore. The questions were related to patterns of internet access, purpose of use and self reported confidence in performing various internet related tasks, use of health related websites to supplement learning and the problems faced by students in using internet at the institution. Results A total of 532 medical students (70.9%) returned the questionnaire. The mean age of study participants was 21.04 years (SD 1.96 years). Majority of the respondents (84.0%) reported experience with internet use. About half of the students (42.1%) were using internet occasionally with 23.1%, 20.9% and 13.9% doing so frequently, regularly and rarely respectively. About two third of the students (61.0%) stated that they use internet for both academic and professional activities. Most of the participants preferred to use internet at home (70.5%). Self reported ability to search for required article from PubMed and PakMedinet was reported by only 34.0% of the entire sample. Students were moderately confident in performing various internet related tasks including downloading medical books from internet, searching internet for classification of diseases and downloading full text article. Health related websites were being accessed by 55.1% students to supplement their learning process. Lack of time, inadequate number of available computers and lack of support from staff were cited as the most common problems faced by students while accessing internet in the institution premises. There were significant differences among male and female students with respect to the place of internet use (p = 0.001) and the ability to search online databases for required articles (p = 0.014). Conclusions Majority of the medical students in this study had access to internet and were using it for both academic and personal reasons. Nevertheless, it was seen that there is under utilization of the potential of internet resources to augment learning. Increase in awareness, availability of requisite facilities and training in computing skills are required to enable better utilization of digital resources of digital resources by medical students.
A diagnostic evaluation for a person with suspected Alzheimer's disease is usually initiated by family members whose concerns go beyond strictly medical issues. To determine precisely what questions families want answered, a 15-point questionnaire was developed at a multi-disciplinary geriatric assessment clinic. Caregivers were asked to rate each…
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... 2012-10-01 false Content of medical care evaluation studies. 456.243...HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL...Control: Mental Hospitals Ur Plan: Medical Care Evaluation Studies Â§...
...2012-10-01 false UR plan requirements for medical care evaluation studies. 456.142...HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL...Utilization Control: Hospitals Ur Plan: Medical Care Evaluation Studies Â§...
The Physical Activity Questionnaire for Elderly Japanese (PAQ-EJ) is a self-administered physical activity questionnaire for elderly Japanese; the authors report here on its repeatability and direct and indirect validity. Reliability was assessed by repeat administration after 1 month. Direct validation was based on accelerometer data collected every 4 s for 1 month in 147 individuals age 65-85 years. Indirect validation against a 10-item Barthel index (activities of daily living [ADL]) was completed in 3,084 individuals age 65-99 years. The test-retest coefficient was high (r = .64-.71). Total and subtotal scores for lower (transportation, housework, and labor) and higher intensity activities (exercise/sports) were significantly correlated with step counts and durations of physical activity <3 and >or=3 METs (r = .41, .28, .53), respectively. Controlling for age and ADL, scores for transportation, exercise/sports, and labor were greater in men, but women performed more housework. Sex- and ADL- or age-adjusted PAQ-EJ scores were significantly lower in older and dependent people. PAQ-EJ repeatability and validity seem comparable to those of instruments used in Western epidemiological studies. PMID:18048944
Yasunaga, Akitomo; Park, Hyuntae; Watanabe, Eiji; Togo, Fumiharu; Park, Sungjin; Shephard, Roy J; Aoyagi, Yukitoshi
Evaluated two different taped relaxation training programs with 39 psychiatric inpatients, half of whom received minor tranquilizers in conjunction with relaxation training. The enhanced relaxation program produced slightly more therapeutic effects than the standard training program. Significant differences were found between the medicated and the…
BACKGROUND: In 1996 The University of Liverpool reformed its medical course from a traditional lecture-based course to an integrated PBL curriculum. A project has been underway since 2000 to evaluate this change. Part of this project has involved gathering retrospective views on the relevance of both types of undergraduate education according to graduates. This paper focuses on the views of
The expression of memory worries and the self-reporting of daily forgetfulness easily spark discussion among sufferers and their family or friends about what is normal or abnormal forgetfulness. One way to investigate whether the reporting of forgetfulness might be excessive is to use a standardized memory questionnaire--for instance, the Multifactorial Memory Questionnaire (MMQ). The MMQ measures worries, daily forgetfulness, and memory strategy use. In this study we present a psychometric evaluation of the Dutch translation of the MMQ and provide normative data to determine the significance of individual differences in subtest scores. In addition, clinical examples are given of the use and interpretation of percentile norms and single-case statistics. PMID:21253959
This paper presents the evaluation of a Breaking Bad News course run for three groups of medical students (fourth and fifth year from the London Hospital Medical College and fourth year from St Bartholomew's Hospital Medical College). The course, which is student centred, uses group discussion, videotape presentations and role-play including actors. All teachers, clinicians and human science tutors, had been through a staff training programme on teaching methods. At the end of the course, students' knowledge of important principles in giving bad news had increased, particularly in relation to interpersonal communication; they were more confident in their ability to break bad news well; and the course learning methods were highly rated. The course was just as well received by fourth year as by fifth year students and several said they would like more of this training. The evaluation shows that if reservations about role-play can be overcome then this experiential learning is highly valued by students. PMID:8594407
|This instrument was designed to provide a goal-free evaluation of a pilot training program for Medical Nurse Practitioners. With minor modification, the instrument can be applied to programs at several educational levels: secondary, college, adult, and continuing. The instrument uses 5-point Likert-type scales (with positive and negative…
|This article describes a psychotropic PRN Evaluative Tool developed by interprofessional clinicians to address inconsistent reporting and assessment of the effectiveness of PRN medications used for people who are developmentally disabled. Fifty-nine participants (37 males, 22 females), ages 16 to 60 years, were included in the review, all…
Silk, Larry; Watt, Jackie; Pilon, Nancy; Draper, Chad
This study examined the records of 252 admissions to an impatient drug rehabilitation program for African American women between July 1989 and July 1991 to determine the prevalence and treatability of the medical conditions found on screening evaluation. All but 0.7% of subjects were on General Relief, Medicare, Medicaid, or had no payment source. The results showed a high prevalence
Mary Anne Curtiss; Kellene M. Lenz; Nicole R. Frei
Results are presented of a project undertaken to evaluate the success of the MED-WISE Programs systems approach in effecting medication compliance in the elderly. The project had three objectives: (1) to improve the patient-physician relationship, (2) to ...
A continuing medical education program is discussed that addresses chronic obstructive pulmonary disease and that links primary care physicians to a source of needed clinical knowledge at a relatively low cost. The educational methods, evaluation design, diagnosis of educational needs, selection of program content and behavioral outcomes are…
The development of medical imaging equipments generates growing amount of pictorial data from the intern organs of the human body. On the other hand the automatically evaluation of the huge amount of pictures and videos is in the very beginning phase, which causes a high need for well trained personal. Over the high cost, the lack of sophisticated and reliable
This study reports experience with standardized patients in evaluating an educational intervention to promote smoking?cessation skills among third?year medical students at Case Western Reserve University School of Medicine. In the context of an objective structured clinical examination, students obtained only 50% of items recommended for assessment of nicotine dependency, motivation to quit smoking, and recognition of barriers to smoking cessation.
This article suggests that quality assessment in the UK has been largely set apart from learning and teaching and reports on a pilot project at the Hull York Medical School which attempted to integrate students' evaluation of their clinical placements into the curriculum. It outlines the operational demands of this integrated method and compares…
We study a policy aimed at reducing the insurance costs paid by local public healthcare providers. The policy is based on enhanced monitoring of medical malpractice claims by the regional government that rules local providers. In particular, we implement a Difference-in-Differences strategy using Italian data at the provider level from 2001 to 2008 to evaluate the impact of monitoring on
|Introduction: Much of the international community has an increased awareness of potential biologic, chemical, and nuclear threats and the need for physicians to rapidly acquire new knowledge and skills in order to protect the public's health. The present study evaluated the educational effectiveness of an online bioterrorism continuing medical…
I. Background: This guideline is structured to provide Canadian urologists with practical recommendations for the evaluation and medical management of kidney stone disease, with a particular emphasis on calcium nephrolithiasis. The goals of this guideline are to promote the identification of significant underlying systemic and urinary abnormalities that will predispose the patient to recurrent nephrolithiasis as well as equip urologists
More extensive material characterisation and increased determination of toxicological risks are now required when evaluating new medical devices. The new requirements together with other changes in the ISO 10993 series described here suggest how companies can adjust their approach. PMID:15984539
BACKGROUND: Asthma is the most common chronic disease in children. OBJECTIVES: To describe the prevalence of asthma and allergic disease in a multiethnic, population-based sample of Toronto (Ontario) school children attending grades 1 and 2. METHODS: In 2006, the Toronto Child Health EvaluationQuestionnaire (T-CHEQ) used the International Study of Asthma and Allergies in Childhood survey methodology to administer questionnaires to 23,379 Toronto school children attending grades 1 and 2. Modifications were made to the methodology to conform with current privacy legislation and capture the ethnic diversity of the population. Lifetime asthma, wheeze, hay fever and eczema prevalence were defined by parental report. Asthma was considered to be current if the child also reported wheeze or asthma medication use in the previous 12 months. RESULTS: A total of 5619 children from 283 randomly sampled public schools participated. Children were five to nine years of age, with a mean age of 6.7 years. The overall prevalence of lifetime asthma was 16.1%, while only 11.3% had current asthma. The reported prevalence of lifetime wheeze was 29.2%, while 14.2% reported wheeze in the past 12 months. Sociodemographic and major health determinant characteristics of the T-CHEQ population were similar to 2001 census data, suggesting a diverse sample that was representative of the urban childhood population. CONCLUSIONS: Asthma continues to be a highly prevalent chronic disease in Canadian children. A large proportion of children with reported lifetime asthma, who were five to nine years of age, did not report current asthma symptomatology or medication use.
Dell, Sharon D; Foty, Richard G; Gilbert, Nicolas L; Jerrett, Michael; To, Teresa; Walter, Stephen D; Stieb, David M
Background: This study was developed to assess study habits of medical students in a third-year surgical clerkship and to determine the relationship of these study habits to performance outcomes.Methods: A questionnaire designed to assess medical student study habits was administered at the end of five consecutive 10-week multidisciplinary surgical clerkships. The results of questionnaires from 81 students were analyzed in
Margaret L Boehler; Cathy J Schwind; Roland Folse; Gary Dunnington; Stephen Markwell; S Dutta
Purpose: The objective of this study was to assess student perceptions of the environment in this medical college using the Dundee Ready Educational Environment Measure (DREEM). Methods: Cross-sectional study; 348 medical student volunteers (68.1%) of all semesters participated (511 enrolled). DREEM has 50 items, each rated from 0–4 (Likert scale: 0, strongly disagree to 4, strongly agree), that measure five domains: students’ perceptions of learning; perceptions of teachers; academic self-perception; perceptions of the atmosphere; and social self-perception. Mean item scores, domain scores, and global scores were computed. Results: The three highest rated items were knowledgeable teachers, having good friends, and confidence about passing; the three most problematic items were a poor support system for stressed students, inability to memorize everything, and over-emphasis on factual learning. The percentage score for perception of learning (47.26± 14.85) was significantly lower than that for teachers (52.28± 9.91; P< 0.001); academic self-perception (52.14 ± 15.21; P < 0.001); perception of the atmosphere (51.21 ± 13.60; P = 0.001); and social self-perception (50.63± 13.90; P= 0.010). The global scores were lowest for eighth-semester students (89.8± 21.24) when compared to second (101.33± 21.05; P= 0.003), fourth (107.69± 18.96; P< 0.001), and sixth (100.07± 20.61; P= 0.020). Conclusion: Improvement is required across all domains of the educational environment at this institution. Students, particularly of the eighth semester, perceived the teaching negatively. The lowest scores were given to the support system, burdensome course content, and factual learning; thus, a hybrid curriculum that includes problem-based learning might provide students with stimulating learning; structured clinical teaching with specific curricular objectives, as well as mentoring of senior students by faculty and near-peers, might improve the learning environment for senior students.
The current study compared the psychometric properties and clinical/research utility of four distinct factor/subscale models of alcohol craving (three factor-derived models, and one rationally-derived model) as measured by the Alcohol Craving Questionnaire-Now in social (n = 52) and alcohol dependent (n = 71) drinkers. All participants completed a self-report measure of alcohol abuse in addition to engaging in a structured interview and cue reactivity protocol. Participants provided self-reported craving, as well as desire to approach or avoid drinking, during a cue exposure task using separate analogue scales. Factor/subscale models were compared in terms of internal consistency, convergent and divergent validity, and ability to predict cue-elicited approach and craving in addition to diagnostic status. All models demonstrated high levels of internal consistency, convergent and divergent validity, and the ability to predict both cue-elicited craving and alcohol dependence status. Specific strengths and weaknesses of each model are examined and the theoretical, clinical, and research utility of the current findings are discussed.
Connolly, Kevin M.; Coffey, Scott F.; Baschnagel, Joseph S.; Drobes, David J.; Saladin, Michael E.
Objective: Simulations of doctor-patient interactions have become a popular method for the training of medical skills, primarily communication skills. A new questionnaire for the measurement of students’ satisfaction with medical courses using this technique is presented, the Student Evaluation Scale for Medical Courses with Simulations of the Doctor-Patient Interaction (SES-Sim). Method: A set of items focusing on the course quality and the core elements of simulations was created and presented to 220 medical students who had been trained with this method. Results: Based on factor-analyses 18 items were selected for the final version of the scale, which represent five dimensions: learning success, actors, premises, tutors and students. The five dimensions are all significantly correlated with a 1-item-measure of the general satisfaction with the course. Conclusion: The SES-Sim enables tutors to assess in an economic way whether the course has met the students’ needs and what can be done better.
Neumann, Eva; Obliers, Rainer; Schiessl, Christine; Stosch, Christoph; Albus, Christian
Objectives. We sought to determine the frequency of psychological symptoms and elevated posttraumatic stress disorder (PTSD) risk among New York City firefighters after the World Trade Center (WTC) attack and whether these measures were associated with Counseling Services Unit (CSU) use or mental health–related medical leave over the first 2.5 years after the attack. Methods. Shortly after the WTC attack, a computerized, binary-response screening questionnaire was administered. Exposure assessment included WTC arrival time and “loss of a co-worker while working at the collapse.” We determined elevated PTSD risk using thresholds derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and a sensitivity-specificity analysis. Results. Of 8487 participants, 76% reported at least 1 symptom, 1016 (12%) met criteria for elevated PTSD risk, and 2389 (28%) self-referred to the CSU, a 5-fold increase from before the attack. Higher scores were associated with CSU use, functional job impairment, and mental health–related medical leave. Exposure–response gradients were significant for all outcomes. Conclusions. This screening tool effectively identified elevated PTSD risk, higher CSU use, and functional impairment among firefighters and therefore may be useful in allocating scarce postdisaster mental health resources.
Corrigan, Malachy; McWilliams, Rita; Kelly, Kerry J.; Niles, Justin; Cammarata, Claire; Jones, Kristina; Wartenberg, Daniel; Hallman, William K.; Kipen, Howard M.; Glass, Lara; Schorr, John K.; Feirstein, Ira
The objective of the investigation was to better assess the degree of overall patient satisfaction with and acceptance of the physical therapist as a primary evaluator for patients presenting with musculoskeletal disorders. A one page anonymous questionna...
Although the 36-Item Short-Form General Health Survey (SF-36) has been utilized to assess quality of life (QoL) in cross-sectional\\u000a studies, no longitudinal studies have evaluated this instrument in stone formers. Hence, we evaluated the performance of the\\u000a SF-36 over time in a group of stone formers. From January to May 2007, the SF-36 was administered by independent interviewers\\u000a to 155
Chester J. Donnally; Amit Gupta; Karim Bensalah; Altug Tuncel; Jay Raman; Margaret S. Pearle; Yair Lotan
Background Although cervical cancer is ??the second most common tumor among Brazilian women, studies that evaluate the quality of life of these women are still scarce. This situation is explained by the lack of specific and validated tools for this purpose in Portuguese (Brazil). The aim of this study was to evaluate the psychometric properties of the Portuguese version of the FACT-CX (Functional Assessment of Cancer Therapy-Cervix) questionnaire in a population of Brazilian women with cervical cancer. Methods The psychometric properties of the FACT-CX questionnaire were tested in a sample of 100 women diagnosed with cervical cancer who were previously treated in the Barretos Cancer Hospital. We analyzed the internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient - ICC), confirmatory factor analysis, convergent validity (correlation with the SF-36 questionnaire), and discriminant validity by disease stage and two questions related to self-perception of health was also performed. Results The scales had Cronbach´s alpha coefficients ranging from 0.61 to 0.80. However, three scales did not have a statistically significant coefficient greater than 0.70. The ICC ranged from 0.68 to 0.82 and all considered satisfactory. Factor analysis did not generate consistent components. The FACT-G and FACT-CX total scores had good internal consistency and reproducibility, and also correlated well with the General Health and Vitality scales of the SF-36. However, only two FACT-CX scales had a significant correlation with SF-36. Discriminant analysis showed that FACT-CX failed to discriminate groups according to clinical stage but was able to divide the women according to the self-perception of health. Conclusion FATC-CX total score had good internal consistency, reproducibility and discriminant validity. In addition, it correlated well with General Health and Vitality scales of SF-36. However, three scales had questionable internal consistency and only two had significant correlation with SF-36.
Fregnani, Cristiane Menezes Sirna; Fregnani, Jose Humberto Tavares Guerreiro; Dias de Oliveira Latorre, Maria do Rosario; de Almeida, Ana Maria
Objective: This study was undertaken to determine if a systematic review of the evidence from thirty years of literature evaluating clinical medical librarian (CML) programs could help clarify the effectiveness of this outreach service model. Methods: A descriptive review of the CML literature describes the general characteristics of these services as they have been implemented, primarily in teaching-hospital settings. Comprehensive searches for CML studies using quantitative or qualitative evaluation methods were conducted in the medical, allied health, librarianship, and social sciences literature. Findings: Thirty-five studies published between 1974 and 2001 met the review criteria. Most (30) evaluated single, active programs and used descriptive research methods (e.g., use statistics or surveys/ questionnaires). A weighted average of 89% of users in twelve studies found CML services useful and of high quality, and 65% of users in another overlapping, but not identical, twelve studies said these services contributed to improved patient care. Conclusions: The total amount of research evidence for CML program effectiveness is not great and most of it is descriptive rather than comparative or analytically qualitative. Standards are needed to consistently evaluate CML or informationist programs in the future. A carefully structured multiprogram study including three to five of the best current programs is needed to define the true value of these services.
Background The patient-centered medical home (PCMH) has become a widely cited solution to the deficiencies in primary care delivery in the United States. To achieve the magnitude of change being called for in primary care, quality improvement interventions must focus on whole-system redesign, and not just isolated parts of medical practices. Methods Investigators participating in 9 different evaluations of Patient Centered Medical Home implementation shared experiences, methodological strategies, and evaluation challenges for evaluating primary care practice redesign. Results A year-long iterative process of sharing and reflecting on experiences produced consensus on 7 recommendations for future PCMH evaluations: (1) look critically at models being implemented and identify aspects requiring modification; (2) include embedded qualitative and quantitative data collection to detail the implementation process; (3) capture details concerning how different PCMH components interact with one another over time; (4) understand and describe how and why physician and staff roles do, or do not evolve; (5) identify the effectiveness of individual PCMH components and how they are used; (6) capture how primary care practices interface with other entities such as specialists, hospitals, and referral services; and (7) measure resources required for initiating and sustaining innovations. Conclusions Broad-based longitudinal, mixed-methods designs that provide for shared learning among practice participants, program implementers, and evaluators are necessary to evaluate the novelty and promise of the PCMH model. All PCMH evaluations should as comprehensive as possible, and at a minimum should include a combination of brief observations and targeted qualitative interviews along with quantitative measures.
Crabtree, Benjamin F.; Chase, Sabrina M.; Wise, Christopher G.; Schiff, Gordon D.; Schmidt, Laura A.; Goyzueta, Jeanette R.; Malouin, Rebecca A.; Payne, Susan M. C.; Quinn, Michael T.; Nutting, Paul A.; Miller, William L.; Jaen, Carlos Roberto
|In many countries, there has been a development towards the inclusion of students with special educational needs in regular education. Over the past decade, this has resulted in an increased interest in attitudes towards this educational change of those directly involved. This current study aims at the development, psychometric evaluation, and…
de Boer, Anke; Timmerman, Marieke; Pijl, Sip Jan; Minnaert, Alexander
|Recently, several instruments have been developed to measure the subjective component of the quality of life (QOL) of people with profound intellectual and multiple disabilities (PIMD). A next step, however, must be the further validation of these instruments. The present study aimed at evaluating the psychometric properties of one of these…
Aims This study was designed to develop and evaluate a self-report measure of gambling motives. Participants A community-recruited sample of 193 gamblers (70% male; mean age = 35.5 years) were selected to fill two groups according to scores on the South Oaks Gambling Screen: probable pathological gamblers (PPG; n = 154) and non- pathological gamblers (NPG; n = 39). Measures
Alcohol expectancies are important in the mediation and prediction of alcohol use. Expectancies for the effects of other drugs, although less well delineated, appear equally important. Therefore, development and validation of expectancy measures for drugs other than alcohol is necessary for evaluating the importance of these constructs. We examined the factor structure, reliability, and validity of the Marijuana Effect Expectancy
Gregory A. Aarons; Sandra A. Browna; Eric Sticed; Michael T. Coee
Economic evaluation in health care is still an evolving discipline. One of the current controversies in cost-effectiveness analysis regards the inclusion or exclusion of future non-medical costs (i.e. consumption net of production) due to increased survival. This paper examines the implications of a symmetry rule stating that there should be consistency between costs included in the numerator and utility aspects
Bengt Liljas; Göran S. Karlsson; Nils-Olov Stålhammar
Background: Osteoporosis is the most common osteopathy. Osteoporosis is recognized by World Health Organization as a civilization disease. Still, the awareness of osteoporosis in polish society is unknown. The aim of the study is demographic evaluation of people who are interested in diagnosis and treatment of osteoporosis. Another aim is to analyze data such as age, sex, fracture occurrence, style of life of people who have phoned to Osteoporosis Information Telephone (OIT). Material and methods: The analysis was based on 501 individuals (446 women, 55 men). The evaluated parameters were age, sex, place of living, education, risk factor awareness, fracture occurrence and the source of knowledge about OIT. The auxiliary questions concerned previous diagnosis and treatment. Results: In 83,3 % of analyzed group the general information about osteoporosis was acquired from newspapers, 13,11% from books and folders, 3 % from radio programmes, 0,4 % from TV, and 0,19% from internet. 23,5% of people acquired information about OIT from magazines including weekly TV programme. 148 people (29,5%) were examined by densitometry. 57 people (11,3%) had a previous history of bone fractures. Conclusions: Our study helps to evaluate the social awareness of osteoporosis in people interested in this problem. We hope that our results will help to rise social awareness of osteoporosis thanks to new medial advertising companies in the future and will become the base for others analyzes of osteoporosis. PMID:17581512
Górski, Rados?aw; Chmielewski, Dariusz; Zgoda, Marcin
Body checking is considered an expression of an excessive preoccupation with appearance. The first aim of this study was to evaluate the psychometric properties of a Brazilian Portuguese version of the Body Checking Questionnaire (BCQ). Additionally, we wanted to examine the questionnaire’s associations with body avoidance behaviour, body mass index, dietary habits, and the intensity, frequency, and length of physical exercise. Finally, we also examined the differences between the total BCQ score and the individual BCQ factor scores. Differences between active and sedentary persons and between non-dieters and those on weight-loss diets were also analyzed. For the psychometric study, 546 female public university students from four different courses were surveyed. Two minor samples of university students and eating disorders women were also recruited. In the second part of the study, 403 women were recruited from weight-loss programs, gyms, and a university. All participants were verbally invited to participate in the research and voluntarily took part. Confirmatory factor analysis showed a good fit to the original model of the Brazilian BCQ that retained all 23 items. Satisfactory evidence of construct validity and internal consistency were also generated through analysis of factor loadings, t-values, Cronbach’s alpha, and construct reliability tests. The results also showed associations among body checking and body avoidance, body satisfaction, social anxiety, body mass index, and the frequency and intensity of physical exercise. Significant differences were found between non-dieters and weight-loss dieters for all BCQ factors and the total BCQ score. For physically active and sedentary persons, a significant difference was only observed for idiosyncratic checking behaviour. In conclusion, the BCQ appears to be a valid and reliable scale for Brazilian research, and the associations and differences found in this study suggest that women at gyms and especially in weight-loss programs should be targeted for future body checking studies.
Campana, Angela Nogueira Neves Betanho; Swami, Viren; Onodera, Carolina Mie Kawagosi; da Silva, Dirceu; Tavares, Maria da Consolacao Gomes Cunha Fernandes
In an attempt to improve data quality and ease of administration of standard self-administered food frequency questionnaires, various alternative approaches were tried for inquiring about frequency of consumption, portion size, seasonal intake, and food preparation. Evaluation consisted of a cognitive interviewing method in which respondents verbalize their thought process while completing several variations of a questionnaire. Interviewers observed and asked
AMY F SUBAR; FRANCES E THOMPSON; ALBERT F SMITH; JARED B JOBE; REGINA G ZIEGLER; NANCY POTISCHMAN; ARTHUR SCHATZKIN; ANNE HARTMAN; CHRISTINE SWANSON; LAURA KRUSE; RICHARD B HAYES; DENISE RIEDEL LEWIS; LINDA C HARLAN
In 1991, the NRC, Division of Industrial and Medical Nuclear Safety, began a program to evaluate the use of probabilistic risk assessment (PRA) in regulating medical devices. This program represents an initial step in an overall plant to evaluate the use of PRA in regulating the use of nuclear by-product materials. The NRC envisioned that the use of risk analysis techniques could assist staff in ensuring that the regulatory approach was standardized, understandable, and effective. Traditional methods of assessing risk in nuclear power plants may be inappropriate to use in assessing the use of by-product devices. The approaches used in assessing nuclear reactor risks are equipment-oriented. Secondary attention is paid to the human component, for the most part after critical system failure events have been identified. This paper describes the risk methodology developed by Lawrence Livermore National Laboratory (LLNL), initially intended to assess risks associated with the use of the Gamma Knife, a gamma stereotactic radiosurgical device. For relatively new medical devices such as the Gamma Knife, the challenge is to perform a risk analysis with very little quantitative data but with an important human factor component. The method described below provides a basic approach for identifying the most likely risk contributors and evaluating their relative importance. The risk analysis approach developed for the Gamma Knife and described in this paper should be applicable to a broader class of devices in which the human interaction with the device is a prominent factor. In this sense, the method could be a prototypical model of nuclear medical or industrial device risk analysis.
Jones, E.D. [Lawrence Livermore National Lab., CA (United States); Cunningham, R.E.; Rathbun, P.A. [Nuclear Regulatory Commission, Washington, DC (United States). Office of Nuclear Material Safety and Safeguards
Four possible froms of bias in the evaluation of diagnostic information are evaluated. Reanalysis of a previously published experiment, in which radiologists evaluated excretory urograms, shows that the radiologists' assessment of the likelihood of a tumor being present was inappropriately influenced by the importance of ruling the tumor out. A new experiment is described in which fourth-year medical students and practicing pediatricians completed workups of hypothetical patients. In this study, both students and physicians subjectively distorted information in the latter part of the workup to support opinion formed up to that point. Also in evaluating diagnoses, students to a large degree and physicians to a lesser degree tended to ignore rates of disease prevalence. A fourth possible bias, that early, unreliable historical information dominates later, more reliable laboratory data, was not confirmed. Suggestions for overcoming the demonstrated biases, as well as other cognitive biases in the processing of diagnostic information, are made. PMID:7052407
Aim To examine the knowledge, skills and attitudes of medical students to alcohol and drugs as training progresses. Design A longitudinal, prospective, cohort-based design. Setting The four schools of medicine in New Zealand. Participants All second-year medical students (first year of pre-clinical medical health sciences) in New Zealand were administered a questionnaire which was repeated in the fourth (first year
The lack of an available Swedish version of the Patient Health Questionnaire 15-Item Somatic Symptom Severity Scale (PHQ-15) motivated the present psychometric evaluation of such a version as well as providing normative data for the PHQ-15. Data from 3,406 individuals who took part in the Västerbotten Environmental Health Study in Sweden were used. The respondents constitute a random sample, aged 18 to 79 years, stratified for age and sex. They responded to a Swedish translation of the PHQ-15 as well as the Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the Shirom Melamed Burnout Questionnaire for assessment of convergent validity. The distribution of PHQ-15 scores was positively skewed and mesokurtic in shape, and the internal consistency of the PHQ-15 was satisfactory. Correlation coefficients between PHQ-15 score and the measures of anxiety, depression, stress and mental/physical exhaustion indicate satisfactory validity. Normative data for PHQ-15 scores as well as for categories of somatic symptom severity are provided. The favorable psychometric properties of the Swedish version of the PHQ-15 suggest use of this instrument for quantification of somatization in Swedish and similar populations, and has the advantage of available normative data. PMID:23294182
College students (N=396), chronic pain patients (N=319), and schizophrenic veterans (N=43) completed the Depression Coping Questionnaire (DCQ) and the Beck Depression Inventory (BDI). Factor analysis of the DCQ identified eleven coping responses: social support, problem solving, self-blame/escape, aggression, indulgence, activities, medication,…
|College students (N=396), chronic pain patients (N=319), and schizophrenic veterans (N=43) completed the Depression Coping Questionnaire (DCQ) and the Beck Depression Inventory (BDI). Factor analysis of the DCQ identified eleven coping responses: social support, problem solving, self-blame/escape, aggression, indulgence, activities, medication,…
In this paper, we propose a methodology for evaluatingmedical image segmentation algorithms where the only information available is boundaries outlined by multiple expert observers. In this case, the results of the segmentation algorithm can be evaluated against the multiple observers' outlines. We have derived statistics to enable us to find whether the computer-generated boundaries agree with the observers' hand-outlined boundaries as much as the different observers agree with each other. We illustrate the use of this methodology by evaluating image segmentation algorithms on two different applications in ultrasound imaging. In the first application, we attempt to find the epicardial and endocardial boundaries from cardiac ultrasound images, and in the second application, our goal is to find the fetal skull boundaries from prenatal ultrasound images.
Background Consumer and patient participation proved to be an effective approach for medical pictogram design, but it can be costly and time-consuming. We proposed and evaluated an inexpensive approach that crowdsourced the pictogram evaluation task to Amazon Mechanical Turk (MTurk) workers, who are usually referred to as the “turkers”. Objective To answer two research questions: (1) Is the turkers’ collective effort effective for identifying design problems in medical pictograms? and (2) Do the turkers’ demographic characteristics affect their performance in medical pictogram comprehension? Methods We designed a Web-based survey (open-ended tests) to ask 100 US turkers to type in their guesses of the meaning of 20 US pharmacopeial pictograms. Two judges independently coded the turkers’ guesses into four categories: correct, partially correct, wrong, and completely wrong. The comprehensibility of a pictogram was measured by the percentage of correct guesses, with each partially correct guess counted as 0.5 correct. We then conducted a content analysis on the turkers’ interpretations to identify misunderstandings and assess whether the misunderstandings were common. We also conducted a statistical analysis to examine the relationship between turkers’ demographic characteristics and their pictogram comprehension performance. Results The survey was completed within 3 days of our posting the task to the MTurk, and the collected data are publicly available in the multimedia appendix for download. The comprehensibility for the 20 tested pictograms ranged from 45% to 98%, with an average of 72.5%. The comprehensibility scores of 10 pictograms were strongly correlated to the scores of the same pictograms reported in another study that used oral response–based open-ended testing with local people. The turkers’ misinterpretations shared common errors that exposed design problems in the pictograms. Participant performance was positively correlated with their educational level. Conclusions The results confirmed that crowdsourcing can be used as an effective and inexpensive approach for participatory evaluation of medical pictograms. Through Web-based open-ended testing, the crowd can effectively identify problems in pictogram designs. The results also confirmed that education has a significant effect on the comprehension of medical pictograms. Since low-literate people are underrepresented in the turker population, further investigation is needed to examine to what extent turkers’ misunderstandings overlap with those elicited from low-literate people.
This module provides a strategy for determining whether a written questionnaire is an appropriate means of gathering data to meet the goals of an evaluation. The authors define which conditions are suitable for using questionnaires.
Economic evaluation is established within health-technology assessment but is challenged by those wanting to use economic evaluation to inform pricing and/or incorporate nontraditional sources of value and the views of diverse stakeholders. The changing role of economic evaluation in (formally or informally) assessing prices/values in four jurisdictions (UK, Australia, Germany and USA) is detailed and the authors propose a taxonomy of factors impacting the value of medical technology spanning clinical utility (effectiveness, safety/tolerability and quality of evidence), consumer demand (consumer preferences, process utility and unmet need), economic incentives (innovation, option value and market competition) and the societal perspective (social justice, social values and national interest). The authors suggest that multicriteria decision analysis methods grounded in hedonic-pricing theory can facilitate the valuing/pricing of medical technologies. The use of such an approach is hindered by a paucity of relevant educational opportunities, vested interests and aversion to placing prices/values on health. PMID:23252354
Rotter, Jason S; Foerster, Douglas; Bridges, John Fp
Background: Educational evaluation is a process which deals with data collection and assessment of academic activities’ progress. In this research, educational evaluation of Dentistry School of Tehran University of Medical Sciences, which trains students in undergraduate and residency courses, was studied. Methods: This descriptive study was done with a model of educational evaluation in ten steps and 13 fields including purposes and mission objectives, management and organization, academic board members, students, human resources and support, educational, research, health and treatment spaces, educational, diagnostic, research and laboratory tools, educational, research, health and treatment programs and courses, process of teaching and learning, evaluation and assessment, alumni, and patients satisfaction. Data were collected using observation, interviews, questionnaires, and checklists. Results: Results of the study were mainly qualitative and in some cases quantitative, based on defined optimal situation. The total mean of qualitative results of educational evaluation of dentistry school in all 13 fields was 55.98% which is relatively desirable. In the case of quantitative ones, results of some fields such as treatment quality of patients and education and learning of the students were relatively desirable (61.32% and 60.16% respectively). Conclusion: According to the results, educational goals and missions, educational and research facilities and spaces which were identified as the weakest areas need to be considered and paid more serious attention.
In 2000, nearly 200,000 international adoptees under age 18 lived with families in the United States. These children bring with them unique sets of medical, developmental and behavioral issues that ultimately require evaluation and management by a health care provider. In this article, we discuss the pre-adoption consultation with parents as well as the child's first examination upon entering the United States. We offer recommendations for baseline and follow-up analyses and immunizations and laboratory screening tests. Additionally, we provide a selected list of internet sites available for information about international adoption. PMID:19006912
MARCO, an interfacility communication system, has been designed to promote safe relevant health care delivery to the inner city pediatric patient receiving care in a network consisting of Boston City Hospital and its affiliated Neighborhood Health Centers. This application of computer technology to communication of medical information compiled on an individual patient in multiple locations has implications for private group practice as well as other urban networks similar to our own. This paper provides the MARCO system concept, the system design and evaluation of its success after two years of operation.
Moffatt, P. H.; Heisler, B. D.; Mela, W. D.; Alpert, J. J.; Goldstein, H.M.
The scope of this paper was to evaluate advertising for medication broadcast on radio stations in Natal, State of Rio Grande do Norte, Brazil, from April to September 2008 and from April to September 2010. The advertising was recorded and transcribed in order to conduct legal analysis and content analysis based on the precepts of Laurence Bardin. Both the advertising recorded during the first stage (regulated by RDC 102/00) and the second stage (regulated by RDC 96/08) contained some form of legal violation. Content analysis detected practically the same violations in both stages, namely the lack of information regarding adverse effects of the medication, appeal to consumption, exaggeration of efficiency/effectiveness and abusive exploitation of illness. Despite the inclusion of more modern and restrictive legislation, radio advertising continues to violate the law blatantly, committing abuse and disrespecting the population's entitlement to good health. The study reveals the need for medication advertising to be dealt with in a broader context, in other words to be treated as a public health concern. It must take into consideration the socio-historical scenario in which it evolved, since the legislation alone is insufficient to combat abuse committed to the detriment of public health. PMID:23358781
Batista, Almária Mariz; Carvalho, Maria Cleide Ribeiro Dantas de
The objective of the present study was to conduct a short-term international course on translational physiology for medical students from Wright State University and the University of Iowa. The goals were to 1) provide students with an exposure to the academic, cultural, and medical environments in Brazil; 2) promote awareness of the global medical community; and 3) provide an academic course focused on translational physiology. An evaluation of the students was conducted to determine whether such a short-term course might be useful in the medical curriculum. The 2-wk course was held in the summer of 2005 at the University of São Paulo School of Medicine in Ribeirão Preto, Brazil, for 23 American students. The program included presentations of basic and clinical topics, meetings with medical students, and clinical presentations. The program finished with student attendance at a scientific meeting sponsored by the Brazilian Society of Hypertension. Student surveys evaluated issues related to perceived treatment, Brazilian medical school environment, culture and personal attributes, and career aspirations. The international Medical Sciences Translational Physiology course for medical students provided a brief, but intense, experience. It gave students a picture of the medical environment in Brazil and an appreciation for the differences and similarities in cultures. Most students reported that it was a positive experience that would be beneficial to their careers. In conclusion, a short-term international course provides an efficient means for medical students to experience aspects of global medical science. PMID:16912146
Morris, Mariana; Jones, T David; Rocha, Maria Jose Alves; Fazan, Rubens; Chapleau, Mark W; Salgado, Helio C; Johnson, Alan Kim; Irigoyen, Maria Claudia; Michelini, Lisete C; Goldstein, David L
During the last 20 years, safety evaluation of medical devices has evolved from screening assays to the “pharmaceutical model” of preclinical testing. Biocompatibility testing guidelines for medical devices are published in the International Organization for Standardization (ISO) document 10993–1: Biological evaluation of medical devices—Part 1: Evaluation and testing. These guidelines are recognized by most national regulatory bodies and supplement, but
Body checking is considered an expression of an excessive preoccupation with appearance. The first aim of this study was to evaluate the psychometric properties of a Brazilian Portuguese version of the Body Checking Questionnaire (BCQ). Additionally, we wanted to examine the questionnaire's associations with body avoidance behaviour, body mass index, dietary habits, and the intensity, frequency, and length of physical exercise. Finally, we also examined the differences between the total BCQ score and the individual BCQ factor scores. Differences between active and sedentary persons and between non-dieters and those on weight-loss diets were also analyzed. For the psychometric study, 546 female public university students from four different courses were surveyed. Two minor samples of university students and eating disorders women were also recruited. In the second part of the study, 403 women were recruited from weight-loss programs, gyms, and a university. All participants were verbally invited to participate in the research and voluntarily took part. Confirmatory factor analysis showed a good fit to the original model of the Brazilian BCQ that retained all 23 items. Satisfactory evidence of construct validity and internal consistency were also generated through analysis of factor loadings, t-values, Cronbach's alpha, and construct reliability tests. The results also showed associations among body checking and body avoidance, body satisfaction, social anxiety, body mass index, and the frequency and intensity of physical exercise. Significant differences were found between non-dieters and weight-loss dieters for all BCQ factors and the total BCQ score. For physically active and sedentary persons, a significant difference was only observed for idiosyncratic checking behaviour. In conclusion, the BCQ appears to be a valid and reliable scale for Brazilian research, and the associations and differences found in this study suggest that women at gyms and especially in weight-loss programs should be targeted for future body checking studies. PMID:24040304
Campana, Angela Nogueira Neves Betanho; Swami, Viren; Onodera, Carolina Mie Kawagosi; da Silva, Dirceu; Tavares, Maria da Consolação Gomes Cunha Fernandes
Background The changes in the organization of mental health care services have made the role of the family even more important in caring for patients with mental disorders. Caring may have serious consequences for family caregivers, with a great impact on the quality of family life. This study reports on the translation, cultural adaptation, and validation of the Involvement EvaluationQuestionnaire-European Union (IEQ-EU) into the Greek language. Methods Caregivers of patients with major mental disorders were interviewed to test a modified version of the IEQ-EU questionnaire. Psychometric measurements included reliability coefficients, exploratory factor analysis and confirmatory analysis by linear structural relations. To measure the concurrent validity we used the Nottingham Health Profile (NHP). Results Most caregivers were female (83%), mainly mothers living with the patient (80%), with quite a high level of burden. The Greek version of the IEQ-EU (G-IEQ-EU) demonstrated a good reliability with high internal consistency (? = 0.88), Guttman split-half correlation of 0.71, high test-retest reliability (ICC = 0.82) and good concurrent validity with the NHP. A four-factor structure was confirmed for the G-IEQ-EU, slightly different from the original IEQ. The confirmatory factor analysis demonstrated that the four-factor model offered modest fit to our data. Conclusions The G-IEQ-EU is a reasonably valid and reliable tool for use in both clinical and research contexts in order to assess the burden of caregivers of patients with mental disorders.
Objectives To first, validate in English hospitals the internal structure of the ‘Patient Evaluation of Emotional Care during Hospitalisation’ (PEECH) survey tool which was developed in Australia and, second, to examine how it may deepen the understanding of patient experience through comparison with results from the Picker Patient Experience Questionnaire (PPE-15). Design A 48-item survey questionnaire comprising both PEECH and PPE-15 was fielded. We performed exploratory factor analysis and then confirmatory factor analysis using a number of established fit indices. The external validity of the PEECH factor scores was compared across four participating services and at the patient level, factor scores were correlated with the PPE-15. Setting Four hospital services (an Emergency Admissions Unit; a maternity service; a Medicine for the Elderly department and a Haemato-oncology service) that contrasted in terms of the reported patient experience performance. Participants Selection of these acute service settings was based on achieving variation of the following factors: teaching hospital/district general hospital, urban/rural locality and high-performing/low-performing organisations (using results of annual national staff and patient surveys). A total of 423 surveys were completed by patients (26% response rate). Results A different internal structure to the PEECH instrument emerged in English hospitals. However, both the existing and new factor models were similar in terms of fit. The correlations between the new PEECH factors and the PPE-15 were all in the expected direction, but two of the new factors (personal interactions and feeling valued) were more strongly associated with the PPE-15 than the remaining two factors (feeling informed and treated as an individual). Conclusions PEECH can help to build an understanding of complex interpersonal aspects of quality of care, alongside the more transactional and functional aspects typically captured by PPE-15. Further testing of the combined instrument should be undertaken in a wider range of healthcare settings.
The purpose of this study was to develop and test a physical ergonomics assessment approach for medical device handles. The method assesses wrist posture and force of exertion simultaneously by task element. Electrogoniometers and EMG sensors were connected through a data acquisition module for synchronization with video recordings of trials. Task analysis of video recordings were performed offline with Observer XT software. Average posture and force data across several repetitions of individual task elements were calculated and presented in a format suitable for informing product designers of specific issues during a test trial. A handle comfort questionnaire is proposed to survey subjective responses. The evaluation approach was applied to an endoscope needle in sampling a biopsy from the stomach wall using a gastrointestinal track simulator with ten physician surrogates. The results showed that for all task elements the wrist was in extension (33(°)-45(°)). Peak muscle forces ranged from 28% to 68% MVC across the three muscles studied. Muscle peak forces were above ACGIH HAL maximum threshold limits for four of the seven task elements, and above the action limit for all seven task elements for two muscles. The handle comfort questionnaire data also supported the high muscle force findings, and also on force distribution on the handle due to contact stresses. This combined approach could be used to collect and report detailed early stage ergonomics data from user trials on patient care simulators. The approach is proposed for use by medical device designers at the design stage of new products using prototypes, but it could also be used on existing products with real patients. PMID:21880299
The use of questionnaires to evaluate educational initiatives is widespread, but often problematic. This paper examines four aspects of an evaluation survey carried out with very able pupils attending out-of-school classes: ethics, design, bias and interpretation. There is a particular focus on the interpretation and analysis of pupils' answers to open questions. Conclusions are drawn from this analysis which will
Four studies evaluate the new Self Description Questionnaire II short-form (SDQII-S) that measures 11 dimensions of adolescent self-concept based on responses to 51 of the original 102 SDQII items and demonstrate new statistical strategies to operationalize guidelines for short-form evaluation proposed by G. T. Smith, D. M. McCarthy, and K. G.…
Marsh, Herbert W.; Ellis, Louise A.; Parada, Roberto H.; Richards, Garry; Heubeck, Bernd G.
Purpose: The aim of the study was the evaluation of parodontium according to Community Peridental Index of Treatment Needs (CPITN) index in 455 students of The Medical and Dentistry Department of The Medical Univer- sity of Bia?ystok. Material and methods: After the examination, the stu- dents filled a survey according to their own project concern- ing hygienic habits as well
The New Mexico EMCRO was the research, development, and evaluation arm of the New Mexico Foundation for Medical Care. In this role they were responsible primarily for research and development projects which included developing, testing, and evaluating: (1...
Medical schools continually evolve their curricula to keep students abreast of advances in basic, translational, and clinical sciences. To provide feedback to educators, critical evaluation of the effectiveness of these curricular changes is necessary. This article describes a method of curriculum evaluation, called "empowerment evaluation," that is new to medical education. It mirrors the increasingly collaborative culture of medical education and offers tools to enhance the faculty's teaching experience and students' learning environments. Empowerment evaluation provides a method for gathering, analyzing, and sharing data about a program and its outcomes and encourages faculty, students, and support personnel to actively participate in system changes. It assumes that the more closely stakeholders are involved in reflecting on evaluation findings, the more likely they are to take ownership of the results and to guide curricular decision making and reform. The steps of empowerment evaluation include collecting evaluation data, designating a "critical friend" to communicate areas of potential improvement, establishing a culture of evidence, encouraging a cycle of reflection and action, cultivating a community of learners, and developing reflective educational practitioners. This article illustrates how stakeholders used the principles of empowerment evaluation to facilitate yearly cycles of improvement at the Stanford University School of Medicine, which implemented a major curriculum reform in 2003-2004. The use of empowerment evaluation concepts and tools fostered greater institutional self-reflection, led to an evidence-based model of decision making, and expanded opportunities for students, faculty, and support staff to work collaboratively to improve and refine the medical school's curriculum. PMID:20520033
Fetterman, David M; Deitz, Jennifer; Gesundheit, Neil
The expression of memory worries and the self-reporting of daily forgetfulness easily spark discussion among sufferers and their family or friends about what is normal or abnormal forgetfulness. One way to investigate whether the reporting of forgetfulness might be excessive is to use a standardized memory questionnaire—for instance, the Multifactorial Memory Questionnaire (MMQ). The MMQ measures worries, daily forgetfulness, and
This thesis examines the Culture in the Workplace [TM] Questionnaire and associated data to determine the suitability and potential implications of this information for further cross-cultural research. The Culture in the Workplace [TM] (CW) questionnaire was designed by Geert Hofstede and was based on his groundbreaking IBM study. This study, as detailed in his book, Culture's Consequences, was based on
Background: Kaiser Permanente Colorado has been responding to the financial challenges of its members by providing a medical financial assistance (MFA) program since 1992. However, there have been no evaluations of the effect of this program on members’ use of health services or their health outcomes. Methods: A prospective cohort study of 308 MFA program members who were enrolled between May 16, 2008, and May 16, 2009, examined changes in their use of health services, costs, and self-reported physical and mental health after enrollment in the MFA program. Use of services was analyzed with multiple regression, and costs of services with generalized linear models. Results: MFA increased members’ access to health services. There were no changes in physical or mental health status. For each health care visit before the MFA award, patients used the health care system 0.23 visits less. The MFA amount was not associated with an increase or decrease in use. There was no significant difference in total overall cost. Hospital costs were lower, but costs for clinic visits, pharmacy services, phone calls, and radiology services were significantly higher, resulting in service cost neutrality, possibly because financial barriers before MFA award led to accumulated demand for services. Conclusions: Use of services decreased after MFA was received. There was no significant change in total service cost. MFA improved members’ ability to pay for medical services and increased their satisfaction with health services.
Conner, Douglas A; Beck, Arne; Clarke, Christina; Wright, Leslie; Narwaney, Komal; Bermingham, Neysa W
Introduction: An increasing number of surgical procedures are performed in a microsurgical and minimally-invasive fashion. However, the performance of surgery, its possibilities and limitations become difficult to teach. Stereoscopic video has evolved from a complex production process and expensive hardware towards rapid editing of video streams with standard and HDTV resolution which can be displayed on portable equipment. This study evaluates the usefulness of stereoscopic video in teaching undergraduate medical students. Material and methods: From an earlier study we chose two clips each of three different microsurgical operations (tympanoplasty type III of the ear, endonasal operation of the paranasal sinuses and laser chordectomy for carcinoma of the larynx). This material was added by 23 clips of a cochlear implantation, which was specifically edited for a portable computer with an autostereoscopic display (PC-RD1-3D, SHARP Corp., Japan). The recording and synchronization of left and right image was performed at the University Hospital Aachen. The footage was edited stereoscopically at the Waseda University by means of our original software for non-linear editing of stereoscopic 3-D movies. Then the material was converted into the streaming 3-D video format. The purpose of the conversion was to present the video clips by a file type that does not depend on a television signal such as PAL or NTSC. 25 4th year medical students who participated in the general ENT course at Aachen University Hospital were asked to estimate depth clues within the six video clips plus cochlear implantation clips. Another 25 4th year students who were shown the material monoscopically on a conventional laptop served as control. Results: All participants noted that the additional depth information helped with understanding the relation of anatomical structures, even though none had hands-on experience with Ear, Nose and Throat operations before or during the course. The monoscopic group generally estimated resection depth to much lesser values than in reality. Although this was the case with some participants in the stereoscopic group, too, the estimation of depth features reflected the enhanced depth impression provided by stereoscopy. Conclusion: Following first implementation of stereoscopic video teaching, medical students who are inexperienced with ENT surgical procedures are able to reproduce depth information and therefore anatomically complex structures to a greater extent following stereoscopic video teaching. Besides extending video teaching to junior doctors, the next evaluation step will address its effect on the learning curve during the surgical training program.
Ilgner, Justus F. R.; Kawai, Takashi; Shibata, Takashi; Yamazoe, Takashi; Westhofen, Martin
Whether developing questions for questionnaires or interviews or focus groups, there are certain guidelines that help to ensure that respondents provide information that is useful and can later be analyzed. This resource offers advice on developing questions for interviews or focus groups. It contains basics conducting the interviews, providing directions to respondents as well as guidelines for composing the content and wording of the questionnaire. This resource is aimed for use in workshops/conferences and is intended for novice evaluators.
Background The Japanese Orthopaedic Association (JOA) has investigated the JOA Back Pain EvaluationQuestionnaire (JOABPEQ) to evaluate\\u000a several aspects of low back pain in patients. The score includes five categories (25 items) selected from the Roland Morris\\u000a Disability Questionnaire and Short Form 36, and a visual analogue scale. Japanese physicians have recently used these scores\\u000a to evaluate back pain; however, the
Compares and contrasts the primary outcomes and methods used to evaluate curricular changes at eight medical schools participating in a large-scale medical curriculum development project. Describes how the evaluative data, both quantitative and qualitative, were collected, and how evaluation drove curricular change. Although the evaluations were…
BACKGROUND: Behavioural conceptualizations of chronic pain posit that solicitous responses to pain behaviours are positively reinforcing and play a role in the development of chronic pain and disability. Recent research suggests that studies investigating this model were likely limited by the use of only a few narrowly defined categories of responses to pain behaviour. A measure of preferences regarding pain-related social support has the potential to improve behavioural models of chronic pain by identifying other potentially reinforcing responses to pain behaviour. OBJECTIVE: The Pain Response Preference Questionnaire (PRPQ) was created to assess preferences regarding pain-related social support. The purpose of the present study was to empirically develop PRPQ scales and examine their psychometric properties. METHODS: A large university student sample (n=487) free of chronic pain completed the 39-item PRPQ. Factor analysis was applied to the data from the present sample to empirically develop PRPQ scales. Using a second student sample (n=87), relationships between the PRPQ scales and theoretically related measures were examined to evaluate the construct validity of the scales. Factor analysis supported four factors that reflected preferences for emotional and instrumental support, assistance in managing pain and emotions, having one’s pain ignored, and being encouraged to persist with one’s activities. Based on this analysis, scales labelled solicitude, management, suppression and encouragement were created. Correlation analyses supported the construct validity of these scales. CONCLUSIONS: The PRPQ is a psychometrically sound measure of preferences of pain-related social support. Research with clinical samples is needed to further evaluate its psychometric properties and clinical utility.
McWilliams, Lachlan A; Saldanha, Kate M; Dick, Bruce D; Watt, Margo C
To facilitate early identification of basic trainees with significant psychiatric problems, the Air Force MedicalEvaluation Test (AFMET) Project has been conducted by the Wilford Hall USAF Medical Center since June 1975. In fiscal year 1982, the USAF sav...
The report addresses the legislative and regulatory framework and criteria for the definition of orphan status, diseases that could be managed by medical food products, the adequacy of current incentives for the development of orphan medical foods, barrie...
AbstractObjective: To develop and evaluate an effective, community based, multiagency course (involving doctors, nurses, non-health statutory workers, and voluntary organisations) for all Leicester medical students, in response to the General Medical Council's recommendation of preparing the doctors of tomorrow to handle society's medical problems.Design: Survey evaluating a task oriented, problem solving course, designed by medical students in partnership with the
Background Significant changes in medical education have occurred in recent decades because of new challenges in the health sector and new learning theories and practices. This might have contributed to the decision of medical schools throughout the world to adopt community-based learning activities. The community-based learning approach has been promoted and supported by the World Health Organization and has emerged as an efficient learning strategy. The aim of the present paper is to describe the characteristics of a community immersion clerkship for third-year undergraduate medical students, its evolution over 15 years, and an evaluation of its outcomes. Methods A review of the literature and consensus meetings with a multidisciplinary group of health professionals were used to define learning objectives and an educational approach when developing the program. Evaluation of the program addressed students’ perception, achievement of learning objectives, interactions between students and the community, and educational innovations over the years. Results The program and the main learning objectives were defined by consensus meetings among teaching staff and community health workers, which strengthened the community immersion clerkship. Satisfaction, as monitored by a self-administered questionnaire in successive cohorts of students, showed a mean of 4.4 on a five-point scale. Students also mentioned community immersion clerkship as a unique community experience. The learning objectives were reached by a vast majority of students. Behavior evaluation was not assessed per se, but specific testimonies show that students have been marked by their community experience. The evaluation also assessed outcomes such as educational innovations (eg, students teaching other students), new developments in the curriculum (eg, partnership with the University of Applied Health Sciences), and interaction between students and the community (eg, student development of a website for a community health institution). Conclusion The community immersion clerkship trains future doctors to respond to the health problems of individuals in their complexity, and strengthens their ability to work with the community.
Chastonay, P; Zesiger, V; Klohn, A; Soguel, L; Mpinga, E K; Vu, NV; Bernheim, L
We carried out a questionnaire survey of the caretakers, using 86 riding horses kept in the Equestrian Park, Tokyo (Japan Racing Association). The questionnaire survey used a 5-point scale and a 3-point scale to assess several caretakers’ impressions of each horse’s temperament, on the basis of the norm and the horse’s tendencies in ordinary care and daily training. Factor analysis
Objectives. This study sought to establish the validity, reproducibility and responsiveness of the Seattle Angina Questionnaire, a 19-item self-administered questionnaire measuring five dimensions of coronary artery disease: physical limitation, anginal stability, anginal frequency, treatment satisfaction and disease perception.Background. Assessing the functional status of patients is becoming increasingly important in both clinical research and quality assurance programs. No current functional status
John A. Spertus; Jennifer A. Winder; Timothy A. Dewhurst; Richard A. Deyo; Janice Prodzinski; Mary McDonnell; Stephan D. Fihn
Podcasting has become a popular means of transferring knowledge in higher education through making lecture contents available to students at their convenience. Accessing courses on media players provides students with enhanced learning opportunities. Development of teaching methods able to cope with ever-changing nature of medicine is crucial to train the millennium students. Pharmacology education in Tehran University of Medical Sciences has been based on lectures so far; our aim was to implement a pilot study to evaluate the advantages and disadvantages of offering the course contents as podcasts as well as evaluating whether such program can be feasible in our educational program. 46% of students downloaded the podcast according to our download center. 48% favored usage of both internet and DVD-ROM concurrently. Overall 96% of students perceived that podcasting had a positive impact on their learning in pharmacology course. Our results indicate that most of attendants proposed the positive yields of podcasting despite low usage of it, mainly as a pre-class preparing tool. PMID:23456586
Background Point-of-care electronic medical records (EMRs) are a key tool to manage chronic illness. Several EMRs have been developed for use in treating HIV and tuberculosis, but their applicability to primary care, technical requirements and clinical functionalities are largely unknown. Objectives This study aimed to address the needs of clinicians from resource-limited settings without reliable internet access who are considering adopting an open-source EMR. Study eligibility criteria Open-source point-of-care EMRs suitable for use in areas without reliable internet access. Study appraisal and synthesis methods The authors conducted a comprehensive search of all open-source EMRs suitable for sites without reliable internet access. The authors surveyed clinician users and technical implementers from a single site and technical developers of each software product. The authors evaluated availability, cost and technical requirements. Results The hardware and software for all six systems is easily available, but they vary considerably in proprietary components, installation requirements and customisability. Limitations This study relied solely on self-report from informants who developed and who actively use the included products. Conclusions and implications of key findings Clinical functionalities vary greatly among the systems, and none of the systems yet meet minimum requirements for effective implementation in a primary care resource-limited setting. The safe prescribing of medications is a particular concern with current tools. The dearth of fully functional EMR systems indicates a need for a greater emphasis by global funding agencies to move beyond disease-specific EMR systems and develop a universal open-source health informatics platform.
Replies to the questionnaire on the determination of ammonia, sent to participants in the Fifth ICES Intercomparison Exercise for nutrients in seawater, are evaluated. The conclusions provide some useful recommendations for analysts.Berthelot's reaction (formation of indophenol-blue) is the basis of the colorimetry used by the great majority of participants, and their individual methods are examined in detail. Application of the
Describes an evaluation of a self-report questionnaire administered to seventh graders (N=396). Using the test-retest reliability matrix, eight of nine drug-use indices appeared to have acceptable to good reliability. The three measures included in the test-retest reliability matrix provide stronger evidence for good reliability than could any…
|An essential goal of evaluation is to foster learning. Across the medical education spectrum, evaluation of clinical performance is dominated by subjective feedback to learners based on observation by expert supervisors. Research in non-medical settings has suggested that participants' perceptions of evaluation processes exert considerable…
...document is limited to the biological evaluation of sterile and...Standard ISO-10993, ``Biological Evaluation of Medical Devices...International Standard ISO-10993, `Biological Evaluation of Medical Devices...have been approved under OMB control number 0910-0120; the...
A survey of 61 teaching hospitals concerning mechanisms for clinical evaluation found about a third had clinical evaluation units, primarily supported by hospital administrations rather than medical school deans. Eighteen respondents had clinical evaluation activities integrated into the medical staff hierarchy and dispersed throughout departments…
An essential goal of evaluation is to foster learning. Across the medical education spectrum, evaluation of clinical performance is dominated by subjective feedback to learners based on observation by expert supervisors. Research in non-medical settings has suggested that participants' perceptions of evaluation processes exert considerable…
Purpose Multiple factors can influence patients’ adherence to topical ophthalmic intraocular pressure–lowering medications. An important factor that is often overlooked is the method of eye drop administration, including the handling, storing, and actual administering of eye drops. These aspects of patients’ eye drop administration, which may be strongly related to the success of prescribed therapies, are evaluated. Methods A 2-page questionnaire was distributed to 253 sequential glaucoma patients at the time of their regular clinical visit with one of two geographically distinct glaucoma specialists. In addition to providing demographic data, the patients were asked to complete a 2-page questionnaire about their current use of eye drops. Results The study participants had a mean age of 71.5 years (SD, 15.1 years) and were predominantly female (59.8%) and white (72.6%). Approximately 17% of them relied on others for the administration of drops and most commonly cited inadequate vision and trouble with manual dexterity leading to this dependency. Of those who self-administered drops, only 16.3% used a mirror. The most common location for administration was the bedroom (46.8%), followed by the bathroom (23.4%) and kitchen (16.1%). Almost 16% reported “rarely” or “never” washing their hands. Conclusions Although most individuals may have little difficulty with the use, storage, and handling of eye drops, this study demonstrates that broad variation in reported practices exists. This finding suggests a need for better instruction in eye drop administration and illuminates some of the methodological problems that could be overcome to reduce patients’ frustration, improve compliance, and increase efficacy.
Medical treatment for cystinuria aims to decrease the concentration of cystine in the urine, increase its solubility and therefore prevent stone formation. Ascorbic acid and captopril have been recommended as alternatives to thiol drugs, though conflicting data undermining their efficacy has been widely reported, too. The aim of this study was to verify the effects of ascorbic acid and captopril on cystine stone formation in the cystinuria mouse model. A total of 28 male homozygous pebbles mice were used for characterizing the mice on normal diet, ascorbic acid and captopril supplemented diets. The baseline physiological parameters of the mice were determined initially. The normal diet was then replaced with the supplemented diet (ascorbic acid/captopril) for the next 48 weeks and various biochemical parameters in urine and plasma were analyzed. All homozygous mice developed urinary cystine stones during the first year of life. No reduction in the urinary cystine concentration was seen with either of the supplemented diets. The stone mass varied widely in the study and a beneficial effect of ascorbic acid in some of the animals was possible though an overall statistical significance was not seen. Conclusions: The cystinuria mouse model provides an ideal tool for evaluation of stone preventive measures in a standardized environment. This study confirms that ascorbic acid and captopril are not effective in cystinuria.
Sagi, Sreedhar; Wendt-Nordahl, Gunnar; Alken, Peter; Knoll, Thomas
A study investigated medical students' opinions of curriculum reform efforts at eight United States and two Canadian medical schools. At all schools, students appreciated reform efforts that encouraged individuation, connection, and diversity. Enrollees at smaller schools with more distinctly teaching-service missions objected to extensive…
|The expansion of biomedical knowledge and the pursuit of more meaningful learning have led to world-wide evidence-based innovative changes in medical education and curricula. The recent emphasis on problem-based learning (PBL) and student-centred learning environments are, however, not being implemented in Nigerian medical schools. Traditional…
Anyaehie, U. S. B.; Nwobodo, E.; Oze, G.; Nwagha, U. I.; Orizu, I.; Okeke, T.; Anyanwu, G. E.
Human errors in medical device use account for a large portion of medical errors. Most of these errors are due to inappropriate designs for user interactions, rather than mechanical failures. Evaluating and predicting patient safety in medical device use is critical for developing interventions to reduce such errors either by redesigning the devices or, if redesign is not an option,
Jiajie Zhang; Vimla L. Patel; Todd R. Johnson; Philip Chung; James P. Turley
|Medical school admissions committees are expected to select physicians with specific attributes such as intelligence, altruism, dutifulness, and compassion. Besides basing these attributes on the best professional judgment of the physicians and medical school faculty, there has been little quantitative research to determine the psychological…
Medical devices based on microelectro-mechanical systems (MEMS) platforms are currently being proposed for a wide variety of implantable applications. However, biocompatibility data for typical MEMS materials of construction and processing, obtained from standard tests currently recognized by regulatory agencies, has not been published. Likewise, the effects of common sterilization techniques on MEMS material properties have not been reported. Medical device
Geoffrey Kotzar; Mark Freas; Phillip Abel; Aaron Fleischman; Shuvo Roy; Christian Zorman; James M. Moran; Jeff Melzak
|This program affiliated with the Western Interstate Commission for Higher Education, defrays costs faced by an Arizona student in attending an out-of-state medical school by paying the difference between the resident and nonresident tuition at the out-of-state school. It has failed to increase the numbers of medicals students and physicians…
|The authors describe the development and validation of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y), a child-report measure of psychological inflexibility engendered by high levels of cognitive fusion and experiential avoidance. Consistent with the theory underlying acceptance and commitment therapy (ACT), items converged into a…
This study assessed the validity of the Driving Anger Expression Inventory (DAX) and Driver's Angry Thoughts Questionnaire (DATQ). Scales within the DAX and DATQ appeared to assess separate, correlated constructs. Aggressive forms of thinking and anger expression correlated positively with each other, trait driving anger, aggressive and risky behavior, some crash-related conditions, general trait anger, and general forms of anger
Jerry L. Deffenbacher; Gail S. White; Rebekah S. Lynch
Temperament is a developmentally important construct, hierarchically comprised of several lower-order dimensions subsumed under effortful control, negative affectivity, and surgency. The Children's Behavior Questionnaire-Very Short Form (CBQ-VSF) was developed as a brief measure of the higher-order factors of temperament to aid researchers in…
Allan, Nicholas P.; Lonigan, Christopher J.; Wilson, Shauna B.
Individuals differ in the intensity of exercise that they prefer and the intensity that they can tolerate. We examined the psychometric properties of the Preference for and Tolerance of the Intensity of Exercise Questionnaire (PRETIE-Q; Ekkekakis, Hall, & Petruzzello, 2005: Journal of Sport and Exercise Psychology, 27, 350 – 374). A sample of 601 college women (mean age 20 years) completed the
Panteleimon Ekkekakis; Jennifer Thome; Steven J. Petruzzello; Eric E. Hall
Individuals differ in the intensity of exercise that they prefer and the intensity that they can tolerate. We examined the psychometric properties of the Preference for and Tolerance of the Intensity of Exercise Questionnaire (PRETIE-Q; Ekkekakis, Hall, & Petruzzello, 2005: Journal of Sport and Exercise Psychology, 27, 350 - 374). A sample of 601 college women (mean age 20 years)
PANTELEIMON EKKEKAKIS; JENNIFER THOME; STEVEN J. PETRUZZELLO; ERIC E. HALL
|A study focused on researchers' use of the English-Language Background Questionnaire (EBQ) portion of the National Adult Literacy Survey (NALS), the results of which were released in 1993. Data were gathered by surveying NALS data users about how they have used the EBQ data, their perspectives on the strengths and weaknesses of the EBQ, and their…
We developed three ethnic food frequency questionnaires (FFQs) to characterize the diets of South Asian, Chinese, and European immigrants. FFQs were developed from foods reported in the diet records and recalls of 29 South Asians, 25 Chinese, and 20 Europeans participating in a pilot study from 1995–1996 in Hamilton, Ontario, Canada. The FFQ and a seven-day diet record were then
Linda E. Kelemen; Sonia S. Anand; Vladimir Vuksan; Qilong Yi; Koon K. Teo; Sudarshan Devanesen; Salim Yusuf
|Temperament is a developmentally important construct, hierarchically comprised of several lower-order dimensions subsumed under effortful control, negative affectivity, and surgency. The Children's Behavior Questionnaire-Very Short Form (CBQ-VSF) was developed as a brief measure of the higher-order factors of temperament to aid researchers in…
Allan, Nicholas P.; Lonigan, Christopher J.; Wilson, Shauna B.
Background: Soy foods may have various health benefits, but lit- tle is known about the patterns and correlates of soy consumption among postmenopausal women in the United States. Objective: We assessed the reliability and validity of a soy food- frequency questionnaire (FFQ) and examined demographic, lifestyle, and dietary correlates of plasma isoflavone concentra- tions in postmenopausal women. Design: In this
Cara L Frankenfeld; Ruth E Patterson; Neilann K Horner; Marian L Neuhouser; Heather E Skor; Thomas F Kalhorn; William N Howald; Johanna W Lampe
Abstract Objective: To assess the American Medical Association (AMA) guide to the evaluation of binaural hearing impairment (BHI) as a procedure for estimating severity of hearing loss from audiograms. Design: The BHIs of Australian war veterans were calculated from their hearing threshold levels (HTLs) and compared with their scores on a hearing questionnaire, the hearing measurement scale (HMS). Study sample: The HTLs of 282 Australian war veterans were measured at frequencies from 0.25 to 8 kHz and scores on the HMS were obtained from 154 of those veterans. Results: No grounds could be found for altering the frequencies included in the average HTL or the high fence of 92 dB HL used in calculating the monaural hearing impairments (MHIs) of the veterans, and no grounds could be found for altering the ratio of 5:1 used in determining the BHI from the MHIs of the better and worse ears. However, agreement between HMS score and BHI was improved by reducing the low fence used in calculating MHI from 25 to 15 dB HL. Conclusion: A modified version of BHI provided an improved procedure for estimating severity of hearing loss from audiograms but would not be suitable for compensation purposes. PMID:23984820
Since June 2002, revised regulations in Germany allow medical faculties to implement new curricular concepts. The medical faculty of the Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Germany, decided to start a major reform experiment in winter 2003, focussing on an interdisciplinary integration of organs and organ systems such as the cardiovascular or respiratory system. Furthermore, students will have contact with patients at an early stage of their studies. Thus, re-organisation of course contents should lead to a chance to improve practical experience. With the public having the right to expect that physicians and all physicians in training possess a basic knowledge of emergency medical care and the necessary skills to manage acute problems, it was decided to start the first year of the Medical Reform Curriculum Aachen with 3 weeks interdisciplinary introduction into emergency medical care. The task consisted of defining interdisciplinary core objectives and the need to implement teaching and learning principles necessary for further education. Due to this, the content of this course should have practical relevance for the students concerning their practical experiences in the future. The result is an introductory course in emergency medical care in the first semester, coordinated with the lectures. Besides skill training on basics of emergency medical care (basic life support (BLS), early defibrillation), practical training in other lifesaving techniques (e.g., immobilisation skills) and basic principles of daily clinical care are included. In addition, personal safety and a standard algorithm for assessing the patient are covered by problem-based learning sessions. The course evaluation data clearly showed acceptance of the new approach and enhances possibilities of extending implementation of relevant topics concerning emergency medical care within the Medical Reform Curriculum Aachen. PMID:15919573
|Medical practitioners need the skills to find relevant information and evaluate its authenticity, validity, and reliability. The learning of information literacy has been embedded in the University of Western Australia (UWA) medical course since 2000. The purpose of this study was to evaluate the effectiveness of the enhanced information literacy…
It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles…
The differential attrition of persons from comparison groups severely restricts the inferences that can be made from results of evaluative research. This problem is particularly troublesome in the evaluation of medical technologies, such as coronary artery bypass graft surgery, since a substantial percentage of medical or control patients cross over to the surgical group. A procedure using worst case assumptions
William H. Yeaton; Paul M. Wortman; Naftali Langberg
Curriculum evaluation encompasses practice, scholarship and research. We propose that evaluation of curricula in medical education should draw upon those who have experience of the curriculum. There are many ways of conceptualising curriculum, each of which can be articulated through different understandings of the experiences of those that inhabit and interact with curriculum. Agents that interact and experience medical curricula
|It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the…
It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles of the physician
Objective: To examine the concurrent validity and test–retest reliability of the Modified Jebsen Test of Hand Function (MJT) and the University of Maryland Arm Questionnaire for Stroke (UMAQS).Design: Individuals with acquired neurological disorders were retested within an average of 9.6 days after the first assessment.Setting: Individuals were recruited from two specialist rehabilitation units, members of the Multiple Sclerosis Society and
T JH BovendEerdt; H Dawes; H Johansen-Berg; D T Wade
In order to clarify the relationships between lifestyle behaviors and mental health status in Japanese workers, the 28-item General Health Questionnaire (GHQ-28) and Zung's Self-rating Depression Scale (SDS) were administered to 254 male factory workers; further, eight of their personal health practices were surveyed using the Health Practice Index (HPI). Few studies have used the GHQ-28 and SDS simultaneously; moreover,
Background In 1996 The University of Liverpool reformed its medical course from a traditional lecture-based course to an integrated PBL curriculum. A project has been underway since 2000 to evaluate this change. Part of this project has involved gathering retrospective views on the relevance of both types of undergraduate education according to graduates. This paper focuses on the views of traditional Liverpool graduates approximately 6 years after graduation. Methods From February 2006 to June 2006 interviews took place with 46 graduates from the last 2 cohorts to graduate from the traditional Liverpool curriculum. Results The graduates were generally happy with their undergraduate education although they did feel there were some flaws in their curriculum. They felt they had picked up good history and examination skills and were content with their exposure to different specialties on clinical attachments. They were also pleased with their basic science teaching as preparation for postgraduate exams, however many complained about the overload and irrelevance of many lectures in the early years of their course, particular in biochemistry. There were many different views about how they integrated this science teaching into understanding disease processes and many didn't feel it was made relevant to them at the time they learned it. Retrospectively, they felt that they hadn't been clinically well prepared for the role of working as junior doctor, particularly the practical aspects of the job nor had enough exposure to research skills. Although there was little communication skills training in their course they didn't feel they would have benefited from this training as they managed to pick up had the required skills on clinical attachments. Conclusion These interviews offer a historical snapshot of the views of graduates from a traditional course before many courses were reformed. There was some conflict in the interviews about the doctors enjoying their undergraduate education but then saying that they didn't feel they received good preparation for working as a junior doctor. Although the graduates were happy with their undergraduate education these interviews do highlight some of the reasons why the traditional curriculum was reformed at Liverpool.
The repeatability of a telephone questionnaire on cat-ownership patterns, demographics and attitudes towards homeless cats in a community was evaluated. Randomly selected households (n=100) within Caldwell, Texas, were included in the study. The response percentage was 84% (100\\/119) among those contacted and 75% (100\\/134) among all eligible respondents. Repeatability was measured by administering the same survey twice to the first
M. E. Ramon; M. R. Slater; M. P. Ward; R. R. Lopez
Aims We evaluated a generic quality of life (QoL) Functional Status Questionnaire (FSQ), in patients with chronic heart failure\\u000a (CHF). The FSQ assesses the 3 main dimensions of QoL: physical functioning, mental health and social role. It also includes\\u000a 6 single item questions about: work status, frequency of social interactions, satisfaction with sexual relationships, days\\u000a in bed, days with restricted activity
Siobhan Gallanagh; Davide Castagno; Ben Wilson; Erland Erdmann; Faiez Zannad; Willem J. Remme; José L. Lopez-Sendon; Philippe Lechat; Ferenc Follath; Christer Höglund; Viacheslav Mareev; Zygmunt Sadowski; Ricardo J. Seabra-Gomes; Henry J. Dargie; John J. V. McMurray
ObjectiveThe causes of low back pain in China and Western countries are extremely different. We attempted to analyze the risk factors of low back pain in urban and rural patients under the dual economy with the simplified Chinese version of Roland-Morris disability questionnaire (SC-RMDQ) to demonstrate that SC-RMDQ could evaluate patients with low back pain arising from different causes.MethodsRoland-Morris disability
Honglei Yi; Xinran Ji; Xianzhao Wei; Ziqiang Chen; Xinhui Wang; Xiaodong Zhu; Wei Zhang; Jiayu Chen; Diqing Zhang; Ming Li
The quality of medical and psychological certificates and expert opinions in asylum and residence legislation was analyzed using judicial requirements as well as standards of the German Bundesärztekammer (SBPM). A sample of 53 cases of asylum seekers including 86 medical certificates and 15 expert opinions was evaluated qualitative and quantitative. The quality varies strongly from exemplary to insufficient. Predominantly, the medical certificates did not comply with judicial requirements. Two thirds of the expert opinions met the standards formulated by SBPM. Experts should write medical/psychological opinions being familiar with both traumatized individuals and refugees. The minimum requirements and standards should be better communicated to involved medical and psychological practitioners. PMID:23784797
Hofmann, Mareike; Hagemeier, Ina; Altenhain, Karsten; Kruse, Johannes
The purpose of this study was to determine and compare the responsiveness of the Disabilities of the Arm, Shoulder and Hand\\u000a (DASH) questionnaire, the Michigan Hand Questionnaire (MHQ), and the Patient-Specific Functional Scale (PSFS) in patients\\u000a with carpal tunnel syndrome, wrist pain, finger contracture, or tumor. Eighty-one subjects prospectively completed each questionnaire\\u000a shortly before and 3 and 6 months after surgery.
Evaluation of doctoral education in nursing is needed with the rapid increase in doctoral nursing programs in Japan. This study aimed to compare the evaluations of doctoral nursing education by students, graduates, and faculty. All 46 doctoral nursing programs in Japan were target settings. 127 students who had been in the doctoral program, 24 graduates and 87 faculty members had responded to the survey. A questionnaire with 17 items for program evaluation, 12 items for faculty evaluation, 9 items for resource evaluation, and 3 for overall evaluations was distributed in November and December 2008. Responses to 1 program evaluation item, 2 faculty evaluation items and 4 resource evaluation items indicated significant differences among evaluators. While 79.2% of graduates responded positively that the number of faculty members was sufficient to facilitate learning, only 36.1% of faculty members and 49.6% of students responded affirmatively. Graduates' ratings were the most positive and faculty members were the least positive, especially for infrastructure or equipment such as libraries, computers, and the number of technical and support staff. The significant differences among the evaluators suggested that having evaluators in various roles is important to evaluate the quality of doctoral nursing education. PMID:21665333
Nagata, Satoko; Gregg, Misuzu F; Miki, Yuko; Arimoto, Azusa; Murashima, Sachiyo; Kim, Mi Ja
The Experimental Medical Care Review Organization (EMCRO) program was initiated in order to study the ability of regional medical appraisal programs to both improve the quality of medical care and moderate its cost. Grants were provided to selected local ...
Psychometric properties of the Group Environment Questionnaire were investigated in a large sample of soccer (n = 222) and professional basketball players (n = 375). Confirmatory factor analysis was performed both on the total sample and on the two subsamples through a multi-group approach; associations between cohesion and the duration of belonging to the team were also explored. Results confirmed the four-factor structure proposed by Carron's original model even though some items with low loadings were eliminated. No significant associations were found between team cohesion and the duration of belonging to the team. PMID:23829152
Steca, P; Pala, A Norcini; Greco, A; Monzani, D; D'Addario, M
Background Standardized doctor’s orders are replacing traditional order writing in teaching hospitals. The impact of this shift in practice on medical education is unknown. It is possible that preprinted orders interfere with knowledge acquisition and retention by not requiring active decision-making. The objective of the study was to evaluate the impact of standardized admission orders on disease-specific knowledge among undergraduate medical trainees. Methods This prospective cohort study enrolled Year 3 (n?=?121) and Year 4 (n?=?54) medical students at two academic hospitals in Toronto (Ontario, Canada) during their general internal medicine rotation. We used standardized orders for patient admissions for alcohol withdrawal (AW) and for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) as the intervention and manual order writing as the control. Educational outcomes were assessed through end-of-rotation questionnaires assessing disease-specific knowledge of AW and AECOPD. Results and discussions Of 175 students, 105 had exposure to patients with alcohol withdrawal during their rotation, and 68 students wrote admission orders. Among these 68 students, 48 used standardized orders (intervention, n?=?48) and 20 used manual order writing (control, n?=?20). Only 3 students used standardized orders for AECOPD, precluding analysis. There was no significant difference found in mean total score of questionnaires between those who used AW standardized orders and those who did not (11.8 vs. 11.0, p?=?0.4). Students who had direct clinical experience had significantly higher mean total scores (11.6 vs. 9.0, p?0.0001 for AW; 13.8 vs. 12.6, p?=?0.02 for AECOPD) compared to students who did not. When corrected for overall knowledge, this difference only persisted for AW. Conclusions No significant differences were found in total scores between students who used standardized admission orders and traditional manual order writing. Clinical exposure was associated with increase in disease-specific knowledge.
A voluntary class meeting twice a week for 9 weeks, was conducted for 19 medical students whose reading skill was recognized as being at a low level. Speed was emphasized by timing easy selections. Comprehension tests were also given. Class discussions concerned improvement of vocabulary, concentration, memorization, and the reviewing for and taking of examinations. The preliminary and final scores
|The Week-end Intervention Program (WIP) used by Wright State University School of Medicine, which assesses the alcohol problems of those convicted of offenses such as drunk driving and then assists in finding treatment, is described. The impact of the program in educating medical students about alcoholism is discussed. (MLW)|
|Recently, the Medical University of South Carolina adopted a lecture recording system (LRS). A retrospective study of LRS was implemented to document the students' perceptions, pattern of usage, and impact on the students' grades in three basic sciences courses (Cell Biology/Histology, Physiology, and Neurosciences). The number of accesses and…
Bacro, Thierry R. H.; Gebregziabher, Mulugeta; Fitzharris, Timothy P.
Project Health, a division of the Multnomah County Department of Human Services, recently completed a 5-year demonstration project covering Medically Needy families in the metropolitan area of Portland, Oregon. The Project was able to place up to 90% of t...
...INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate Â§ 549.63 Initial...upon initial referral of an inmate on a hunger strike: (1) Measure and record height...every 24 hours while the inmate is on a hunger strike. Other procedures...
...INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate Â§ 549.63 Initial...upon initial referral of an inmate on a hunger strike: (1) Measure and record height...every 24 hours while the inmate is on a hunger strike. Other procedures...
We examined in the previous chapter several common computable measures of image quality, as well as subjective quality ratings. While these quality measures are useful in many ways, for medical images one wishes a quality measure to take proper account of the diagnostic purpose of the image. The ROC methodology discussed in the previous chapter is one approach to this.
OBJECTIVES To calculate and describe the anticholinergic burden of medications in community-dwelling older adults and to identify patient-specific risk factors. DESIGN Descriptive cross-sectional study. SETTING Cardinal Health Visiting Pharmacist Program, Columbus, OH, between August 2002 and August 2009. PARTICIPANTS Community-dwelling adults 65 years or older who were referred through LifeCare Alliance (a provider of home-based senior services). INTERVENTION Comprehensive medication review records from medication therapy management (MTM) activities were used to calculate the anticholinergic burden using the anticholinergic cognitive burden (ACB) scale for each patient. MAIN OUTCOME MEASURE Proportion of older adults in the community with a clinically relevant anticholinergic burden (defined as ACB score ?3). RESULTS From 341 included records, ACB score was calculated for all patients and an ACB score of 3 or greater was identified in 47.8% (n = 163) of patients. The odds increased significantly as the number of prescription (odds ratio 1.23 [95% CI 1.14-1.32], P < 0.001] and over-the-counter (1.17 [1.02-1.33], P = 0.02] medications increased. The odds also were significantly greater for patients with hypertension (3.01 [1.73-5.21], P < 0.001) and depression (2.6 [1.14-5.9], P = 0.02). CONCLUSION Nearly one-half of community-dwelling older adults had a clinically relevant ACB score of 3 or greater. The ACB score could be used as a component of MTM services in a variety of practice settings to identify older adults who are at higher risk for potential central and peripheral adverse effects related to cumulative anticholinergic activity of their medications. Additional research to measure the clinical impact of ACB assessment and modification is needed. PMID:24030127
West, Teri; Pruchnicki, Maria C; Porter, Kyle; Emptage, Ruth
OBJECTIVE To explore the diagnostic thinking process of medical students. SUBJECTS AND METHODS Two hundred twenty-four medical students were presented with 3 clinical scenarios corresponding to high, low, and intermediate pre-test probability of coronary artery disease. Estimates of test characteristics of the exercise stress test, and pre-test and post-test probability for each scenario were elicited from the students (intuitive estimates) and from the literature (reference estimates). Post-test probabilities were calculated using Bayes' theorem based upon the intuitive estimates (Bayesian estimates of post-test probability) and upon the reference estimates (reference estimates of post-test probability). The differences between the reference estimates and the intuitive estimates, and between Bayesian estimates and the intuitive estimates were used for assessing knowledge of test characteristics, and ability of estimating pre-test and post-test probability of disease. RESULTS Medical students could not rule out disease in low or intermediate pre-test probability settings, mainly because of poor pre-test estimates of disease probability. They were also easily confused by test results that differed from their anticipated results, probably because of their inaptitude in applying Bayes' theorem to real clinical situations. These diagnostic thinking patterns account for medical students or novice physicians repeating unnecessary examinations. CONCLUSIONS Medical students' diagnostic ability may be enhanced by the following educational strategies: 1) emphasizing the importance of ruling out disease in clinical practice, 2) training in the estimation of pre-test disease probability based upon history and physical examination, and 3) incorporation of the Bayesian probabilistic thinking and its application to real clinical situations.
We propose an approach to multilingual medical document retrieval in which complex word forms are segmented according to medically relevant morpho-semantic criteria. At its core lies a multilingual dictionary, in which entries are equivalence classes of subwords, i.e. semantically minimal units. Using two different standard test collections for the medical domain, we evaluate our approach for six languages covered by our system. PMID:17911746
Introduction: Errors in the concentration of intravenous medications are not uncommon. We evaluated steps in the infusion-preparation process to identify factors associated with preventable medication errors. Methods: We included 118 health care professionals who would be involved in the preparation of intravenous medication infu- sions as part of their regular clinical activities. Participants per- formed 5 infusion-preparation tasks (drug-volume calculation,
Christopher S. Parshuram; Winnie Seto; Angela Trope; Gideon Koren MBBS; Andreas Laupacis
Evaluation of undergraduate medical education programs is necessary to meet accreditation standards; however, implementation and maintenance of an adequate evaluation process is challenging. A curriculum evaluation committee (CEC) was established at the Penn State University College of Medicine in 2000 to complement the already established activities of the Office of the Vice Dean for Medical Education and the Committee on Undergraduate Medical Education. Herein, we describe the methodology used by the CEC at our academic medical center and outcomes attributable to the curriculum evaluation process that was enacted. Strengths of our process include ongoing, regular assessments that guarantee a course is reviewed at least every two years and a feedback loop whereby course directors are held accountable for implementing changes when necessary. Our evaluative process has proven effective, sustainable, and has identified additional areas for curricular improvements. PMID:22816980
Background Evidence-based medicine (EBM) is increasingly taught in medical schools, but few curricula have been evaluated using validated\\u000a instruments.\\u000a \\u000a \\u000a \\u000a Objective To evaluate a longitudinal medical school EBM curriculum using a validated instrument.\\u000a \\u000a \\u000a \\u000a Design, Participants, Measurements We evaluated EBM attitudes and knowledge of 32 medical students as they progressed through an EBM curriculum. The first part\\u000a was an EBM “short course” with didactic and
The study objective was to explore the diagnostic suitability of the Xerostomia Inventory and the association between xerostomia,\\u000a hyposalivation and medication use in a group of nursing home residents. A cross-sectional study was carried out in 50 physically\\u000a impaired nursing home residents (20 men) with a mean age of 78.1 years (range, 53–98) in The Netherlands. The Xerostomia Inventory-Dutch\\u000a version was
Gert-Jan van der Putten; Henk S. Brand; Jos M. G. A. Schols; Cees de Baat
...to manage DM due to a mental disorder, or inadequate treatment. a...of DKA may result from mood or eating disorders, which we evaluate under 12...adolescents may result from mood or eating disorders, which we evaluate under...
Methadone medical maintenance (MMM) is a model for the treatment of opioid dependence in which a monthly supply of methadone is distributed in an office setting, in contrast to more highly regulated settings where daily observed dosing is the norm. We assessed patient characteristics and treatment outcomes of an MMM program initiated in the Bronx, New York, in 1999 by conducting a retrospective chart review. Participant characteristics were compared with those of patients enrolled in affiliated conventional methadone maintenance treatment programs. Patients had diverse ethnicities, occupations, educational backgrounds, and income levels. Urine toxicology testing detected illicit opiate and cocaine use in 0.8% and 0.4% of aggregate samples, respectively. The retention rate was 98%, which compares favorably with the four other MMM programs that have been reported in the medical literature. This study demonstrates that selected patients from a socioeconomically disadvantaged population remained clinically stable and engaged in treatment in a far less intensive setting than traditional methadone maintenance.
Harris, Kenneth A.; Arnsten, Julia H.; Joseph, Herman; Hecht, Joe; Marion, Ira; Juliana, Patti; Gourevitch, Marc N.
Thermoluminescent detectors (TLDs) can provide accurate and precise measurements for both patient and personnel dosimetry in the medical imaging environment. They have the advantages of tissue equivalency, an excellent dynamic range, and dose rate independence. In the work reported here, experiments with planar x-ray, fluoroscopy, and a 57Co source were conducted to test the repeatability and energy dependence of an LiF TL ribbon/automatic reader system and a four-element CaSO2 and Li2B4O7 badge/automatic reader system for diagnostic radiology and nuclear medicine dosimetry. The results indicate the usefulness and appropriateness of the TLD systems tested for both personnel and patient dosimetry in the medical diagnostic environment.
Kearfott, K.J.; Nabelssi, B.K.; Rucker, R.H.; Klingler, G.W. (Georgia Institute of Technology, Atlanta (USA))
A thorough assessment of a patient's medical status is standard practice when dental care is provided. Although this is true for procedures performed under local anesthesia alone, the information gathered may be viewed somewhat differently if the dentist is planning to use sedation or general anesthesia as an adjunct to dental treatment. This article is the first of a 2-part sequence and will address general principles and cardiovascular considerations. A second article will address pulmonary, metabolic, and miscellaneous disorders.
Objective The purpose of this study was to systematically review the reliability of scores on the Eating Disorder Examination (EDE) and the Eating Disorder Examination-Questionnaire (EDE-Q) and to examine the validity of their use as measures of eating disorder symptoms. Method Articles describing the psychometric properties of the EDE and EDE-Q were identified in a systematic search of major computer databases and a review of reference lists. Articles were selected based on a priori inclusion and exclusion criteria. Results Fifteen studies were identified that examined the psychometrics of the EDE, whereas 10 studies were found that examined the psychometrics of the EDE-Q. Discussion Both instruments demonstrated reliability of scores. There is evidence that scores on the EDE and EDE-Q correlate with scores on measures of similar constructs and support for using the instruments to distinguish between cases and non-cases. Additional research is needed to broaden the generalizability of the findings.
Berg, Kelly C.; Peterson, Carol B.; Frazier, Patricia; Crow, Scott J.
The purpose of the present review is to provide an update about the most common risk factors or medical conditions associated with renal stone formation, the current methods available for metabolic investigation, dietary recommendations and medical treatment. Laboratory investigation of hypercalciuria, hyperuricosuria, hyperoxaluria, cystinuria, hypocitraturia, renal tubular acidosis, urinary tract infection and reduction of urinary volume is based on the results of 24-hr urine collection and a spot urine for urinary sediment, culture and pH. Blood analysis for creatinine, calcium and uric acid must be obtained. Bone mineral density has to be determined mainly among hypercalciurics and primary hyperparathyroidism has to be ruled out. Current knowledge does not support calcium restriction recommendation because it can lead to secondary hyperoxaluria and bone demineralization. Reduction of animal protein and salt intake, higher fluid intake and potassium consumption should be implemented. Medical treatments involve the use of thiazides, allopurinol, potassium citrate or other drugs according to the metabolic disturbances. The correction of those metabolic abnormalities is the basic tool for prevention or reduction of recurrent stone formation. PMID:17117307
One (A.I) of the authors has developed BDIM (Before-Discharge Intervention Method) for the purpose of making alcoholics aware of their drinking problems. 153 patients were treated by BDIM. After the practiced BDIM, the patients underwent a 52 month observational period. 82 patients (53.6%) continued with either treatment as outpatient or inpatients, or attendance of a self-help group. We administered these 82 patients our questionnaire that asked for their assessment about the therapeutic effects of BDIM. 76 patients (49.7%) completed our questionnaire. Regarding the impression of family members' letters in BDIM, 70 patients (92.1% of 76) answered that the letter have had a positive impression on them. 52 patients (68.4% of 76) answered that they have had very strong or strong impressions. The numbers of patients who have [very strong or strong] impression are significantly more in the abstinence group than in the drinking group. Also, we asked patients about which messages of spouses, daughters and sons in BDIM gave the strongest impression to these patients. The result showed that their daughter gave the strongest impression to many patients. We believe that their children, especially the patients' daughter's messages, have therapeutic effects as impact messages even though alcoholics have cognitive or memory disorder. Patients positively assessed that BDIM strengthened motivation for treatment or attendance of self-help group meetings, for abstinence and for the consequence to their lives. Many patients assessed that BDIM has effect on awareness of their drinking problems. But the ratio of positive answers about motivation of awareness of drinking problem is smaller than the ratio of positive answers about other questions. As a result, we surmised that BDIM will have the effect of empowerment, including the effect of awareness. PMID:17037344
Background Socio-cultural differences for country-specific activities are rarely addressed in physical activity questionnaires. We examined the reliability and validity of the Indian Migration Study Physical Activity Questionnaire (IMS-PAQ) in urban and rural groups in India. Methods A sub-sample of IMS participants (n = 479) was used to examine short term (?1 month [n = 158]) and long term (> 1 month [n = 321]) IMS-PAQ reliability for levels of total, sedentary, light and moderate/vigorous activity (MVPA) intensity using intraclass correlation (ICC) and kappa coefficients (k). Criterion validity (n = 157) was examined by comparing the IMS-PAQ to a uniaxial accelerometer (ACC) worn ?4 days, via Spearman's rank correlations (?) and k, using Bland-Altman plots to check for systematic bias. Construct validity (n = 7,000) was established using linear regression, comparing IMS-PAQ against theoretical constructs associated with physical activity (PA): BMI [kg/m2], percent body fat and pulse rate. Results IMS-PAQ reliability ranged from ICC 0.42-0.88 and k = 0.37-0.61 (?1 month) and ICC 0.26 to 0.62; kappa 0.17 to 0.45 (> 1 month). Criterion validity was ? = 0.18-0.48; k = 0.08-0.34. Light activity was underestimated and MVPA consistently and substantially overestimated for the IMS-PAQ vs. the accelerometer. Criterion validity was moderate for total activity and MVPA. Reliability and validity were comparable for urban and rural participants but lower in women than men. Increasing time spent in total activity or MVPA, and decreasing time in sedentary activity were associated with decreasing BMI, percent body fat and pulse rate, thereby demonstrating construct validity. Conclusion IMS-PAQ reliability and validity is similar to comparable self-reported instruments. It is an appropriate tool for ranking PA of individuals in India. Some refinements may be required for sedentary populations and women in India.
This study aims to investigate the disease-related knowledge of gout patients and doctors in south China and to identify the important targets of education for patients and doctors. A cross-section survey of 154 primary gout patients and 185 doctors who may see gout patients was conducted with a modified questionnaire with ten items of gout-related knowledge. The participants were considered to have gout-related knowledge if he or she correctly answered seven or more items. One hundred and forty-nine valid questionnaires from patients, 33 from rheumatology physicians, and 151 from non-rheumatology doctors were collected for statistical analysis. The mean correctly answered items of three groups were 6.6?±?2.2, 9.6?±?0.53, and 8.0?±?1.4, with rate of being considered to have knowledge about gout 51.7, 100, and 90.1 %, respectively (P?0.05). The correct answer rate for each particular item was over 80 % in the rheumatology physician group. Patients or non-rheumatology doctors knew the optimal serum uric acid (sUA) level (48.3 vs 55.6 %), the need to take lifelong urate-lowering drugs (29.5 vs 43.6 %), that allopurinol is a urate-lowering drug (55.7 vs 76.0 %), and how to prevent attacks induced by urate-lowering therapy (ULT) (60.4 vs 74.0 %). Logistic regression showed that higher education predicted which patients had gout-related knowledge. Both the gout patients and non-rheumatology doctors in south China had poor knowledge on ULT. Since many gout patients do not see rheumatologists, our data suggest that further education should focus on patients and non-rheumatologists and emphasize the use of urate-lowering drugs, treatment duration, the target sUA level, and prophylaxis against acute attacks. PMID:23857664
|Purpose of the study: The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer…
Human beings are more subjective than objective, In this paper, paying attention to our internal emotion, especially “subjectivity”, we introduce frame-oriented theory and show an application of the theory to decision processing and evaluation of medical diagnosis. Most medical diagnoses depend on the subjectivity of its specialist. Occasionally they are highly influenced by their subjectivity. Especially, a subjective diagnostic statement
|Background: No single assessment method can successfully evaluate the clinical ability of medical students in psychiatric clerkships; however, few studies have examined the efficacy of multiple assessments, especially in psychiatry. The aim of this study was to examine the relationship among different types of assessments of medical students'…
Sixty-one forensic medical expert conclusions on the loss of professional working capacity are analyzed and typical errors are characterized. The procedure of forensic medical expert evaluation of the degree of loss of professional working capacity in accordance with the Civil Code and Civil Judicial Procedure Code of the Russian Federation and the actual norm-setting documents is described. PMID:10769588
Kapustin, A V; Tomilin, V V; Ol'khovik, V P; Panfilenko, O A; Pushakov, S M; Rivenson, M S; Serebriakova, V G
One very effective strategy to achieve good blood pressure (BP) control in primary care is the use of physician\\/pharmacist collaborative management. Interventions by pharmacists in both community pharmacies and primary care clinics have been shown to significantly reduce BP by both improving medication adherence and intensifying medications. This review will evaluate the strengths and weaknesses of various health services' research
Purpose of the study: The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer…
This paper is a review of past community-based medical experiments in light of the growing interest in similar projects focused on the prevention of alcoholrelated problems. It begins by questioning the appropriateness of the medical metaphor for designing alcohol prevention programs and suggests a few alternatives. The paper then discusses the logic of program design, implementation, and evaluation of alcohol
|The second preclinical year of the medical curriculum at the Medical Faculty of the University of Lausanne in Switzerland includes nine multidisciplinary organ-system-oriented modules consisting of lectures and problem-based-learning tutorials. This study reports the experience accumulated with the evaluation of lectures during the academic years…
Autism is an age-dependent neurologic disorder that is often associated with autoimmune disorders in the patients' relatives. To evaluate the frequency of autoimmune disorders, as well as various prenatal and postnatal events in autism, we surveyed the families of 61 autistic patients and 46 healthy controls using questionnaires. The mean number of autoimmune disorders was greater in families with autism;
Anne M. Comi; Andrew W. Zimmerman; Virginia H. Frye; Paul A. Law; Joseph N. Peeden
Health professions education is dealing with major transformations in light of the changing nature of the health care delivery system, including the use of technology for "just in time" delivery of care, evidence-based practice, personalized medical care and learning, as health professionals strive to integrate biomedical advances and clinical practice. This has forced the medical education community to reassess the current teaching and learning practices and more importantly, the evaluation of the medical education process. There have been recent advances in cognitive and learning sciences theories, some of which can inform medical educators about best teaching and learning practices and their impact on the evaluation process. An understanding of these theories provides a sound rationale for choosing specific instructional strategies and choosing evaluation measures that assess the curricular objectives. The review begins with an overview of evaluation and assessment in education, followed by an overview of major theories from the cognitive and learning sciences. Next, the role of cognitive and learning sciences theories in informing the process of medical education evaluation is discussed, including its impact on student learning, performance and professional competence, as well as recommendations for reform of medical curricula based on such theories. The paper continues with the elaboration of current trends in health sciences education, particularly medical education, and available evidence for the impact on student learning and performance as well as areas where more research is needed. PMID:18214707
Patel, Vimla L; Yoskowitz, Nicole A; Arocha, Jose F
The challenge was to evaluate the crashworthiness of the UH-1 Medical Attendant's Seat and investigate the feasibility of modifications to improve the seat and its restraint system. This report is a record of USAARL's involvement, from researching the bac...
E. B. Barber F. T. Aguilar G. E. Tornquist S. C. Knapp S. P. Desjardins
Reports the results of an evaluation of Distance Interactive Learning in Obstetrics and Gynecology (DIALOG) which is an electronic program for continuing education. Presents 10 golden rules for designing software for medical practitioners. (Contains 26 references.) (Author/YDS)
This article reports a study evaluating the sources and availability of career advice available to students in UK medical schools in order to ascertain the need for an enhanced role for careers information in undergraduate curricula. PMID:19966706
...FEDERAL MOTOR CARRIER SAFETY REGULATIONS QUALIFICATIONS OF DRIVERS AND LONGER COMBINATION VEHICLE (LCV) DRIVER INSTRUCTORS Physical Qualifications and Examinations Â§ 391.47 Resolution of conflicts of medicalevaluation. (a) Applications....
In March 2000, the National Institute for Occupational Safety and Health (NIOSH) received a request from the Service Employees International Union (SEIU) local 1997 to conduct a health hazard evaluation (HHE) at Riverside County Regional Medical Center in...
The National Institute for Occupational Safety and Health (NIOSH) conducted a health hazard survey to evaluate exposure to sulfamic acid in CSCO Ice Machine Cleaner used to clean ice machines at Tripler Army Medical Center, Honolulu, Hawaii. Based upon ob...
This paper describes an evaluation methodology designed for the IMSA (Interactive Multimedia System for Auto-medication) system. IMSA stands in the multidisciplinary field of medical informatics and aims at providing a health care Internet tool for the general public. As far as a medical information system is patient-oriented, issues in understanding content and of human - computer interface usability are key factors to achieve success. The team developing IMSA concentrated part of its work on designing an evaluation methodology to ensure that the system is user-friendly and responds in a way that can be easily understood by the general public. This methodology is built on a three-tier architecture with the user, the evaluator and a set of medical case descriptions. The testing protocol is based on a user trying to run scenarios related to mild clinical signs on the IMSA prototype under the passive presence of an evaluator. PMID:12851053
The objective of this report is to describe the methods used in and lessons learned from a research study that evaluated prescriptions for medication errors prior to the implementation of an ambulatory computerized prescriber order entry (ACPOE) system in...
E. B. Devine J. L. Wilson-Norton N. M. Lawless T. K. Hazlet R. Hansen
In response to a request from the respiratory therapist educator of HCA Wesley Medical Center in Wichita, Kansas, an evaluation was conducted of the effectiveness of revised procedures for administering ribavirin (36791045) via hood. The containment syste...
The philosophy of evaluating the need of a victim in extra care is discussed. The method for evaluating the need in transport vehicles for the victim is described in detail. Legislative documents which help solve such problems are cited, including those used by committees of forensic medicalevaluations. PMID:11061008
Kapustin, A V; Tomilin, V V; Ol'khovnik, V P; Panfilenko, O A; Serebriakova, V G
|Programme evaluation is essential for quality assurance in education. In this paper, we describe our evaluation strategy for the first year of a new medical programme. Although we used multiple methods in the evaluation, the use of the focus group method was core. This paper reports our experiences of focus groups for this purpose. We describe…
Nestel, Debra; Ivkovic, Amelie; Hill, Robyn A.; Warrens, Anthony N.; Paraskevas, Paraskeva A.; McDonnell, Jacqueline A.; Mudarikwa, Ruvimbo S.; Browne, Chris
Programme evaluation is essential for quality assurance in education. In this paper, we describe our evaluation strategy for the first year of a new medical programme. Although we used multiple methods in the evaluation, the use of the focus group method was core. This paper reports our experiences of focus groups for this purpose. We describe the implementation of the
Debra Nestel; Amélie Ivkovic; Robyn A. Hill; Anthony N. Warrens; Paraskeva A. Paraskevas; Jacqueline A. McDonnell; Ruvimbo S. Mudarikwa; Chris Browne
This study firstly describes current status of surgical robot development and various social barriers for clinical application such as pre-clinical evaluation study, governmental authorization, and commercialization. And then a novel experimental platform as an evaluation environment of newly developed medical devices is proposed. As model cases of evaluation study, MR scanning and surgeries were conducted in “intelligent animal operating room”.
Hospitals have always generated and consumed large amounts of data concerning patients, treatment and outcomes. As computers and networks have permeated the hospital environment it has become feasible to collect and organize all of this data. This raises naturally the question of how to deal with the resulting mountain of information. In this report we detail a proof-of-concept test using two commercially available parallel database systems to analyze a set of real, de-identified medical records. We examine database scalability as data sizes increase as well as responsiveness under load from multiple users.
This paper reviews the first two years of overseas postgraduate dental placements in the UK under the Medical Training Initiative (MTI), which is part of Tier 5 government authorised exchange. Details of the objectives of the programme, the trainees appointed, specialty areas studied and length of training are described. The methods used for assessing the training are reported. It is concluded that the objectives of the MTI have been met in dentistry and that Tier 5 provides a valuable opportunity for establishing international links in postgraduate clinical dentistry. PMID:22402542
In response to reports of negative cooperation between sufferers of chronic fatigue syndrome (CFS) and their doctors, semi-structured interviews were conducted with sufferers from two different patient samples. Satisfaction with support received and with medical professionals in general was low. Sufferers complained about insufficient informational as well as emotional support from their doctors, and as a consequence most opted for alternative or complementary forms of treatment. In addition, disagreements over illness aetiology and treatment precluded effective cooperation. If satisfaction and compliance are to improve, sufferers will need more information about CFS and more support.
Although many individuals applying for political asylum allege maltreatment and sometimes torture in their countries of origin,\\u000a the utility of medicalevaluations in asylum adjudication has not been documented. This study compares the asylum grant rate\\u000a among US asylum seekers who received medicalevaluations from Physicians for Human Rights (PHR), with rates among asylum seekers\\u000a who did not receive PHR
Stuart L. Lustig; Sarah Kureshi; Kevin L. Delucchi; Vincent Iacopino; Samantha C. Morse
Transferring results of economic evaluations across countries or jurisdictions can potentially save scarce evaluation resources while helping to make market access and reimbursement decisions in a timely fashion. This article points out why transferring results of economic evaluations is particularly important in the field of medical technologies. It then provides an overview of factors that are previously identified in the literature as affecting transferability of economic evaluations, as well as methods for transferring results in a scientifically sound way. As the current literature almost exclusively relates to transferability of pharmacoeconomic evaluations, this article highlights those factors and methodologies that are of particular relevance to transferring medical technology assessments. Considering the state-of-the-art literature and a worked, real life, example of transferring an economic evaluation of a product used in orthopedic surgery, we provide recommendations for future work in this important area of medical technology assessment. PMID:18452383
Steuten, Lotte; Vallejo-Torres, Laura; Young, Terry; Buxton, Martin
Ever since Taiwan's National Health Insurance implemented the diagnosis-related groups payment system in January 2010, hospital income has declined. Therefore, to meet their medical waste disposal needs, hospitals seek suppliers that provide high-quality services at a low cost. The enactment of the Waste Disposal Act in 1974 had facilitated some improvement in the management of waste disposal. However, since the implementation of the National Health Insurance program, the amount of medical waste from disposable medical products has been increasing. Further, of all the hazardous waste types, the amount of infectious medical waste has increased at the fastest rate. This is because of the increase in the number of items considered as infectious waste by the Environmental Protection Administration. The present study used two important findings from previous studies to determine the critical evaluation criteria for selecting infectious medical waste disposal firms. It employed the fuzzy analytic hierarchy process to set the objective weights of the evaluation criteria and select the optimal infectious medical waste disposal firm through calculation and sorting. The aim was to propose a method of evaluation with which medical and health care institutions could objectively and systematically choose appropriate infectious medical waste disposal firms.
Ho, Chao Chung, E-mail: firstname.lastname@example.org [Department of Industrial Management, National Taiwan University of Science and Technology, Taipei, Taiwan (China)
...the Humphrey Field Analyzer (HFA) and Octopus perimeters that were provided in the introductory...tests (HFA 30-2, HFA 24-2, and Octopus 32) that can be used to evaluate visual...Analyzer (HFA) 30-2, HFA 24-2, and Octopus 32. d. Evaluation under 2.03B....
This report presents an evaluation of the TRIPAD system at Keesler AFB. The evaluation focuses on the system objectives which were established as part of the system development process. The results were based on data collected before and after the system ...
The effectiveness of medical masks in preventing respiratory infection was investigated by testing bacterial leakage, filtration efficiency, respiratory resistance and oxygen concentration of the enclosed space. Polypropylene (PP) fibres were treated with dimethyldioctadecylammonium bromide to impart a positive electrical charge capable of attracting bacteria. The fluffed PP fibres were used to make a polypropylene mask and to edge standard surgical and N-95 respirators to prevent leakage. A PP napkin was created by melting and blowing PP. The PP edging seal dramatically reduced bacterial leakage of standard masks and was more effective than adhesive paper tape edging in reducing respiratory resistance. Bacterial or viral filtration efficiency was almost 100% for the PP mask and the PP napkin. The specially designed PP mask with a synthetic adhesive at the edge of the mask may be more effective than the standard surgical mask and the N-95 respirator. The PP napkin is an important tool in preventing the spread of pathogens. PMID:17542408
Although a vast literature has indicated that stimulant medications are effective for reducing inappropriate behavior in children with attention deficit hyperactivity disorder (ADHD), the effects of stimulant medication on ancillary behaviors (e.g., play) have yet to be investigated with the same rigor. We used a reinforcer assessment procedure to evaluate the effects of medication on the play and social behavior of 5 preschool children who had been diagnosed with ADHD. Conditions included (a) social reinforcement (i.e., playing with friends), (b) alone play, and (c) quiet time (i.e., resting). Results indicated that 1 of the 5 participants selected fewer social reinforcers and more nonsocial reinforcers (alone play or quiet time) while on medication. The findings indicate that the reinforcer assessment procedure may be a viable way to evaluatemedication effects on an ongoing basis and to inform treatment decisions. PMID:18468289
Larue, Robert H; Northup, John; Baumeister, Alan A; Hawkins, Mike F; Seale, Lauren; Williams, Tara; Ridgway, Andrea
Although a vast literature has indicated that stimulant medications are effective for reducing inappropriate behavior in children with attention deficit hyperactivity disorder (ADHD), the effects of stimulant medication on ancillary behaviors (e.g., play) have yet to be investigated with the same rigor. We used a reinforcer assessment procedure to evaluate the effects of medication on the play and social behavior of 5 preschool children who had been diagnosed with ADHD. Conditions included (a) social reinforcement (i.e., playing with friends), (b) alone play, and (c) quiet time (i.e., resting). Results indicated that 1 of the 5 participants selected fewer social reinforcers and more nonsocial reinforcers (alone play or quiet time) while on medication. The findings indicate that the reinforcer assessment procedure may be a viable way to evaluatemedication effects on an ongoing basis and to inform treatment decisions.
LaRue, Robert H; Northup, John; Baumeister, Alan A; Hawkins, Mike F; Seale, Lauren; Williams, Tara; Ridgway, Andrea
The School of Medicine at the University of Tasmania has recently begun to implement a process of curriculum evaluation,which aims to reflect contemporary best practice in evaluation in tertiary pedagogy and medical education. Best practice must accommodate a broadening interest in cooperative and collaborative evaluation strategies among stakeholders, advances in applied qualitative educational research and recognition that critical reflection on practice is the cornerstone of professional education. This paper reports a recent evaluation strategy in a specific year-long unit in the second year of a six-year undergraduate medical degree. The paper begins by presenting the context; it then discusses and rationalises the evaluation strategy and presents findings. The paper concludes by arguing that curriculum evaluation as best practice must be reflective, informed by the scholarship of medical education, and internalized as a dynamic process that can promote sustainable change and improvement in medical curricula. Such an approach will contribute to an undergraduate medical curriculum that prepares students for the demands and complexities of medical practice. PMID:14741864
We report on psychometric properties of a new questionnaire to study long-term strategies, practices and tactics that may help injection drug users (IDUs) avoid infection with HIV and hepatitis C. Sixty-two long-term IDUs were interviewed in New York City in 2009. Five scales based on a total of 47 items were formed covering the following domains: stigma avoidance, withdrawal prevention, homeless safety, embedding safety within a network of users, and access to resources/social support. All scales (? ? .79) except one (? = .61) were highly internally consistent. Seven single-item measures related to drug use reduction and injection practices were also analyzed. All variables were classified as either belonging to a group of symbiotic processes that are not directly focused upon disease prevention but nonetheless lead to risk reduction indirectly or as variables describing prevention tactics in risky situations. Symbiotic processes can be conceived of as unintentional facilitators of safe behaviors. Associations among variables offer suggestions for potential interventions. These Staying Safe variables can be used as predictors of risk behaviors and/or biological outcomes.
Vazan, Peter; Mateu-Gelabert, Pedro; Cleland, Charles M.; Sandoval, Milagros
We report on psychometric properties of a new questionnaire to study long-term strategies, practices and tactics that may help injection drug users (IDUs) avoid infection with HIV and hepatitis C. Sixty-two long-term IDUs were interviewed in New York City in 2009. Five scales based on a total of 47 items were formed covering the following domains: stigma avoidance, withdrawal prevention, homeless safety, embedding safety within a network of users, and access to resources/social support. All scales (? ? .79) except one (? = .61) were highly internally consistent. Seven single-item measures related to drug use reduction and injection practices were also analyzed. All variables were classified as either belonging to a group of symbiotic processes that are not directly focused upon disease prevention but nonetheless lead to risk reduction indirectly or as variables describing prevention tactics in risky situations. Symbiotic processes can be conceived of as unintentional facilitators of safe behaviors. Associations among variables offer suggestions for potential interventions. These Staying Safe variables can be used as predictors of risk behaviors and/or biological outcomes. PMID:22038081
Vazan, Peter; Mateu-Gelabert, Pedro; Cleland, Charles M; Sandoval, Milagros; Friedman, Samuel R
Five studies were conducted to construct and psychometrically evaluate a marital satisfaction questionnaire for older persons. The questionnaire content was generated and refined in Study 1. Temporal stability was evaluated in Study 2, and criterion-related validity was examined in Study 3. Norms, factor structure, and construct validity of the questionnaire were established in Study 4. The degree to which scores
Stephen N. Haynes; Frank J. Floyd; Carolyn Lemsky; Elizabeth Rogers
Five studies were conducted to construct and psychometrically evaluate a marital satisfaction questionnaire for older persons. The questionnaire content was generated and refined in Study 1. Temporal stability was evaluated in Study 2, and criterion-related validity was examined in Study 3. Norms, factor structure, and construct validity of the questionnaire were established in Study 4. The degree to which scores
Stephen N. Haynes; Frank J. Floyd; Carolyn Lemsky; Elizabeth Rogers; David Winemiller; Nancy Heilman; Mary Werle; Tria Murphy; Lydia Cardone
BACKGROUND Evidence-based medicine (EBM) is an important element of medical education. However, limited information is available on effective\\u000a curricula.\\u000a \\u000a \\u000a \\u000a \\u000a OBJECTIVE To evaluate a longitudinal medical school EBM curriculum using validated instruments.\\u000a \\u000a \\u000a \\u000a DESIGN, PARTICIPANTS, MEASUREMENTS We evaluated EBM attitudes and knowledge of medical students as they progressed through an EBM curriculum. The first component\\u000a of the curriculum was an EBM “short course” with didactic
Colin P. West; Thomas M. Jaeger; Furman S. McDonald
Background: The subject of Biomedical Ethics has become recognized as an essential integral component in the undergraduate curriculum of medical students. Objectives: (1) To review the current Biomedical Ethics Course offered at the College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences (KSAU-HS). (2) To explore the perception of medical students on the different components of the course. Materials and Methods: The medical students were requested to participate in the study at the end of the course by filling in a pre-designed questionnaire. A qualitative approach was used also to examine their perceptions about certain components of the course. Results: Forty-one medical students participated in this study. All students expressed their strong agreement on the importance of their learning biomedical ethics. Their views about the role of Biomedical Ethics were also considered. These include professional development, assessment of ethical competencies, and the timing of the teaching of ethics. Conclusion: The students provided valuable comments that were supported by the literature reviews. Medical Students’ views of the teaching of the various components of biomedical ethics are important and should be sought in the planning of a curriculum.
Objectives Patients' self-report of medicine taking is a feasible method of assessing their adherence to prescribed pharmacological treatment. Aim of this study was to assess whether the German version of the Medication Adherence Report Scale (MARS-D) is an appropriate instrument for measuring patient adherence. Methods After translation into German, the questionnaire was sent to 1488 patients with chronic diseases and patients with risk factors of cardiovascular disease. Reliability and validity of the MARS-D were assessed and compared with the psychometric properties of the original English version. The relationship between patients' characteristics and adherent behaviour was estimated using bivariate correlation and a linear regression model. Results The MARS-D was analysed if patients were taking medicines and the MARS-D was complete leaving 523 (35.1%) analysable questionnaires. Internal consistency of the MARS-D (Cronbach's alpha 0.60-0.69) was satisfactory and comparable to the English original (Cronbach's alpha 0.69-0.90). Test-retest reliability was satisfactory (Pearson's r 0.61-0.63), however, lower than in the English sample (r = 0.97). Convergent validity was low but showed statistical significance. Patient socio-demographic characteristics had weak influence on MARS-D score indicating high reported adherence for older patients (P < 0.05), patients with German mother tongue (P < 0.05) and high number of medicines (P < 0.01). Conclusions Preliminary psychometric evaluation of the MARS-D is encouraging. MARS-D is an appropriate measure to detect patients at risk of non-adherence. The MARS-D could be used in routine care to support communication about the medication taking behaviour, as self-report of non-adherent behaviour corresponds to the facts. PMID:20210821
An attempt was made to formulate a tool that, when compared to the appropriateness evaluation protocol (AEP) used for evaluating the utilization of hospital services for medical patients, would be an improvement. To establish this, a four-phase project was evolved, which included: (a) taxonomy definition of medical and nonmedical reasons for acute-care hospital bed utiliza tion for a day of
B. Mozes; Y. Rosenblum; L. Rom; N. Friedman; E. Shabtai; A. Porat
Purpose: Pain is a common symptom among cancer patients, yet many patients do not receive adequate pain management. Few data exist quantifying analgesic use by radiation oncology patients. This study evaluated the causes of pain in cancer patients and investigated the reasons patients fail to receive optimal analgesic therapy. Methods and Materials: An institutional review board-approved, Internet-based questionnaire assessing analgesic use and pain control was posted on the OncoLink (available at (www.oncolink.org)) Website. Between November 2005 and April 2006, 243 patients responded. They were predominantly women (73%), white (71%), and educated beyond high school (67%) and had breast (38%), lung (6%), or ovarian (6%) cancer. This analysis evaluated the 106 patients (44%) who underwent radiotherapy. Results: Of the 106 patients, 58% reported pain from their cancer treatment, and 46% reported pain directly from their cancer. The pain was chronic in 51% and intermittent in 33%. Most (80%) did not use medication to manage their pain. Analgesic use was significantly less in patients with greater education levels (11% vs. 36%, p = 0.002), with a trend toward lower use by whites (16% vs. 32%, p 0.082) and women (17% vs. 29%, p = 0.178). The reasons for not taking analgesics included healthcare provider not recommending medication (87%), fear of addiction or dependence (79%), and inability to pay (79%). Participants experiencing pain, but not taking analgesics, pursued alternative therapies for relief. Conclusions: Many radiation oncology patients experience pain from their disease and cancer treatment. Most study participants did not use analgesics because of concerns of addiction, cost, or failure of the radiation oncologist to recommend medication. Healthcare providers should have open discussions with their patients regarding pain symptoms and treatment.
Simone, Charles B. [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA (United States); Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States)], E-mail: email@example.com; Vapiwala, Neha; Hampshire, Margaret K.; Metz, James M. [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA (United States)
Computing has developed slowly in British general medical practice, and the impact on patient care has yet to be fully evaluated. There is an acknowledged need for further training in informatics. This article describes a tool for assessing recommended medical informatics skills. The tool is based on self-scoring of 15 skills on a matrix questionnaire. A survey of 1 15
This paper presents the study done to evaluate the accuracy of drug interaction (DI) alerts triggered by two Electronic Medical Record (EMR) systems used in primary heal th care . Elderly patients commonly find it onerous to recollect their medications during medical interrogation. P hysicians and pharmacists find it hard to keep abreast with the expanding medical and pharmacologic knowledge
In order to help sick persons with making an aware decision to undergo a surgical treatment it is necessary to instruct them in every possible aspect of the proposed therapy. Aiming at adjusting the range and form of information to individual case of each patient, we have tried to estimate his/her general medical awareness and the extent of the acquirement of information received. On the ground of analysis of the results, it was found that 20-50% of patients had no basic knowledge of their illness at the moment of their admission to the hospital. Although 67% of the patients were satisfied with the questionnaire and preoperative explanation, every other patient had no understanding of the essence of the medical action planned. At the same time, about 50% of the patients declared a possibility of withdrawing their consent to surgical treatment, if given more comprehensive information about possible complications. PMID:10375943
|As part of a broader study aimed at evaluating perceived alliance with service providers and level of satisfaction with services received, 103 monolingual Spanish speaking Hispanic women were interviewed. Participants were receiving ongoing behavioral health treatment at three different community service provider sites located in the greater New…
Bedregal, Luis E.; Paris, Manuel Jr.; Anez, Luis M.; Shahar, Golan; Davidson, Larry
This paper evaluates the associations of a subset of concepts extracted by VCGS (Vocabulary Cluster Generating System), a concept extraction and association tool, based on 6000 titles and abstracts downloaded from EBSCOhost Health Source - Consumer Edition database, against associations decided by 30 participants. The results show that after incorporating LSA (Latent Semantic Analysis) technique, the VCGS system establishes term
ObjectivesSuboptimal compliance and failure to persist with drug treatments are important determinants of therapeutic nonresponse and are of potential economic significance. The present article aims to describe the methodologies that may be appropriate for integrating noncompliance and nonpersistence in economic evaluations.
...examine the nasopharynx, nose, oral pharynx, mouth, and neck when they evaluate hearing loss. While we agree that otologists...inner ear or to the nerve pathways from the inner ear to the brain. Persons with the degree of sensorineural hearing loss...
The overall stability of medicated chewing gums is investigated under different storage conditions. Active substances with different chemical stabilities in solid state are chosen as model drugs. The dosage form is a three layer tablet obtained by direct compression. The gum core contains the active ingredient while the external layers are formulated to prevent gum adhesion to the punches of the tableting machine. Two accelerated test conditions (40°C/75% RH and 30°C/65% RH) are performed for 6 months. Furthermore, a long-term stability test at room conditions is conducted to verify the predictability of the results obtained from the stress tests. Some drugs are stable in all the conditions tested, but other drugs, generally considered stable in solid dosage forms, have shown relevant stability problems particularly when stress test conditions are applied to this particular semi-solid dosage forms. For less stable drugs, the stress conditions of 40°C/75% RH are not always predictable of chewing gum stability at room temperature and may produce false negative; intermediate conditions, 30°C/65% RH, are more predictive for this purpose, the results of drug content found after 6 months at intermediate stress conditions and 12 months at room conditions are generally comparable. But the results obtained show that only long-term conditions stability tests gave consistent results. During aging, the semi solid nature of the gum base itself, may also influence the drug delivery rate during chewing and great attention should be given also to the dissolution stability. PMID:22794248
Maggi, Lauretta; Conte, Ubaldo; Nhamias, Alain; Grenier, Pascal; Vergnault, Guy
Our hospital became interested in the extraction of electronic data from our bedside monitor network to enrich clinical care, and enable various quality improvement projects, research projects, and future applications involving advanced decision-support. We conducted a range of tests to confirm the safety of deploying BedMaster (Excel Medical Electronics, Jupiter FL, USA), which is third-party software sold expressly to provide electronic data extraction and storage from networked General Electric Healthcare bedside patient monitors. We conducted a series of tests examining the changes in network performance when the BedMaster system was on our isolated patient monitor network. We found that use of BedMaster led to measurable, but trivial increases in network traffic and latency. We did not identify any failure scenarios in our analysis and testing. The major value of this report is to highlight potential challenges inherent in data and electronic device integration within the healthcare setting. In describing our strategy for testing the BedMaster system, it is our intention to present one testing protocol and to generate thought and discussion in the broader community about what types of problems can arise with inter-operability, and what types of testing are necessary to mitigate against these risks. Standards for inter-operability would surely reduce the inherent risks. PMID:23367271
Liddle, Stephanie; Grover, Lata; Zhang, Rachel; Khitrov, Maxim; Brown, Joan C; Cobb, J Perren; Goldman, Julian; Chou, Joseph; Yagoda, Daniel; Westover, Brandon; Reisner, Andrew T
Objective The causes of low back pain in China and Western countries are extremely different. We attempted to analyze the risk factors of low back pain in urban and rural patients under the dual economy with the simplified Chinese version of Roland-Morris disability questionnaire (SC-RMDQ) to demonstrate that SC-RMDQ could evaluate patients with low back pain arising from different causes. Methods Roland-Morris disability questionnaire was translated into SCRMDQ according to international guidelines for questionnaire adaptation. In this study, causes of low back pain of 187 outpatients and inpatients (99 urban patients and 88 rural patients) were analyzed. All patients underwent simplified Chinese version of Roland-Morris disability questionnaire (SC-RMDQ), simplified Chinese Oswestry disability index (SCODI) and visual analogue scale (VAS). Reliability was tested using reproducibility (intraclass coefficient of correlation – ICC) and internal consistency (Cronbach's alpha). Validity was tested using Pearson correlation analysis. Results The leading causes for low back pain were sedentariness (38.4%) and vibration (18.1%) in urban patients and waist bending (48.9%) and spraining (25%) in rural patients. Although causes of low back pain in the two groups of population were completely different, SCRMDQ had high internal consistency (Cronbach's ? value of 0.874 in urban patients and 0.883 in rural patients) and good reproducibility (ICC value of .952 in urban patients and 0.949 in rural patients, P<0.01). SCRMDQ also showed significant correlation with Simplified Chinese version of Oswestry disability index (SCODI) and visual analogue scale (VAS) in rural areas (SCRMDQ-SCODI r?=?0.841; SCRMDQ -VAS: r?=?0.685, P<0.01) and in urban areas (SCRMDQ-SCODI: r?=?0.818, P<0.01; SCRMDQ –VAS: r?=?0.666, P<0.01). Conclusions Although causes of low back pain are completely different in rural and urban patients, SCRMDQ has a good reliability and validity, which is a reliable clinical method to evaluate disability of rural and urban patients.
Background An outcome measure to evaluate the neurological function of cervical myelopathy was proposed by the Japanese Orthopaedic Association\\u000a in 1975 (JOA score), and has been widely used in Japan. However, the JOA score does not include patients’ satisfaction, disability,\\u000a handicaps, or general health, which can be affected by cervical myelopathy. The purpose of this study was to develop a new
Safety assessment of medical devices includes sterilization and biological evaluation or biocompatibility testing. Sterilization by ETO gas is critised for their carcinogenic potency or even banned. Mutual acceptance of biological evaluation test results is promoted by a laboratory accreditation and qualification program.
Safety assessment of medical devices includes sterilization and biological evaluation or biocompatibility testing. Sterilization by ETO gas is critised for their carcinogenic potency or even banned. Mutual acceptance of biological evaluation test results is promoted by a laboratory accreditation and qualification program.
... Frequencies for Pain Reliever Questionnaire Items: Focused Attention – People taking medications for high blood pressure should ask a doctor ... More results from www.fda.gov/drugs/developmentapprovalprocess/developmentresources
Autism spectrum disorder (ASD) are a group of behaviorally defined neurodevelopmental disabilities with core deficits in socialization, communication, and behavior, although the presentation can be extremely variable. This article describes the core deficits in ASD, as well as the differential diagnosis and the more commonly associated comorbid disorders. The importance of early diagnosis is emphasized, and screening and assessment tools are reviewed. Finally, the role of the pediatric neurologist is discussed with regard to specific components of the evaluation, including history, physical examination, and ancillary testing. PMID:15575413
The second preclinical year of the medical curriculum at the Medical Faculty of the University of Lausanne in Switzerland includes nine multidisciplinary organ-system-oriented modules consisting of lectures and problem-based-learning tutorials. This study reports the experience accumulated with the evaluation of lectures during the academic years 1998–1999 and 1999–2000. The ratings of the different modules were highly variable, indicating the ability
Catherine Krantz-girod; Jacques Lanares; Seágoleine Cueánot; Fred Bosman; Bernard Waeber
Medical residents do not receive adequate training in screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other drug use disorders. The federally funded Pennsylvania SBIRT Medical and Residency Training program (SMaRT) is an evidence-based curriculum with goals of training residents in SBIRT knowledge and skills and disseminating the curriculum throughout the medical residency programs. The SMaRT program collaborates with 4 hospital systems and 7 residency sites, with a target of 1147 residents to be trained. This brief report describes the design of the SMaRT program curriculum, implementation across settings and programs, and its evaluation methods. PMID:22738008
The work is devoted to investigation of some theoretical and practical aspects of organizational diagnosis of troops medical support during the peace-time. The analysis of literature, the materials obtained during the practical training of the students of Saratov Military Medical Institute, the expert questioning of the teaching stuff (14 persons) allowed to characterize the difficulties in diagnosis of different objects as well as the qualities necessary for the diagnostician. It also permitted to determine the functions, methods, classification and stages of organizational diagnosis, to substantiate the requirements necessary for evaluation of troops medical support. PMID:11668797
|Internet-based surveys are still relatively new, and researchers are just beginning to articulate best practices for questionnaire design. Online questionnaire design has generally been guided by the principles applying to other self-administered instruments, such as paper-based questionnaires. Web-based questionnaires, however, have the…
Background: The knowledge of medical ethics is essential for health care practitioners worldwide. The main objective of this study was to evaluate the knowledge of medical doctors in a tertiary care hospital in Nigeria in the area of medical ethics. Materials and Methods: A cross-sectional questionnaire-based study involving 250 medical doctors of different levels was carried out. The questionnaire, apart from the bio-data, also sought information on undergraduate and postgraduate training in medical ethics, knowledge about the principles of biomedical ethics and the ethical dilemmas encountered in daily medical practice. Results: One hundred and ninety (190) respondents returned the filled questionnaire representing a response rate of 76%. One hundred and fifty-two respondents (80%) have had some sort of medical ethics education during their undergraduate level in the medical education. The median duration of formal training or exposure to medical ethics education was 3.00 hours (range: 0-15). One hundred and twenty-nine respondents have read at least once the code of medical ethics of the Medical and Dental Council of Nigeria while 127 (66.8%) have some general knowledge of the principles of biomedical ethics. The breakdown of the identified ethical dilemmas shows that discharge against medical advice was the most identified by the respondents (69.3%) followed by religious/cultural issues (56.6%) while confidentiality was recognized by 53.4%. Conclusion: The knowledge of medical ethics by Nigerian medical doctors is grossly inadequate. There is an urgent need for enhancement of the teaching of the discipline at both undergraduate and postgraduate levels in Nigeria.
Fadare, Joseph O.; Desalu, Olufemi O.; Jemilohun, Abiodun C.; Babatunde, Oluwole A.
This booklet covers the Medical Care Evaluation (MCE) study process, requisite characteristics for MCE studies, and MCE audit. The objective of such a study is to define which patterns of medical care practice/administration and which patterns of patient ...
AIM: This article investigates attitudes towards and awareness of research and use of research findings among primary healthcare nurses, determinants of attitudes and evaluation of psychometric properties of an instrument measuring nurses' attitudes. BACKGROUND: The production of new knowledge is ongoing and the amount of research of relevance for health care has increased, but there remains a gap between what is known and what is done in practice. To enhance evidence-based practice and patient safety, the use of research findings needs to be encouraged and promoted. METHOD: An explanatory study using a cross-sectional survey was conducted in 2005-2006. The survey included items about background data and the instrument attitudes towards and awareness of research and development in nursing. 1054 nurses participated in the study. Factor analyses and Cronbach's alpha were used to evaluate internal structure and internal consistency of the instrument. RESULT: The nurses generally held positive attitudes towards research. Although most of the nurses reported using research in practice, 37% claimed that they never or rarely used research findings. Half of the respondents perceived they had the ability to analyse scientific reports/articles. This ability and research use were significant determinants of attitudes. Factor analysis of the scale resulted in a three-factor solution, which differs from the seven-factor structure previously identified by the originators of the instrument. CONCLUSION: Our results support the view that implementation of research is a complex process involving several factors. The different factor structure identified suggests that further work is needed on this instrument. PMID:23517064
This comprehensive guide leads the user step-by-step through questionnaire creation. Topics include preliminary considerations, writing the questionnaire items, issues that may come up when giving the questionnaire, statistical considerations, and references for further reading. This resource is intended for novice and professional evaluators.
Background In medical education, feedback from students is helpful in course evaluation. However, the impact of medical students' feedback on long-term course development is seldom reported. In this project we studied the correspondence between medical students' descriptive evaluations and key features of course development over five years. Methods Qualitative content analysis was used. The context was consultation skills courses in the middle of the Göteborg undergraduate curriculum during five years. An analysis of 158 students' descriptive evaluations was brought together with an analysis of key features of course development; learning objectives, course records, protocols from teachers' evaluations and field notes. Credibility of data was tested by two colleagues and by presenting themes at seminars and conferences. Authors' experiences of evaluating the course over many years were also used. Results A corresponding pattern was found in students' descriptive evaluations and key features of course development, indicating the impact of students' open-ended feed-back. Support to facilitators and a curriculum reform also contributed. Students' descriptive feedback was both initiating and validating longitudinal course implementation. During five years, students' descriptive evaluations and teachers' course records were crucial sources in a learner-centred knowledge-building process of course development. Conclusion Students' descriptive evaluations and course records can be seen as important instruments in developing both courses and students' learning. Continuity and endurance in the evaluation process must be emphasized for achieving relevant and useful results.
The benefit of anterior cruciate ligament (ACL) reconstruction has been questioned based on patient-reported outcome measures (PROMs). Valid interpretation of such results requires confirmation of the psychometric properties of the PROM. Rasch analysis is the gold standard for validation of PROMs, yet PROMs used for ACL reconstruction have not been validated using Rasch analysis. We used Rasch analysis to investigate the psychometric properties of the Knee Numeric-Entity Evaluation Score (KNEES-ACL), a newly developed PROM for patients treated for ACL deficiency. Two-hundred forty-two patients pre- and post-ACL reconstruction completed the pilot PROM. Rasch models were used to assess the psychometric properties (e.g., unidimensionality, local response dependency, and differential item functioning). Forty-one items distributed across seven unidimensional constructs measuring impairment, functional limitations, and psychosocial consequences were confirmed to fit Rasch models. Fourteen items were removed because of statistical lack of fit and inadequate face validity. Local response dependency and differential item functioning were identified and adjusted. The KNEES-ACL is the first Rasch-validated condition-specific PROM constructed for patients with ACL deficiency and patients with ACL reconstruction. Thus, this instrument can be used for within- and between-group comparisons. PMID:23682990
Comins, J D; Krogsgaard, M R; Kreiner, S; Brodersen, J
Major efforts have been pursued to improve palliative care education for physicians at all levels of their training. Such changes include the incorporation of palliative care curriculum and guidelines, an established process for competency-based evaluation and certification, faculty development, innovative educational experiences, the improvement of textbooks, and the establishment of accredited palliative medicine fellowships. Hospice and palliative medicine (HPM) has been clearly defined as a subspecialty and a crucial area of medical education. As innovative curricular approaches have become available to educate medical and other interprofessional trainees, this article aims to describe different models and methods applied in curriculum evaluation, tailoring such approaches to the field of palliative medicine. A stepwise process of curriculum development and evaluation is described, focusing on available curriculum evaluation competency-based tools for each level of learners. As HPM evolves and its educational programs grow, curriculum evaluation will provides invaluable feedback to institutions and programs in many ways. PMID:22268408
Purpose The purpose of this study is to evaluate the prescription of essential or futile medications for terminal cancer patients during their final admission. Materials and Methods We conducted a retrospective review of the medical charts of terminally ill cancer patients admitted to the Hemato-oncology Department of two teaching hospitals from March 1, 2007 to December 31, 2009. Essential medications were based on the drugs listed by the International Association for Hospice and Palliative Care, while futile medications were defined when short-term benefit to patients with respect to survival, quality of life, or symptom control was not anticipated. Results A total of 196 patients were included. Among essential medications, strong opioids were the most frequently prescribed drugs during the last admission (62.2% fentanyl, 44.3% morphine), followed by megestrol (46.0%), and metoclopramide (37.2%); 51% of gastric protectors were prescribed with potential futility. Anti-hypertensive and antiglycemic agents were administered to those who experienced arterial blood pressure below 90 mm Hg (47.3%) or presented with a single measurement of fasting glucose below 50 mg/dL (10.7%), respectively. Statins were prescribed to 6.1% (12/196) of patients, and 75% of those prescriptions were regarded as futile. Conclusion Our data suggest that effective prescription of essential medications and withdrawal from futile medications should be actively reconciled for improvement of a patient's end-of-life care.
The current French hospital reform is based on the disease-related group (DRG) approach and the constitution of bigger units pooling several departments of different specialties. This reform needed an efficient assessment of various medical activities. We report our experience of a medical table of our hospital activities used for 27 months. This medical table was made with a basic software integrating 24 parameters. The original concept was the translation of the specific final diagnosis for DRG defined by the site of infection. To create this medical table, we first simplified the conclusions of the patient's chart using a consensual and systematic plan. The number of patients per DRG and their evolution were therefore specifically determined. The medical table helped us in the daily management of our department, to identify the area of recruitment, the potential for heterogeneous care, allowing the implementation of protocols and their applications. Moreover, the table quantified morbidity and mortality, indicating our need for cooperation with other departments. All this data used medical-lexical terms, allowing other than economic analyses, even if this table identifies hospitalization-related costs, namely duration of hospital-stay, nosocomial infections and iatrogenic events. Finally, our table supports medical research and evaluation of practice. Our future goals are to introduce this table in several infectious-diseases units, and create specific tables for the main RDG, including economic parameters. PMID:18707833
Roger, P-M; Farhad, R; Leroux, S; Rancurel, S; Licari, M; Bellissimo, R; Cua, E
Background: Seven to 12% of foreign-born patients in the United States has experienced torture. We aimed to teach medical students to identify and care for asylum seekers/torture survivors. Description: One hundred twenty-five students participated in a program consisting of a workshop covering sequelae of torture, asylum law, and an approach to patient evaluation; twice-monthly clinical sessions; and mentored preparation of medical affidavits. We observed clinical encounters; evaluatedmedical affidavits; and assessed students' knowledge, attitudes, and skills pre- and postcurriculum. Evaluation: Students successfully performed physical and psychological evaluations and prepared affidavits resulting in 89% asylum application approval. We observed improvement in student attitudes toward working with survivors (p < .05), knowledge of sequelae of torture (p < .001), and self-efficacy in clinical evaluation (p < .001). Conclusions: Medical students learned necessary skills to provide services for survivors, which will also serve them in caring for other vulnerable populations. As an advocacy, cultural competency, and domestic global health opportunity, this training was feasible and achieved its educational goals. PMID:24112205
Asgary, Ramin; Saenger, Pamela; Jophlin, Loretta; Burnett, Delia C
Online, interactive video modules were created to demonstrate good skills in history taking, counseling, and communication. The authors evaluated the effect of the modules on students' data gathering, counseling, and communication skills with standardized patients (SPs). A student cohort without the online modules (n = 76 medical students and n = 43 dental students) was compared to a cohort of different students who were assigned the modules (n = 88 medical students and n = 39 dental students). Students were evaluated by SPs using case-specific content checklists and the Master Interview Rating Scale (MIRS). Compared to their counterparts who did not use the modules, medical and dental students who used the modules showed significantly higher performance on several outcomes. The areas that showed benefit were those that were novel to students. Student accuracy in grading others was generally unrelated to their own performance. In conclusion, the online, interactive video modules were associated with improvements in a majority of clinical skills. PMID:21613245
Wagner, Julie Ann; Pfeiffer, Carol A; Harrington, Karen L
This is a pamphlet instructing the construction of questionnaires, as the use of questionnaires in business, industry, government, and education has increased steadily in recent years. They are used in many different areas of government operation, includi...
This study investigated the effect on observer responses of the presence/absence of information about medical evidence for pain and psychosocial influences on the patient's pain experience. Additionally, the moderating role of the patient's pain expressions and the mediating role of the observer's belief in deception and evaluation of the patient was examined. Sixty-two participants were presented with videos of 4 patients, each accompanied by a vignette describing the presence or absence of both medical evidence for the pain and psychosocial influences on the patient's pain. Participants estimated patients' pain and rated their own sympathy and inclination to help; they re-estimated patients' pain when the patient's self-report of pain was provided. Finally, participants evaluated each patient as positive or negative and the likelihood that the patient was feigning pain. Participants gave lower ratings on pain, sympathy, and help when medical evidence was absent. Further, in the presence of psychosocial influences, participants took patients' self-reported pain less into account. Next, only for patients expressing high-intensity pain, information about both medical evidence and psychosocial influences was taken into account. Finally, the observer's evaluation of the patient and his/her belief in deception fully, respectively partially, explained the effect of medical evidence. The results indicate that discounting pain in the absence of medical evidence may involve negative evaluation of the patient. Further, the patient's pain expression is a moderating variable, and psychosocial influences negatively impact the degree to which patients' self-reports are taken into account. The results indicate that contextual information impacts observer responses to pain. PMID:23391696
De Ruddere, Lies; Goubert, Liesbet; Stevens, Michaël; de C Williams, Amanda C; Crombez, Geert
This monograph describes the basic physical/neurological examination of children with special needs and how such an exam fits into the multidisciplinary evaluation and development of individualized programming for such children. The first section addresses the importance of the medical history. Next, the basic exam is described, followed by…
Teachers' approaches to teaching may influence the way they interpret and respond to student evaluations. In this article we explore the relationship between teachers' approaches to teaching and responses to qualitative student feedback in a problem?based medical program. We asked all lecturers and theme session presenters in 2003 who had received student feedback comments in the past 2 years (N=121)
The demand for health care using telemedicine is set to increase, because specialized medical care is needed throughout the world. In particular, the evaluation of brain function has become important in order to diagnose dementia, cerebrovascular disease and the other brain diseases when early symptoms appear. However, the brain is a complex organ in comparison with other organs, such as
Y. Mizuno-Matsumoto; S. Date; Y. Tabuchi; S. Tamura; Y. Sato; R. A. Zorooh; S. Shimojo; Y. Kadobayashi; T. H. Nogawa; K. Shinosaki; M. Takeda; I. T. Osaka; H. Miyahara
|A study to determine the feasibility of creating and administering computer-based problem-solving examinations for evaluating second-year medical students in immunology and to determine how students would perform on these tests relative to their performances on concurrently administered objective and essay examinations is described. (Author/MLW)|
A medical school at a Southeastern university implemented a tobacco free policy to promote a healthy environment for its employees, patients, and visitors. Eighteen months post policy implementation, undergraduate students in the Department of Health Education and Promotion evaluated the satisfaction, awareness, and perceived…
Decker, Jesse; Ronay, Ashley; Telfer, Megan; Becker, Craig M.; Cremeens, Jennifer; Swinker, Marian
|This monograph describes the basic physical/neurological examination of children with special needs and how such an exam fits into the multidisciplinary evaluation and development of individualized programming for such children. The first section addresses the importance of the medical history. Next, the basic exam is described, followed by…
|The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment (SBIRT) methods for alcohol and substance use problems. This paper describes the training program and provides initial evaluation after the…
Bray, James H.; Kowalchuk, Alicia; Waters, Vicki; Laufman, Larry; Shilling, Elizabeth H.
Brown Medical School developed a comprehensive curriculum in which enriched aging content increased from 22 to 80 hours in preclerkship courses and was also added for clerkships, residencies, and nongeriatrician physicians. Innovative evaluation strategies are also described. Highlights include “treasure hunts” in the anatomy laboratory, a Scholarly Concentration in Aging, Schwartz Communication Sessions, a Website of aging-related materials, and a
Richard W. Besdine; Renée R. Shield; Lynn McNicoll; Susan E. Campbell; Terrie Wetle
An experiment for evaluating some relevant factors in human-computer interaction with health care information systems is described. The results concern the comparison among three lnpuVOutput devices that can be used by the staff who manipulate medical records during outpatient care. A data entry activity, based on item selections and (short string) typing, has been considered as the basic task to
The Baylor College of Medicine SBIRT Medical Residency Training Program is a multi-level project that trains residents and faculty in evidenced-based screening, brief intervention and referral to treatment methods for alcohol and substance use problems. This paper describes the training program and provides initial evaluation after the first year of the project. The program was successfully incorporated into the residency
James H. Bray; Alicia Kowalchuk; Vicki Waters; Larry Laufman; Elizabeth H. Shilling
Objective: Children with special health care needs are known to be at increased risk of all forms of child maltreatment when compared to children without such needs. We describe a health care team’s experience providing medicalevaluations for suspected child maltreatment to children with special health care needs.Method: Consecutive cases seen as outpatients in the Abuse Referral Clinic for Children
Throughout the developed world, economic evaluation of costly new pharmaceuticals and medical devices became increasingly widespread and systematic during the 1990s. However, serious concerns remain about the validity and relevance of this economic evidence, and about the transparency and accountability of its use in public sector reimbursement decisions. In this article, we summarise current concerns in Europe, based on interviews
A study to determine the feasibility of creating and administering computer-based problem-solving examinations for evaluating second-year medical students in immunology and to determine how students would perform on these tests relative to their performances on concurrently administered objective and essay examinations is described. (Author/MLW)
|Brown Medical School developed a comprehensive curriculum in which enriched aging content increased from 22 to 80 hours in preclerkship courses and was also added for clerkships, residencies, and nongeriatrician physicians. Innovative evaluation strategies are also described. Highlights include "treasure hunts" in the anatomy laboratory, a…
Besdine, Richard W.; Shield, Renee R.; McNicoll, Lynn; Campbell, Susan E.; Wetle, Terrie
Objective: To use process evaluation methods to describe the development of a hospital-based mental health clinic for children facing medical stressors. Methods: Over a 21-month time period, we collected data regarding presenting concern, service use, and referral source using hospital administrative, clinic intake, and clinical records for 356 children. Results: Nearly 90% of the children were referred to the clinic
Susan Douglas Kelley; Melissa Van Horn; David Ray DeMaso
The editors introduce the Biomedical Optics Express feature issue on “Phantoms for the Performance Evaluation and Validation of Optical Medical Imaging Devices.” This topic was the focus of a technical workshop that was held on November 7–8, 2011, in Washington, D.C. The feature issue includes 13 contributions from workshop attendees.
Hwang, Jeeseong; Ramella-Roman, Jessica C.; Nordstrom, Robert
The manuscript presents the European Guidelines on medico-legal Methods of Ascertainment and Criteria of Evaluation in cases of suspected subjective "Medical Responsibility and/or Liability" developed by an international working group under the patronage of the European Academy of Legal Medicine. It includes a step-by-step illustrated explanation of approved Flow Charts, articulated in 18 sequential steps and comprehensive of both Methods of Ascertainment and Evaluation Criteria. PMID:23564275
The aim of this study was to evaluate the psychometric properties of an adaptation of the Alcohol and Alcohol Problems Perceptions Questionnaire to measure the attitudes of staff to working with drug users (the DDPPQ). Participants were a stratified random sample of medical staff, clinical psychologists, occupational therapists and nurses (n = 672) who work within generic mental health, adolescent
Fourteen cases of alleged child sexual abuse, where the medical opinion rated a high degree of concordance with the history or suspicion of abuse given to the doctor, were reviewed to evaluate the objectivity and reliability of the medical evidence. It was common practice for physicians conducting the medical examination to form conclusions that the child had been sexually abused
The authors developed a computer-based general medical history to be taken by patients in their homes over the internet before their first visit with their primary care doctor, and asked six doctors and their participating patients to assess this history and its effect on their subsequent visit. Forty patients began the history; 32 completed the history and post-history assessment questionnaire and were for the most part positive in their assessment; and 23 continued on to complete their post-visit assessment questionnaire and were for the most part positive about the helpfulness of the history and its summary at the time of their visit with the doctor. The doctors in turn strongly favored the immediate, routine use of two modules of the history—the family and social histories—for all their new patients. The doctors suggested further that the summaries of the other modules of the history be revised and shortened to make it easier for them to focus on clinical issues in the order of their preference.
Kowaloff, Hollis B; Davis, Roger B; Delbanco, Tom; Locke, Steven E; Safran, Charles; Bleich, Howard L
Healthy-appearing competitive athletes may harbor unsuspected cardiovascular disease with the potential to cause sudden death. This fact raises issues of physician responsibility in preparticipation screening and eligibility/disqualification decisions. A number of medical-legal cases now represent a framework for screening and eligibility decision making in high school and college athletes. Physicians screening competitive athletes should strictly adhere to recommendations from the American Heart Association. Precedent exists for disqualifying athletes with heart disease from competition to prevent unnecessary exposure to risk of injury or death. By virtue of the court decision in Larkin v Archdiocese of Cincinnati, high school students with heart disease have no compelling right to participate in interscholastic sports without medical clearance. In Knapp v Northwestern University, an appellate court ruled that college athletes can be medically disqualified from sports and supported the use of national association medical guidelines by team physicians in formulating eligibility/disqualification decisions. This medical-legal analysis provides guidelines for physicians participating in medicalevaluations of competitive athletes by clarifying the standard of care, potential pitfalls, and the evolving liability associated with this clinical practice. PMID:16414949
New display technologies enable the usage of 3D-visualization in a medical context. Even though user performance seems to be enhanced with respect to 2D thanks to the addition of recreated depth cues, human factors, and more particularly visual comfort and visual fatigue can still be a bridle to the widespread use of these systems. This study aimed at evaluating and comparing two different 3D visualization systems (a market stereoscopic display, and a state-of-the-art multi-view display) in terms of quality of experience (QoE), in the context of interactive medical visualization. An adapted methodology was designed in order to subjectively evaluate the experience of users. 14 medical doctors and 15 medical students took part in the experiment. After solving different tasks using the 3D reconstruction of a phantom object, they were asked to judge their quality of the experience, according to specific features. They were also asked to give their opinion about the influence of 3D-systems on their work conditions. Results suggest that medical doctors are opened to 3D-visualization techniques and are confident concerning their beneficial influence on their work. However, visual comfort and visual fatigue are still an issue of 3D-displays. Results obtained with the multi-view display suggest that the use of continuous horizontal parallax might be the future response to these current limitations.
Background: Controlled prospective studies are needed to determine whether surgical treatment in fact has an effect additive to that of medical treatment of nasal polyposis. Objective: We sought to compare the effect of medical treatment versus combined surgical and medical treatment on olfaction, polyp score, and symptoms in nasal polyposis. Methods: Thirty-two patients with nasal polyposis and symmetrical nasal airways
Ebba Hedén Blomqvist; Lars Lundblad; Anders Änggård; Per-Olle Haraldsson; Pär Stjärne
Most types of medical technology assessments are performed after the technology has been developed. Consequently, they have only minor effects on changes in clinical practice. Our study introduces a new method of constructive medical technology assessment that can change the development and diffusion of a medical device to improve its later effectiveness in clinical practice. The method, based on Saaty's
The Medical Information System (MIS) at the Los Alamos Scientific Laboratory automates the acquisition, storage, and retrieval of medical information concerning the nine thousand project-connected personnel. The MIS incorporates an on-line, interactive medical history questionnaire, mark sense form processing, and automated coronary risk assesment in the medicalevaluation process. Also, MIS has created the ability for long-term study and comparison of employee health as well as made the physician's time more effective.
An effective intervention to decrease medication errors related to high-risk, high-alert medications is to implement double checks and second verification using the five rights of medication administration. To evaluate the effectiveness and use of the Personalized Bar-Code Identification card in verifying high-risk, high-alert medications, the High-Risk, High-Alert Medication Verification Audit Tool was used to collect data from the medical records of patients who received high-risk, high-alert medications in four ICUs. Data were collected for administered high-risk, high-alert medication, primary registered nurses who administered the high-risk, high-alert medication, and secondary registered nurses who verified the medication. The percentage of medications that were "not verified," "Personalized Bar-Code Identification verified," and "verified" using a method other than the Personalized Bar-Code Identification was calculated and compared using Z tests for two proportions. The percentage of Personalized Bar-Code Identification-verified medications (83.5%) was significantly higher than the percentage of medications that were not verified (10.9%) (Z = 38.43, P < .05). Also, the difference between the proportion of the Personalized Bar-Code Identification-verified medications and those that were verified using another method (5.6%) was significant (Z = 41.42, P < .05). The results show that nurses generally tend to follow the standardized procedure for verifying high-risk, high-alert medications in the four ICUs. PMID:24080750
The questionnaire is the instrument used for recording performance data on the nuclear material protection, control, and accountability (MPC&A) system at a nuclear facility. The performance information provides a basis for evaluating the effectiveness of the MPC&A system. The goal for the questionnaire is to provide an accurate representation of the performance of the MPC&A system as it currently exists in the facility. Performance grades for all basic MPC&A functions should realistically reflect the actual level of performance at the time the survey is conducted. The questionnaire was developed after testing and benchmarking the material control and accountability (MC&A) system effectiveness tool (MSET) in the United States. The benchmarking exercise at the Idaho National Laboratory (INL) proved extremely valuable for improving the content and quality of the early versions of the questionnaire. Members of the INL benchmark team identified many areas of the questionnaire where questions should be clarified and areas where additional questions should be incorporated. The questionnaire addresses all elements of the MC&A system. Specific parts pertain to the foundation for the facility's overall MPC&A system, and other parts pertain to the specific functions of the operational MPC&A system. The questionnaire includes performance metrics for each of the basic functions or tasks performed in the operational MPC&A system. All of those basic functions or tasks are represented as basic events in the MPC&A fault tree. Performance metrics are to be used during completion of the questionnaire to report what is actually being done in relation to what should be done in the performance of MPC&A functions.
The article presents analysis of the basic approaches to evaluation of the cost of medical care quality that are used in the practice of a range of European countries and the USA. There are three processes considered in terms of the general management of the quality - value management from the point of view of a) business, the patient, c) healthcare personnel. Hence, benefits from the results depend on the quality of activity. The authors present a new point of view that connect constant improvement of quality with reengineering (re-design) of medical providence process so that their costs be lower than expenses caused by bad quality. PMID:17691488
Rationale Short- and long-term compliance to prescribed antipsychotic drugs is of particular concern in regard to medication choice\\u000a and treatment outcome in the care of psychotic disorders.\\u000a \\u000a \\u000a \\u000a Objective We evaluated patient-related and treatment-related factors associated with medication compliance in inpatients with a diagnosis\\u000a of schizophrenia, schizoaffective disorder, or other psychotic disorder.\\u000a \\u000a \\u000a \\u000a Methods Within a naturalistic study in seven psychiatric hospitals, individuals with a
Birgit Janssen; Wolfgang Gaebel; Martin Haerter; F. Komaharadi; Birgit Lindel; Stefan Weinmann
The past decade has seen an intense focus on the evaluation of American women for the detection and diagnosis of breast cancer. A concomitant increase in lawsuits filed for delay in diagnosis of breast cancer has occurred, creating consternation in the medical community. Efforts in responding to this public health challenge, comprised by fear of legal reprisal, may be supported by careful and deliberate planning that incorporates risk management principles and an understanding of different goals to be attained with consequent medical and legal responsibilities. PMID:1544098
Evaluated the Hopelessness Depression Symptom Questionnaire (HDSQ; Metalsky & Joiner, 1991). The HDSQ is a 32-item self-report measure of eight symptoms posited by L. Abramson, G. Metalsky, and L. Alloy (1989) to comprise a specific subtype of depression—hopelessness depression. Factor analytic results from 435 subjects suggested that: (a) Each of the eight subscales of the HDSQ reflects a distinct symptom
Introduction: This study presents our online-teaching material within the k-MED project (Knowledge in Medical Education) at the university of Marburg. It is currently organized in five e-learning modules: cytogenetics, chromosomal aberrations, formal genetics, fundamentals of molecular diagnostics, and congenital abnormalities and syndromes. These are basic courses intended to do the educational groundwork, which will enable academic teachers to concentrate on more sophisticated topics during their lectures. Methods: The e-learning modules have been offered to a large group of about 3300 students during four years at the Faculty of Medicine in Marburg. The group consists of science students (human biology) and medical students in the preclinical or the clinical period, respectively. Participants were surveyed on acceptance by evaluating user-tracking data and questionnaires. Results and Conclusion: Analysis of the evaluation data proofs the broad acceptance of the e-learning modules during eight semesters. The courses are in stable or even increasing use from winter term 2005/06 until spring term 2009. Conclusion: Our e-learning-model is broadly accepted among students with different levels of knowledge at the Faculty of Medicine in Marburg. If the e-learning courses are maintained thoroughly, minor adaptations can increase acceptance and usage even furthermore. Their use should be extended to the medical education of technical assistances and nurses, who work in the field of human genetics.
The aims of this study were firstly to evaluate the psychometric properties of the French version of the Orientation towards Chocolate Questionnaire (OCQ), secondly to examine differences in chocolate craving as a function of weight status, and thirdly to examine the OCQ craving dimensions as predictors of body dissatisfaction and disordered eating. Participants included 247 female students from the University of Toulouse, France, who completed measures of chocolate craving, body dissatisfaction, bulimia, drive for thinness, and emotional eating, and for whom body mass index (BMI) was available. Confirmatory factor analysis supported the three-factor model of the OCQ, with guilt, approach, and avoidance subscales. Patterns of endorsement of chocolate craving dimensions differed according to weight status, with ambivalence present only amongst overweight participants. Guilt and approach were positively associated with disordered eating, whereas avoidance was negatively associated with bulimia. These results confirm the validity and reliability of the French version of the OCQ and highlight strong associations between chocolate craving dimensions and disordered eating patterns. PMID:22051356
Rodgers, Rachel F; Stritzke, Werner G K; Bui, Eric; Franko, Debra L; Chabrol, Henri
Based on the Physical Self Description Questionnaire (PSDQ) normative archive (n = 1,607 Australian adolescents), 40 of 70 items were selected to construct a new short form (PSDQ-S). The PSDQ-S was evaluated in a new cross-validation sample of 708 Australian adolescents and four additional samples: 349 Australian elite-athlete adolescents, 986 Spanish adolescents, 395 Israeli university students, 760 Australian older adults. Across these six groups, the 11 PSDQ-S factors had consistently high reliabilities and invariant factor structures. Study 1, using a missing-by-design variation of multigroup invariance tests, showed invariance across 40 PSDQ-S items and 70 PSDQ items. Study 2 demonstrated factorial invariance over a 1-year interval (test-retest correlations .57-.90; Mdn = .77), and good convergent and discriminant validity in relation to time. Study 3 showed good and nearly identical support for convergent and discriminant validity of PSDQ and PSDQ-S responses in relation to two other physical self-concept instruments. PMID:20733208
Marsh, Herbert W; Martin, Andrew J; Jackson, Susan
The International Medical University has a Community and Family Case Study (CFCS) programme as part of the training for medical students. The aim of the programme is to emphasize the family and community perspective of patient care in the home environment. A cross-sectional descriptive study was done among 66 final year medical students using a questionnaire. The students were in the 10th Semester and had completed their Community and Family Case Studies (CFCS) programme. Majority (54.5%) of the students who were interviewed were Malays, 34.8% Chinese and 9.1% Indians. Majority of the students (87.9%) liked the programme because it was a good opportunity to understand the patient in their home environment; it improved their commination skills and made them understand the patient better in the community setting. The perceived problem in this programme by the students were mainly choosing an index patient initially (32.8%), patient cooperation (19.0%) and transportation to the patients' house (13.8%). They said that this programme was useful because they learnt more about the disease (45%) and understood the patient management better (15%). The programme also provided the students a wider exposure to medicine (37.9%) and the opportunity to practice clinical skills. Overall the CFCS programme in IMU was well liked by the students as it gave them an opportunity to practice some of the clinical skills in the patients' home environment and it provided an opportunity to manage the patient better. The major problem the students faced was in selecting the index patient. PMID:23629554
BACKGROUND: With increasing knowledge of chronic pain, clinicians have attempted to assess chronic pain patients with lengthy assessment tools. OBJECTIVES: To describe the functional and emotional status of patients presenting to a tertiary care pain clinic; to assess the reliability and validity of a diagnostic classification system for chronic pain patients modelled after the Multidimensional Pain Inventory; to provide psychometric data on a modified Comprehensive Pain EvaluationQuestionnaire (CPEQ); and to evaluate the relationship between the modified CPEQ construct scores and clusters with Diagnostic and Statistical Manual, Fourth Edition – Text Revision Pain Disorder diagnoses. METHODS: Data on 300 new patients over the course of nine months were collected using standardized assessment procedures plus a modified CPEQ at the Comprehensive Pain Program, Toronto Western Hospital, Toronto, Ontario. RESULTS: Cluster analysis of the modified CPEQ revealed three patient profiles, labelled Adaptive Copers, Dysfunctional, and Interpersonally Distressed, which closely resembled those previously reported. The distribution of modified CPEQ construct T scores across profile subtypes was similar to that previously reported for the original CPEQ. A novel finding was that of a strong relationship between the modified CPEQ clusters and constructs with Diagnostic and Statistical Manual, Fourth Edition – Text Revision Pain Disorder diagnoses. DISCUSSION AND CONCLUSIONS: The CPEQ, either the original or modified version, yields reproducible results consistent with the results of other studies. This technique may usefully classify chronic pain patients, but more work is needed to determine the meaning of the CPEQ clusters, what psychological or biomedical variables are associated with CPEQ constructs or clusters, and whether this instrument may assist in treatment planning or predict response to treatment.
Nelli, Jennifer M; Nicholson, Keith; Lakha, S Fatima; Louffat,