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The Student OutcomesQuestionnaire and the Student Outcomes Information Analysis Service (SOIS) developed by NCHEMS and the College Board are discussed. The term, "student outcomes," is defined as the consequence of a student's enrollment in an educational institution and involvement in its programs. The importance of this type of information is…
Outcomequestionnaires are increasingly used in the current medical practice. Patient reported outcomes serve as an essential and perhaps more relevant means for assessing patients’ response to treatment than clinical measures alone. Many of the procedures performed in plastic surgery are associated with aesthetic outcomes, therefore it is pertinent to thoroughly understand the patient’s perspective of achieved results. Surgeons need to possess the knowledge and skills about outcomes assessments and understand how to apply them to improve quality of care delivered based on evidence. This paper discusses the appropriate use of outcomequestionnaires to rigorously evaluate treatment methods based on patient satisfaction and the outcome measurement instruments frequently used in plastic surgery.
Data from clinical and nonclinical samples ("Ns" = 2,096, 618) were used to evaluate and replicate the measurement structure of the OutcomeQuestionnaire-45.2. Different measurement models and invariance tests were evaluated and the best psychometric support was found for a shortened measure of two factors: overall maladjustment and…
Guidelines for using questionnaires/findings provided through the Student-Outcomes Information Service (SOIS) are presented. SOIS provides institutional decision-makers with information on student characteristics, backgrounds, attitudes, reasons for making various educational choices, activities, educational plans, occupational choices, and…
Developing normed treatment outcome measures is important to research addressing treatment effectiveness and to improved clinical care. The Preschool OutcomeQuestionnaire (POQ) is a new measure designed for use with preschool children aged two to six. Designed in collaboration with parents and clinicians, the POQ is brief, easy to administer,…
Barker, David H.; Lloyd, Thad Q.; Stewart, Peter K.; Wells, M. Gawain
Effectively diagnosing African Americans' mental health with a single intake checklist has posed an unresolved challenge, as most intake checklists were developed from White perspectives. In this study, Rasch analysis was used to assess the psychometric characteristics of a common measure of clinical distress, the OutcomeQuestionnaire (OQ; Lambert, Lunnen, Umphress, Hansen, & Burlingame, 1994), for a sample of African American students split into a calibration and validation subsample. OQ subscales were first identified and were then held up under cross-validation with a second subsample. Rasch analysis of the OQ clearly indicated the measure was multidimensional among African American students with 2 subscales titled Well-Being and Psychological Distress. Our results also indicated appropriate response scale use, adequate person separation, strong stability across subsamples, and little differential item functioning. Moreover, our analysis showed items of the 2 subscales to be well-targeted for African American students. However, if subscales were to be revised for African American students, some items at the same logit position might be deleted and replaced with either very easy or more difficult items or with items at intermediate positions to extend and to fill in gaps in construct coverage. Implications for theory and research on multicultural mental health scales were discussed. PMID:23544393
OBJECTIVE To review the outcome of secondary alveolar bone grafting in unilateral and bilateral cleft lip and palate. DESIGN A surgeon’s experience, by retrospective chart review, of 70 consecutive patients at a tertiary care centre. OUTCOME MEASURE Periapical radiographs were taken at least six months after secondary alveolar bone grafting. The Enemark grading system was used to stratify graft-take. RESULTS In unilateral clefts, 33% were level 1, 36% were level 2, 20% were level 3 and 11% were level 4. In bilateral clefts, 29% were level 1, 50% were level 2, 14% were level 3 and 7% were level 4. There was no statistically significant difference between the level of take and the type of cleft. Complications encountered were infection (n=3), fistula (n=3), pain (n=4) and bone graft exposure that led to failure (n=2). Two patients required reoperation for bone grafting. CONCLUSIONS The iliac crest is a good donor site with excellent results and minimal morbidity.
The development, testing, and characteristics of an instrument--Computers and Robots Attitude Questionnaire--that can be used to measure the attitudes of secondary students towards computers and robots are described. Individual questionnaire items are largely content-free and may be answered by students with no specialist knowledge of…
We used data from two pilot studies to compare the change in patients' self-reported health-related quality of life after participation in two nearly identical Department of Veterans Affairs (VA) Blind Rehabilitation Center (BRC) programs, the Southwestern BRC in Tucson, Arizona, and the BRC at the VA hospital in Hines, Illinois. Researchers at the Southwestern BRC administered the National Eye Institute Visual Functioning Questionnaire as directed by the developer. Researchers at the Hines BRC modified the directions to consider use of low-vision devices. Interval person-ability and item-difficulty measures estimated from patient responses pre- and postrehabilitation were compared with these same measures obtained at follow-up. At the Southwestern BRC, no change was reported in either person or item measures 3 months after rehabilitation. At the Hines BRC, improvement was seen in both the person and item measures when measurements were made immediately following rehabilitation. Because a temporary halo effect may explain the higher ratings at discharge, veterans from the Hines cohort were contacted by telephone and administered the same instrument 3 years later. For these subjects, the improvement noted in the person measure disappeared at follow-up, while the improvement in the item measure was maintained. PMID:17310429
Stelmack, Joan A; Babcock-Parziale, Judith L; Head, Daniel N; Wolfe, Gregory S; Fakhoury, Nader E; Wu, Shelley M; Massof, Robert W
OBJECTIVE--To assess the validity, reliability, and acceptability of the short form 36 (SF 36) health survey questionnaire (a shortened version of a battery of 149 health status questions) as a measure of patient outcome in a broad sample of patients suffering from four common clinical conditions. DESIGN--Postal questionnaire, followed up by two reminders at two week intervals. SETTING--Clinics and four
A M Garratt; D A Ruta; M I Abdalla; J K Buckingham; I T Russell
Data from 520 British secondary school age children were used to explore determinants of and mental health outcomes (measured with the Strengths and Difficulties Questionnaire) from their non-resident fathers' relationships (child-reported father's involvement and frequency of contact) with them. Frequency of contact was negatively related to time…
The Youth-OutcomeQuestionnaire (Y-OQ) and the Ohio Scales (OS) were developed to track the course of child psychotherapy across time. They are unique instruments to the psychological test battery, as they were designed not to diagnose mental illness or elaborate on a patient's psychological state of mind. Instead, they purport to be sensitive to change; that is, both the Y-OQ
The increased availability of electronic medical records and administrative health care databases is adding to the popularity of pharmacoepidemiology and outcomes research studies. Despite their availability, practitioners may be reluctant to use these databases because they lack familiarity with database research in general. The basic principles of research are the same regardless of the data source, but there are a few special considerations. When using secondary data sources for research purposes, special care must be taken to select an appropriate source to ensure that relevant information is available to answer the research question at hand. Special attention must also be paid to selecting the appropriate codes to represent the outcomes and exposures of interest; therefore, a general understanding of coding schemes is necessary. Although time may be saved by not prospectively collecting data, the process of manipulating the data for analysis in secondary databases can be complex. Analysis of data from secondary sources may require special procedures to overcome the lack of randomization. By familiarizing themselves with these special issues, practitioners can use secondary sources to conduct studies that make valuable contributions to the improvement of patient care. PMID:19170584
Research on the health status of international migrants to industrialised countries in general, and on perinatal outcomes in particular, has assumed an interpretative model based on primary migration, characterised by one permanent cross-border movement from the migrant's country of birth. However, many migrants experience more complex migration patterns that may also be associated with human health. Secondary migration, defined as a migration from a country of residence other than the country where the immigrant was born, has been growing during the last two decades, favoured by globalisation. The purpose of this study was to examine the association between secondary migration and preterm birth (PTB) and infant birthweight at term (BW) using a Canadian official immigration database to build a cohort of immigrants to Ontario, Canada, who obtained their permanent residence in the years 1985-2000. The study population comprised 320,398 singleton live infants born to immigrant women during 1988-2007. Primary and secondary migrants were categorised according to whether they were born in an industrialised country or not. Secondary migrants were further subdivided according to whether the country from which they migrated to Canada was industrialised or not. We found that compared to primary migrants, secondary migrants to Canada born in non-industrialised countries had lower odds of PTB and higher mean BW at term. However, such a protective effect was not observed among secondary migrants born in industrialised countries. In a cross-classified multilevel model restricted to secondary migrants, 5.2% of the variation in birthweight was explained by migrants' countries of birth and 0.8% by migrants' countries of last permanent residence. These findings are consistent with the so-called healthy migrant effect, implying that selective migration from non-industrialised countries is associated with protective individual characteristics. PMID:20850920
Urquia, Marcelo L; Frank, John W; Glazier, Richard H
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 and reliable scale that assesses outcome expectancies of non-prescribed use of stimulant medication. A 16-item Stimulant Medication Outcome Expectancy Questionnaire (SMOEQ) was created using qualitative information given by introductory psychology students regarding their expectancies about misusing stimulant medication. An exploratory factor analysis (EFA) identified a three-factor solution: the Academic factor, Recreational factor, and Negative Physiological Effects factor, respectively. A confirmatory factor analysis (CFA) validated the factor structure identified in the EFA and indicated a modest fit of the hypothesized factor structure to the data. Correlation analyses provided support for the internal consistency and construct validity of the SMOEQ. PMID:20356682
Background The Korean version of the Michigan Hand OutcomesQuestionnaire (K-MHQ) was recently validated; however, the questionnaire's responsiveness as well as the degree to which the instrument is sensitive to change has not been thoroughly evaluated in a specific condition in Koreans. We evaluated the responsiveness of the K-MHQ in a homogenous cohort of patients with carpal tunnel syndrome (CTS) and we compared it with that of the Korean version of the Disability of the Arm, Shoulder, and Hand Questionnaire (K-DASH), which was found to have a large degree of responsiveness after carpal tunnel release for Korean patients with CTS. Methods Thirty-seven patients with CTS prospectively completed the K-MHQ and the K-DASH before and 6 months after surgery. The responsiveness statistics were assessed for both the K-MHQ and the K-DASH by using the standardized response mean (SRM), which was defined as the mean change of the original scores after surgery divided by the standard deviation of the change. Results All domains of the K-MHQ significantly improved after carpal tunnel release (p < 0.001). The SRM for all scales but one (the aesthetics scale) showed large responsiveness of ? 0.8. The aesthetics scale showed medium responsiveness of 0.6. The combined function/symptom scale of the K-DASH significantly improved after surgery (p < 0.001). The SRM of the K-DASH revealed large responsiveness of 0.9. Conclusions The K-MHQ was found to have a large degree of responsiveness after carpal tunnel release for Korean patients with CTS, which is comparable not only to the K-DASH, but also to the original version of the MHQ. The region-specific K-MHQ can be useful for outcomes research related to carpal tunnel surgery, especially for research comparing CTS with various other hand and wrist health conditions.
Wi, Seung Myung; Bae, Kee Jeong; Roh, Young Hak; Lee, Young Ho; Baek, Goo Hyun
OBJECTIVE--To assess the validity, reliability, and acceptability of the short form 36 (SF 36) health survey questionnaire (a shortened version of a battery of 149 health status questions) as a measure of patient outcome in a broad sample of patients suffering from four common clinical conditions. DESIGN--Postal questionnaire, followed up by two reminders at two week intervals. SETTING--Clinics and four training practices in north east Scotland. SUBJECTS--Over 1700 patients aged 16-86 with one of four conditions--low back pain, menorrhagia, suspected peptic ulcer, or varicose veins--and a comparison sample of 900 members of the general population. MAIN OUTCOME MEASURES--The eight scales within the SF36 health profile. RESULTS--The response rate exceeded 75% in the patient population (1310 respondents). The SF36 satisfied rigorous psychometric criteria for validity and internal consistency. Clinical validity was shown by the distinctive profiles generated for each condition, each of which differed from that in the general population in a predictable manner. Furthermore, SF36 scores were lower in referred patients than in patients not referred and were closely related to general practitioners' perceptions of severity. CONCLUSIONS--These results provide support for the SF36 as a potential measure of patient outcome within the NHS. The SF36 seems acceptable to patients, internally consistent, and a valid measure of the health status of a wide range of patients. Before it can be used in the new health service, however, its sensitivity to changes in health status over time must also be tested.
Garratt, A M; Ruta, D A; Abdalla, M I; Buckingham, J K; Russell, I T
Abstract Objective: Monitoring of ongoing psychotherapy is of crucial importance in improving the quality of mental health care by detecting therapies being off track, which requires that the instrument used is psychometrically sound. This study investigates the psychometric properties of the Norwegian version of the OutcomeQuestionnaire 45.2 (OQ-45) and situates the results in an international context.Method: Data from one non-clinical sample (N = 338) and one clinical sample (N = 560) were compared to international samples investigating reliability, cut-offs, and factor structure. Results: The results show adequate reliability and concurrent validity. Conclusions: The means, clinical cut-offs, and the reliable change index vary across countries. However, the means of the OQ-45 for nonclinical samples correlate highly with external values of national well-being, indicating that the OQ-45 is a valid instrument internationally. The factor analyses in the present study do not confirm the hypothesized factor structure of the OQ-45, but are similar to the results internationally. PMID:24188797
Amble, Ingunn; Gude, Tore; Stubdal, Sven; Oktedalen, Tuva; Skjorten, Anne Marie; Andersen, Bror Just; Solbakken, Ole André; Brorson, Hanne H; Arnevik, Espen; Lambert, Michael J; Wampold, Bruce E
The perceived personal control (PPC) questionnaire was developed by Berkenstadt and colleagues as an outcome measure for the evaluation of the process of genetic counseling. The present study aimed to further assess the psychometric properties of a Dutch version of the instrument. Data were used from two samples. A reproductive genetic counseling sample (n = 140), which included pregnant and
Ellen M. A. Smets; Arwen H. Pieterse; Cora M. Aalfs; Margreet G. E. M. Ausems; Alexandra M. van Dulmen
Background: The nine-item depression module from the Patient Health Questionnaire (PHQ-9) is well validated and widely used as a brief diagnostic and severity measure, but its validity as an outcome measure for depression has not yet been established. Therefore, we investigated the sensitivity to change of the PHQ-9 in three groups of patients whose depression status either improved, remained unchanged,
Bernd Löwe; Kurt Kroenke; Wolfgang Herzog; Kerstin Gräfe
This study aimed to investigate the reliability and construct validity of a new version of the Brief Job Stress Questionnaire (New BJSQ), which measures an extended set of psychosocial factors at work by adding new scales/items to the current version of the BJSQ. Additional scales/items were extensively collected from theoretical job stress models and similar questionnaires in several countries. Scales/items were field-tested and refined through a pilot internet survey. Finally, an 84-item questionnaire (141 items in total when combined with the current BJSQ) was developed. A nationally representative survey was administered to employees in Japan (n=1,633) to examine the reliability and construct validity. Most scales showed acceptable levels of internal consistency and test-retest reliability. Principal component analyses showed that the first factor explained 50% or greater proportion of the variance in most scales. A scale factor analysis and a correlation analysis showed that these scales fit the theoretical expectations. These findings provided a piece of evidence that the New BJSQ scales are reliable and valid. Although more detailed content and construct validity should be examined in future study, the New BJSQ is a useful instrument to evaluate psychosocial work environment and positive mental health outcomes in the current workplace. PMID:24492763
OBJECTIVES--To test the acceptability, validity, and reliability of the short form 36 health survey questionnaire (SF-36) and to compare it with the Nottingham health profile. DESIGN--Postal survey using a questionnaire booklet together with a letter from the general practitioner. Non-respondents received two reminders at two week intervals. The SF-36 questionnaire was retested on a subsample of respondents two weeks after
J. E. Brazier; R. Harper; N. M. Jones; A. OCathain; K. J. Thomas; T. Usherwood; L. Westlake
This study reports the results of a secondary analysis of two years post-hospitalization data from 2,950 subjects. Subjects' Alcoholics Anonymous Attendance and aftercare attendance (test variables) were correlated with 11 outcome variables suggestive of ...
Using a social cognitive theory framework, we examined the effects of career outcome expectations (COE) and aspiration to enter a science, technology, or math (STM) career on post-secondary academic motivation. Data were collected online from a sample of 380 post-secondary students in Canada and the United States. Analysis of covariance revealed…
Domene, Jose F.; Socholotiuk, Krista D.; Woitowicz, Lyndsay A.
This article examined teachers' teaching experience and students' learning outcomes in the secondary schools in Ondo State Nigeria. As a correlational survey, the study population comprised all the 257 secondary schools in the State. This population was made up of 147 rural schools and 110 urban schools. It was also made up of 12 single sex…
Trials of anemia correction in chronic kidney disease have found either no benefit or detrimental outcomes of higher targets. We did a secondary analysis of patients with chronic kidney disease enrolled in the Correction of Hemoglobin in the Outcomes in Renal Insufficiency trial to measure the potential for competing benefit and harm from achieved hemoglobin and epoetin dose trials. In
Lynda A Szczech; Huiman X Barnhart; Jula K Inrig; Donal N Reddan; Shelly Sapp; Robert M Califf; Uptal D Patel; Ajay K Singh
This research investigated associations between classroom environment and student affective outcomes in Australian secondary schools. The Technology-Rich Outcomes-Focused Learning Environment Inventory (TROFLEI) was used to assess 10 classroom environment dimensions: student cohesiveness, teacher support, involvement, investigation, task…
This study investigated the differential effectiveness of various treatment formats for 55 couples in which the woman reported secondary orgasmic dysfunction (defined as the inability of the woman to reach orgasm during intercourse, with or without clitoral stimulation, more than 50% of the time for the last 5 months). Couples received two 2-hr sessions of sexual reeducation and were then
Peter R. Kilmann; Katherine H. Mills; Charlene Caid; Edward Davidson; Bonnie Bella; Richard Milan; Gerald Drose; Joseph Boland; Diane Follingstad; Bonnie Montgomery; Richard Wanlass
Objective: To evaluate the full range of alcohol treatment effectiveness, it is important to assess secondary nondrinking outcome dimensions in addition to primary alcohol consumption outcomes. Method: We used a large sample (n = 1,226) of alcohol-dependent participants entering the National Institute on Alcohol Abuse and Alcoholism-sponsored COMBINE (Combining Medications and Behavioral Interventions) Study, a multisite clinical trial of pharmacological (naltrexone [ReVia] and acamprosate [Campral]) and behavioral interventions, to examine the effects of specific treatment combinations on nondrinking functional outcomes. We assessed the outcomes at baseline and at the end of 16 weeks of alcohol treatment and again at the 26-week and/or 52-week postrandomization follow-ups. Results: (1) Drinking and secondaryoutcomes were significantly related, especially at the follow-up periods. A higher percentage of heavy drinking days, more drinks per drinking day, and lower percentage of days abstinent were associated with lower quality-of-life measures. (2) All nondrinking outcomes showed improvement at the end of 16 weeks of treatment and most maintained improvement over the 26-week and 52-week follow-ups. Only two measures returned to pretreatment levels at 52 weeks: percentage of days paid for work and physical health. Improvements of nondrinking outcomes remained even after adjusting for posttreatment heavy drinking status. (3) Although nondrinking outcomes showed overall improvement, specific pharmacological and behavioral treatment combinations were not differentially effective on specific secondaryoutcomes. Conclusions: In the current study, changes that resulted from treatment were multidimensional, and improvements in nondrinking outcomes reflected the overall significant improvement in drinking but they were not differentiated between treatment combination groups. Findings from this study support the importance of including secondary nondrinking outcomes in clinical alcohol-treatment trials.
LoCastro, Joseph S.; Youngblood, Marston; Cisler, Ron A.; Mattson, Margaret E.; Zweben, Allen; Anton, Raymond F.; Donovan, Dennis M.
BACKGROUND: Changes in self-concept are an important potential outcome for many interventions for people with long-term conditions. This study sought to identify and evaluate outcomequestionnaires suitable for quantifying changes in self-concept in people with long-term conditions, in the context of treatment with acupuncture and Chinese medicine. METHODS: A literature search was followed by an evaluation of three questionnaires: The
Background To compare health related quality of life (HR-QoL) in patients surgically treated for secondary peritonitis to that of a healthy population. And to prospectively identify factors associated with poorer (lower) HR-QoL. Design A prospective cohort of secondary peritonitis patients was mailed the EQ-5D and EQ-VAS 6-months following initial laparotomy. Setting Multicenter study in two academic and seven regional teaching hospitals. Patients 130 of the 155 eligible patients (84%) responded to the HR-QoL questionnaires. Results HR-QoL was significantly worse on all dimensions in peritonitis patients than in a healthy reference population. Peritonitis characteristics at initial presentation were not associated with HR-QoL at six months. A more complicated course of the disease leading to longer hospitalization times and patients with an enterostomy had a negative impact on the mobility (p = 0.02), self-care (p < 0.001) and daily activities: (p = 0.01). In a multivariate analysis for the EQ-VAS every doubling of hospital stay decreases the EQ-VAS by 3.8 points (p = 0.015). Morbidity during the six-month follow-up was not found to be predictive for the EQ-5D or EQ-VAS. Conclusion Six months following initial surgery, patients with secondary peritonitis report more problems in HR-QoL than a healthy reference population. Unfavorable disease characteristics at initial presentation were not predictive for poorer HR-QoL, but a more complicated course of the disease was most predictive of HR-QoL at 6 months.
Boer, Kimberly R; van Ruler, Oddeke; Reitsma, Johannes B; Mahler, Cecilia W; Opmeer, Brent C; Reuland, E Ascelijn; Gooszen, Hein G; de Graaf, Peter W; Hesselink, Eric J; Gerhards, Michael F; Steller, E Philip; Sprangers, Mirjam A; Boermeester, Marja A; De Borgie, Corianne A
In the aftermath of the terrorist action at the Pentagon there was a critical operational need to understand and document the extent of injuries, illnesses, and exposures sustained by Service members and civilian employees at the Pentagon. It was decided to develop and administer a brief questionnaire to the Pentagon employees that would contain questions about exposures, new or worsening injuries or illnesses, mental health, and factors suggested by the literature to increase risk or be protective for these outcomes. This report describes the development the mental health portion of this questionnaire. Most mental health instruments are very lengthy, limiting their usefulness as rapid public health assessment tools. This brief instrument was designed to cover four main symptom domains, as well as key risk/protective factors, thought to be most important following the terrorist attack. The symptom domains were: acute and post-traumatic stress symptoms, depression, anxiety/panic attacks, and alcohol abuse. Further analyses will assess the usefulness of this questionnaire as a public health tool for rapid assessment of mental health symptoms following the attack. PMID:12363144
Hoge, Charles W; Engel, Charles C; Orman, David T; Crandell, Edward O; Patterson, Virgil J; Cox, Anthony L; Tobler, Steven K; Ursano, Robert J
Disseminated fusariosis is an uncommon clinical condition in immunocompromised patients. We report a fatal case of disseminated fusariosis secondary to neuroblastoma in a male patient, 15 years old, who underwent a bone marrow transplant. The patient was admitted to the pediatric intensive care unit (PICU) of a public hospital in Recife-PE, Brazil, presenting bone marrow aplasia, severe leukopenia, and thrombocytopenia. After 15 days, the patient developed right knee effusion. Synovial fluid and blood samples were analyzed at the Medical Mycology Laboratory of the Federal University of Pernambuco. Mycological diagnosis was based on the presence of hyaline septate hyphae on direct examination and the isolation of Fusarium oxysporum in culture, confirming the case of disseminated fusariosis. In vitro, the isolate showed fluconazole resistance and sensitivity to amphotericin B, anidulafungin, and voriconazole. Therapy with voriconazole in combination with liposomal amphotericin B led to an improved clinical response; however, due to underlying disease complications, the patient progressed to death. PMID:23813153
This article presents research on evaluating problem-based learning using GIS technology in a Singapore secondary school. A quasi-experimental research design was carried to test the PBL pedagogy (PBL-GIS) with an experimental group of students and compare their learning outcomes with a control group who were exposed to PBL but not GIS. The results show significant differences in the learning outcomes
Yan Liu; Elisabeth N. Bui; Chew-Hung Chang; Hans G. Lossman
The Disabilities of the Arm, Shoulder and Hand (DASH) is a standardized patient-based outcome measure, which assesses integrated\\u000a upper-extremity disorders. The objectives of this study were to investigate subjective outcome after upper-extremity surgeries\\u000a for the patients with rheumatoid arthritis (RA) using the DASH questionnaire (Japanese version) and to investigate the influence\\u000a of disease activity on the surgical outcome using the
Background The patient handover is important for the safe transition from the pre-hospital setting to secondary care. The loss of critical information about the pre-hospital phase may impact upon the clinical course of the patient. Methods University Hospital Emergency Care registrars answered a questionnaire about how they perceive clinical documentation from the ambulance services. We also reviewed patient records retrospectively, to investigate to what extent eight selected parameters were transferred correctly to hospital records by clinicians. Only parameters outside the normal range were selected. Results The registrars preferred a verbal handover with hand-written pre-hospital reports as the combined source of clinical information. Scanned report forms were infrequently used. Information from other doctors was perceived as more important than the information from ambulance crews. Less than half of the selected parameters in pre-hospital notes were transferred to hospital records, even for parameters regarded as important by the registrars. Abnormal vital signs were not transferred as often as mechanism of injury, medication administered and immobilisation of trauma patients. Conclusions Data on pre-hospital abnormal vital signs are frequently not transferred to the hospital admission notes. This information loss may lead to suboptimal care.
GPs are not always informed that their patient suffered an adverse drug reaction (ADR) while in hospital. We have conducted a postal questionnaire survey of 270 GPs in order to elicit their views regarding provision of information from secondary care regarding ADRs. Of the 141 (52.2%) GPs that replied, 127 (90.1%) saw patients that had experienced an ADR in hospital. Of these GPs, 113 (89%) stated that they encountered instances where no record of the ADR existed in patients' discharge documentation. Where written information was absent, GPs are reliant on information given to them by patients. Of those responding, none were 'very confident' of this information, while 92 (78.6%) were 'uncertain' or 'very uncertain' of this information. A sample notification form was developed. GPs were generally satisfied with its content and 110 (82.7%) thought that patients should receive a copy. Almost all GPs (135 (97.8%)) felt that it would be appropriate to provide patients with ADR warning cards. Ensuring that patients and their carers are aware of drugs to which they may be allergic or intolerant through verbal and written methods should minimize the unnecessary risks of inadvertent re-exposure. PMID:10380065
Green, C F; Mottram, D R; Pirmohamed, M; Horner, R; Rowe, P H
The Nova Scotia Environmental Health Centre is a treatment facility for individuals with chronic environmental conditions such as multiple chemical sensitivity, chronic fatigue syndrome, fibromyalgia, chronic respiratory conditions and in some cases chronic pain. The premise of care is to provide a patient-centred multidisciplinary care approach leading to self-management strategies. In order to measure the outcome of the treatment in these complex problems, with overlapping diagnoses, symptoms in many body systems and suspected environmental triggers, a detailed symptoms questionnaire was developed specifically for this patient population and validated. Results from a pilot study in which an abbreviated symptoms questionnaire based on the top reported symptoms captured in previous research was used to measure the efficacy of a multidisciplinary care approach in individuals with multiple chemical sensitivity are presented in this paper. The purpose of this study was to examine the extent, type and patterns of changes over time in the top reported symptoms with treatment measured using the abbreviated symptoms questionnaire. A total of 183 active and 109 discharged patients participated in the study where the health status was measured at different time periods of follow up since the commencement of treatment at the Centre. The findings from this study were successful in generating an initial picture of the nature and type of changes in these symptoms. For instance, symptoms such as difficulty concentrating, sinus conditions and tiredness showed early improvement, within the first 6 months of being in treatment, while others, such as fatigue, hoarseness or loss of voice, took longer while others showed inconsistent changes warranting further enquiry. A controlled longitudinal study is planned to confirm the findings of the pilot study.
Aims and objectives This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China. Background The nursing shortage is an urgent global problem and also of concern in China. Studies in Western countries have shown that better work environments are associated with higher nurse satisfaction and lower burnout, thereby improving retention and lowering turnover rates. However, there is little research on the relationship between nurse work environments and nurse outcomes in China. Design This is a cross-sectional study. Survey data were collected from 1104 bedside nurses in 89 medical, surgical and intensive care units in 21 hospitals across the Guangdong province in China. Methods Stratified convenience sampling was used to select hospitals, and systematic sampling was used to select units. All staff nurses working on participating units were surveyed. The China Hospital Nurse Survey, including the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory, was employed to collect data from nurses. Statistical significance level was set at 0·05. Results Thirty-seven per cent of the nurses experienced high burnout, and 54% were dissatisfied with their jobs. Improving nurses’ work environments from poor to better was associated with a 50% decrease in job dissatisfaction and a 33% decrease in job-related burnout among nurses. Conclusion Burnout and job dissatisfaction are high among hospital nurses in Guangdong province, China. Better work environments for nurses were associated with decreased job dissatisfaction and job-related burnout, which may successfully address the nursing shortage in China. Relevance to clinical practice The findings of this study indicate that improving work environments is essential to deal with the nursing shortage; the findings provide motivation for nurse managers and policy makers to improve work environments of hospital nurses in China.
Liu, Ke; You, Li-Ming; Chen, Shao-Xian; Hao, Yuan-Tao; Zhu, Xiao-Wen; Zhang, Li-Feng; Aiken, Linda H
The purpose of secondary vocational education has traditionally been occupational preparation, with the primary activity for achieving that purpose being occupationally specific skill training. Today, however, a significant amount of effort is also directed toward outcomes that prepare an individual for work rather than for a specific job or…
The purpose of this study was to conduct a systematic review of the secondary transition correlational literature to identify in-school predictors of improved postschool outcomes in the areas of education, employment, and/or independent living for students with disabilities. Based on results of this review, 16 evidence-based, in-school predictors…
Test, David W.; Mazzotti, Valerie L.; Mustian, April L.; Fowler, Catherine H.; Kortering, Larry; Kohler, Paula
The foundation of head and neck reconstruction is based on two pillars: the restoration of function and the restoration of aesthetics. The objective of this article is to provide insight into how to prevent undesirable functional and aesthetic outcome after the initial procedure and also to provide solutions for enhancement of functional and aesthetic outcome with secondary procedures. Functional and aesthetic outcome enhancement is discussed in relation to the individual structures within the oral cavity, for the mandible, and for facial reconstruction. Normal prerequisites for all individual structures are described, and key points for restoration of these functional and aesthetic issues are proposed. In addition, further suggestions to improve suboptimal results after initial reconstructive surgery are presented. Understanding the function and aesthetics of the area to be reconstructed will allow appropriate planning and management of the initial reconstruction. Secondary enhancement should be attainable by minor procedures rather than a requirement to redo the initial reconstruction.
Background Augmenting validated paper versions of existing outcome measures with an equivalent online version may offer substantial research advantages (cost, rapidity and reliability). However, equivalence of online and paper questionnaires cannot be assumed, nor can acceptability to respondents. The aim was to test whether online and written versions of the Roland Morris Disability Questionnaire (RMDQ), a standard measure of functional disability in back pain, are equivalent at both group and individual levels to establish whether they can be used interchangeably. Methods This is a within-participants equivalence study. 167 participants with back pain fully completed both the paper and online versions of the RMDQ in random order. Participants were recruited from a chiropractic clinic and patient support groups in Southern England. Limits of equivalence were pre-defined as 0.5 RMDQ points, the Bland-Altman range was calculated, and participants' comments were examined using content analysis. Results The mean score difference was 0.03 (SD = 1.43), with the 95% Confidence Interval falling entirely within our limits of equivalence (-0.19 to 0.25). The Bland-Altman range was -2.77 to 2.83 RMDQ points. Participants identified unique advantages and disadvantages associated with each version of the RMDQ. Conclusions The group and individual level data suggest that online and paper versions of the RMDQ are equivalent and can be used interchangeably. The Bland-Altman range appears to reflect the known measurement properties of the RMDQ. Furthermore, participants' comments confirmed the potential value to be had from offering them the choice of completing the RMDQ online or on paper.
Animal protection organizations claim that dissection is pedagogically unsound and that it will cause students to lose respect for non-human animals. Science teacher organizations support curricula that teach respect for animal life and include dissection. Prior research compared dissection to dissection alternatives. Four of the six studies revealed no difference between groups on tests of cognitive outcomes. One study revealed that dissection was superior, and one revealed that the alternative was superior. No differences in attitudes toward science, dissection or school were found. Attitudes toward non-human animals were not measured. This study focused on the dissections of earthworms and frogs in middle and high school classrooms. Pre and post-tests of conceptual understanding revealed failing scores and no significant pre/post differences. Because these tests required critical thinking skills, and the dissection activities did not, it is difficult to determine if the poor performance on these tests indicates the inability of the students to think critically, and/or if it indicates the ineffectiveness of dissection. Further studies of dissections that focus on critical thinking would be necessary to make this distinction. Classroom observations, student written narratives, and student and adult interviews revealed mixed attitudes toward non-human animals. Student behaviors during dissection were similar to those behaviors exhibited during non-dissection activities. Most students and adults readily supported worm dissections while they expressed some trepidation about frog dissections. Students and adults universally expressed affection for their pets and opposed the use of their own pets for dissection/research. There was slight support for the use of dogs and cats for dissection/research, but only those students who expressed hate for cats said that they could dissect cats. None of the students or adults expressed a willingness to dissect dogs. Some students abandoned plans for life science careers because they did not want to do further dissections. Students and adults often expressed confliction about the use of animals for food and/or research. Students and adults employed psychological mechanisms including dissociation, conflict reduction and viewing animals as an "outgroup" to rationalize their support for the use of animals for food, dissection and research.
Background Development of Traditional Chinese Medicine (TCM) syndrome-specific outcome measures is needed for the evaluation of TCM syndrome-specific therapies. We constructed a Kidney Deficiency Syndrome Questionnaire (KDSQ) for the evaluation of the common TCM syndromes Kidney-Yin Deficiency Syndrome (KDS-Yin) and Kidney-Yang Deficiency Syndrome (KDS-Yang) in middle-aged women with menopausal symptoms. Methods KDS-Yin and KDS-Yang were traditionally defined by expert opinion were validated by exploratory factor analysis (EFA) and structural equation modeling (SEM). Content validity was tested by EFA on a sample of 236 women from a seminar and SEM on another sample of 321 women from a postal survey. Other psychometric properties were tested on 292 women from the seminar at baseline and two systematically selected sub-samples: 54 who reported no changes in discomforts 11–12?days after the baseline and 31 who reported changes in discomforts 67–74?days after the baseline. All participants completed the KDSQ, the Greene Climacteric Scale and the standard 12-item Short Form Health Survey. Results The EFA and SEM established the measurement models of KDS-Yin and KDS-Yang supporting content validity of the KDSQ. Internal consistency was good (Cronbach’s Alpha >0.70). Construct validity was supported by theoretically-derived levels of correlation with the established external measures. Test–retest reliability was strong (ICCagreement: KDS-Yin, 0.94; KDS-Yang, 0.93). The KDSQ was responsive to changes over time as tested by effect size and longitudinal validity. Conclusions The KDSQ was a valid and reliable measure for KDS-Yin and KDS-Yang in Hong Kong Chinese middle-aged women with menopausal symptoms.
Objective: To extend psychometric research on the Community Integration Questionnaire (CIQ) by comparing patients' reports with those of family members.Design: Reports on community integration were obtained from family members and patients 1 year after brain injury. Kappa reliability coefficients were used to examine agreement for individual items on the questionnaire. Total scores for the three CIQ scales were compared between
Angelle M. Sander; Ronald T. Seel; Jeffrey S. Kreutzer; Karyl M. Hall; Walter M. High; Mitchell Rosenthal
Acellular dermal matrices are integrally involved in the majority of expander-implant reconstructions and complex hernia repairs today, and they are now making their way into secondary aesthetic breast surgery. The number of revisional breast surgery cases has continued to increase as the materials and repair techniques have improved. The aesthetic outcome bar is constantly being raised, and the complexity of patient deformities often requires additional tissues to achieve a successful repair. The most common complications in breast augmentation are reviewed, along with indications and some current repair techniques, general principles, and specific caveats to help plastic surgeons deal with these complex and challenging patient problems utilizing acellular dermal matrices. PMID:23096964
BACKGROUND: Despite the increasing availability of multidimensional health status and outcome measures of the patient's physical and emotional functioning, and a number of national initiatives to promote their use, little is known about the attitudes and behaviour of general practitioners (GPs) and practice nurses (PNs) regarding their use in evaluating the effectiveness of health care. What evidence there is remains largely anecdotal but supports the view that health outcome data is currently not used in the routine management of the patient. AIM: To investigate the attitudes and behaviour of GPs and PNs regarding the use of health outcome data in the routine care of patients with diabetes. METHOD: A questionnaire comprising 20 attitudinal and behavioural statements covering the use and benefits of health outcome data in the routine care of patients with diabetes were sent to 156 GPs and 114 PNs in the Doncaster area together with a covering letter and two examples of multidimensional health outcome measures. RESULTS: Completed questionnaires were received from 90 (58%) GPs and 49 (50% corrected for out of scope) nurses. Median response scores showed that both GPs and nurses expressed a positive overall attitude towards health outcome measurement giving responses favourable to it in 15 (75%) and 18 (90%) of the statements respectively. A key finding was that 48% and 46% of GPs and PNs were unclear as to how they would use health outcome data. CONCLUSION: While our findings reflect a favourable view towards the use of health outcome data for the routine management of the patient with diabetes in a general practice setting, a number of important barriers to their implementation have been identified. These include insufficient knowledge on their use, the need for easily interpretable data, and a lack of resources.
While perceived overqualification (POQ) has received increased research attention in recent years, the identification of variables that moderate POQ-outcome relationships is critical to our understanding of how the construct affects career outcomes. This study, involving 170 full-time primary and secondary school educators in a suburban…
Background Outcome measurement in shoulder surgery is essential to evaluate the patient safety and treatment efficiency. Currently this is jeopardized by the fact that most patient-reported self-assessment instruments are not comparable. Hence, the aim was to develop a reliable self-assessment questionnaire which allows an easy follow-up of patients. The questionnaire also allows the calculation of 3 well established scoring systems, i.e. the Shoulder Pain and Disability Index (SPADI), the Constant-Murley Score (CMS), and the Disabilities of the Arm, Shoulder and Hand (DASH) Score. The subjective and objective items of these three systems were condensed into a single 30-questions form and validated against the original questionnaires. Methods A representative collective of patients of our shoulder clinic was asked to fill in the newly designed self-assessment Munich Shoulder Questionnaire (MSQ). At the same time, the established questionnaires for self-assessment of CONSTANT, SPADI and DASH scores were handed out. The obtained results were compared by linear regression analysis. Results Fifty one patients completed all questionnaires. The correlation coefficients of the results were r?=?0.91 for the SPADI, r?=?-0.93 for the DASH and r?=?0.94 for the CMS scoring system, respectively. Conclusions We developed an instrument which allows a quantitative self-assessment of shoulder function. It provides compatible data sets for the three most popular shoulder function scoring systems by one single, short 30-item. This instrument can be used by shoulder surgeons to effectively monitor the outcome, safety and quality of their treatment and also compare the results to published data in the literature.
BACKGROUND: The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper-extremity disability and symptoms. The DASH consists mainly of a 30-item disability\\/symptom scale, scored 0 (no disability) to 100. The main purpose of this study was to assess the longitudinal construct validity of the DASH among patients
Christina Gummesson; Isam Atroshi; Charlotte Ekdahl
OBJECTIVE--To develop and evaluate a short (10 item) simple measure of outcome mainly for use with patients with mild to moderate head injuries. DESIGN--Two studies on patients at three and six months after injury, comparing different methods of administration (two raters and postal questionnaire), and comparing ratings with other assessments. SUBJECTS--Forty three patients seen three months after injury and 46 seen six months after injury; both groups had head injuries covering a range of severity from minor to severe. MAIN OUTCOME MEASURES--Differences between ratings in different groups of patients (Mann-Whitney U test); differences in ratings used different methods of administration (Wilcoxon signed rank test); and correlation between ratings from the same patient (Spearman r). RESULTS--The sum total ratings were consistent between raters and between methods (postal questionnaire v face to face interview) with no evidence of selective bias between rates or methods. Ratings on individual items were also reasonably consistent. The sum total rating varied as anticipated between groups divided by clinical judgement of recovery and patient assessment of recovery, and related as expected to the extent of post-concussion symptomatology. The 10 items included covered the most important problem areas reported by patients. CONCLUSION--The Rivermead head injury follow up questionnaire (RHFUQ) is a short, simple, adequately reliable, and valid measure of outcome, across the entire range of severity, but particularly after mild to moderate head injury.
Trials of anemia correction in chronic kidney disease have found either no benefit or detrimental outcomes of higher targets. We did a secondary analysis of patients with chronic kidney disease enrolled in the Correction of Hemoglobin in the Outcomes in Renal Insufficiency trial to measure the potential for competing benefit and harm from achieved hemoglobin and epoetin dose trials. In the 4 month analysis, significantly more patients in the high-hemoglobin compared to the low-hemoglobin arm were unable to achieve target hemoglobin and required high-dose epoetin-alpha. In unadjusted analyses, the inability to achieve a target hemoglobin and high-dose epoetin-alpha were each significantly associated with increased risk of a primary endpoint (death, myocardial infarction, congestive heart failure or stroke). In adjusted models, high-dose epoetin-alpha was associated with a significant increased hazard of a primary endpoint but the risk associated with randomization to the high hemoglobin arm did not suggest a possible mediating effect of higher target via dose. Similar results were seen in the 9 month analysis. Our study demonstrates that patients achieving their target had better outcomes than those who did not; and among subjects who achieved their randomized target, no increased risk associated with the higher hemoglobin goal was detected. Prospective studies are needed to confirm this relationship and determine safe dosing algorithms for patients unable to achieve target hemoglobin. PMID:18596733
Szczech, Lynda A; Barnhart, Huiman X; Inrig, Jula K; Reddan, Donal N; Sapp, Shelly; Califf, Robert M; Patel, Uptal D; Singh, Ajay K
Advances in treatment technologies and development of evidence-base d standards of care demand better methods for routine assessment of outcomes for schiz- ophrenia in systems of care. This article describes the development and psychometrics of a new instrument to assess outcomes of routine care for persons with schizophrenia in service systems. Candidate items for the Schizophrenia Care and Assessment Program
Anthony F. Lehman; Ellen P. Fischer; Leticia Postrado; Janine Delahanty; Bryan M. Johnstone; Patricia A. Russo; William H. Crown
PURPOSE: Recurrent patella subluxation may be secondary to excessive external tibial torsion. The purpose of this study is to evaluate the clinical and radiographic outcome of patients undergoing tibial derotation osteotomy and tibial tuberosity transfer for recurrent patella subluxation in association with excessive external tibial torsion. METHODS: A combined tibial derotation osteotomy and tibial tuberosity transfer was performed in 15 knees (12 patients) with recurrent patella subluxation secondary to excessive external tibial torsion. Clinical evaluation was carried out using preoperative and post-operative Knee Society Score (KSS), Kujala Patellofemoral score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, the short form-12 (SF-12) and a visual analogue score (VAS) pain scale. RESULTS: The median follow-up period was 84 months (range 15-156) and median patient age was 34 years (range 19-57 years). The median preoperative external tibial torsion was 62° (range 55°-70°), with a median rotational correction of 36° (range 30°-45°) after surgery. Significant improvement (p < 0.05) was found in the KSS part I (37 ± 14 to 89 ± 11 points), KSS part II (25 ± 26 to 85 ± 14 points), Kujala score, the SF-12 outcome, WOMAC score and VAS score (8.8 ± 1.9 to 2.4 ± 1.5). Two patients had a nonunion of the tibial osteotomy site; one patient required bone grafting, while another patient required revision to total knee arthroplasty. CONCLUSION: Patients presenting with recurrent patella subluxation secondary to excessive external tibial torsion >45° who underwent tibial derotation osteotomy and tibial tuberosity transfer achieved a satisfactory outcome in terms of pain relief and improved function. A significant complication was seen in 2/15 patients. LEVEL OF EVIDENCE: Case series, Level IV. PMID:23740327
Drexler, M; Dwyer, T; Dolkart, O; Goldstein, Y; Steinberg, E L; Chakravertty, R; Cameron, J C
PurposeTo improve a questionnaire used to collect patient-reported outcomes from patients with early stage prostate cancer treated with brachytherapy. A secondary aim was to adapt the Late Effects of Normal Tissue (LENT) subjective toxicity questionnaire for use to collect Common Terminology Criteria for Adverse Events (CTCAE) data, the current preferred platform for assessing radiation toxicity.
Damian J. J. Farnell; Paula Mandall; Carmel Anandadas; Jaqueline Routledge; Meriel P. Burns; John P. Logue; James P. Wylie; Ric Swindell; Jac Livsey; Catharine M. L. West; Susan E. Davidson
Many current health status instruments either are too long to use in many acquired immune deficiency syndrome (AIDS) clinical trials or omit important concepts. In this study, human immunodeficiency virus (HIV)-relevant items developed for the Medical Outcomes Study (MOS) from subscales for cognitive function, energy\\/fatigue, health distress, and a single quality of life item were added to a portion of
Albert W. Wu; Haya R. Rubin; William C. Mathews; Ware John E. Jr; Lucy T. Brysk; William D. Hardy; Samuel A. Bozzette; Stephen A. Spector; Douglas D. Richman
This study used longitudinal youth outcome data in routine mental health services to test a system for identifying cases at risk for treatment failure. Participants were 2,715 youth (M age = 14) served in outpatient managed care and community mental health settings. Change trajectories were developed using multilevel modeling of archival data.…
Cannon, Jennifer A. N.; Warren, Jared S.; Nelson, Philip L.; Burlingame, Gary M.
The Disabilities of the Arm, Shoulder and Hand (DASH) is a standardized patient-based outcome measure, which assesses integrated upper-extremity disorders. The objectives of this study were to investigate subjective outcome after upper-extremity surgeries for the patients with rheumatoid arthritis (RA) using the DASH questionnaire (Japanese version) and to investigate the influence of disease activity on the surgical outcome using the Disease Activity Score (DAS) 28-CRP(4). Approximately 127 surgical procedures for the upper extremities in 127 patients with RA were recruited in this study. Surgeries were performed in 4 shoulders, 35 elbows, 60 wrists and 28 hands. The DASH score (disability/symptom score) was investigated just before surgery and at follow-up. The mean follow-up period after the surgery was 15 months on average (range, 6 to 24 months). The preoperative DASH score (disability/symptom score) 50 +/- 23 (mean +/- SD) decreased significantly to 38 +/- 23 at the follow-up (n = 127, p < 0.01). Standardized response mean and effect size revealed a medium effect of -0.6 and -0.5. Patients with various degrees of disease activity improved and the improvements per se were comparable of preoperative disease activity and postoperative response to medical treatment. A favorable subjective outcome of rheumatoid upper-extremity surgeries can be anticipated under the good control of disease activity. PMID:18214571
Background Self-reported outcome instruments in health research have become increasingly important over the last decades. Occupational therapy interventions often focus on occupational balance. However, instruments to measure occupational balance are scarce. The aim of the study was therefore to develop a generic self-reported outcome instrument to assess occupational balance based on the experiences of patients and healthy people including an examination of its psychometric properties. Methods We conducted a qualitative analysis of the life stories of 90 people with and without chronic autoimmune diseases to identify components of occupational balance. Based on these components, the Occupational Balance-Questionnaire (OB-Quest) was developed. Construct validity and internal consistency of the OB-Quest were examined in quantitative data. We used Rasch analyses to determine overall fit of the items to the Rasch model, person separation index and potential differential item functioning. Dimensionality testing was conducted by the use of t-tests and Cronbach’s alpha. Results The following components emerged from the qualitative analyses: challenging and relaxing activities, activities with acknowledgement by the individual and by the sociocultural context, impact of health condition on activities, involvement in stressful activities and fewer stressing activities, rest and sleep, variety of activities, adaptation of activities according to changed living conditions and activities intended to care for oneself and for others. Based on these, the seven items of the questionnaire (OB-Quest) were developed. 251 people (132 with rheumatoid arthritis, 43 with systematic lupus erythematous and 76 healthy) filled in the OB-Quest. Dimensionality testing indicated multidimensionality of the questionnaire (t?=?0.58, and 1.66 after item reduction, non-significant). The item on the component rest and sleep showed differential item functioning (health condition and age). Person separation index was 0.51. Cronbach’s alpha changed from 0.38 to 0.57 after deleting two items. Conclusions This questionnaire includes new items addressing components of occupational balance meaningful to patients and healthy people which have not been measured so far. The reduction of two items of the OB-Quest showed improved internal consistency. The multidimensionality of the questionnaire indicates the need for a summary of several components into subscales.
This study explored potential influences that students' educational label, behavior, and learning characteristics have on program expectations, modifications, accommodations, and postsecondary outcomes as perceived by Indiana secondary career and technical education (CTE) instructors. This is a replication study of research conducted with…
Harvey, Michael W.; Cotton, Samuel E.; Koch, Kourtland R.
Objective To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with secondary lymphedema after breast cancer treatment. Methods In a prospective clinical trial, ESWT was performed consecutively 4 times over two weeks in 7 patients who were diagnosed with stage 3 secondary lymphedema after breast cancer treatment. Each patient was treated with four sessions of ESWT (0.056-0.068 mJ/mm2, 2,000 impulses). The parameters were the circumference of the arm, thickness of the skin and volume of the arm. We measured these parameters with baseline values before ESWT and repeated the evaluation after each ESWT treatment. Subjective data on skin thickness, edema and sensory impairment were obtained using a visual analogue scale (VAS). Results The mean volume of the affected arm after four consecutive ESWT was significantly reduced from 2,332 to 2,144 mL (p<0.05). The circumference and thickness of the skin fold of the affected arm were significantly decreased after the fourth ESWT (p<0.05). The three VAS scores were significantly improved after the fourth ESWT. Almost all patients were satisfied with this treatment and felt softer texture in their affected arm after treatment. Conclusion ESWT is an effective modality in the treatment of stage 3 lymphedema after breast cancer treatment. ESWT reduced the circumference and the thickness of arms with lymphedema and satisfied almost all patients with lymphedema. Therefore, this treatment provides clinically favorable outcome to patients with breast cancer-related lymphedema.
Pneumonia occurring as a secondary infection after influenza is a major cause of excess morbidity and mortality, despite the availability and use of antibiotics active against Streptococcus pneumoniae. We hypothesized that the use of a bacteriostatic protein synthesis inhibitor would improve outcomes by reducing the inflammatory response. BALB/cJ mice infected with influenza virus and superinfected with S. pneumoniae were treated with either the cell-wall-active antibiotic ampicillin or the protein synthesis inhibitor clindamycin or azithromycin. In the model, ampicillin therapy performed significantly worse (survival rate, 56%) than (1) clindamycin therapy used either alone (82%) or in combination with ampicillin (80%) and (2) azithromycin (92%). Improved survival appeared to be mediated by decreased inflammation manifested as lower levels of inflammatory cells and proinflammatory cytokines in the lungs and by observation of less-severe histopathologic findings. These data suggest that beta-lactam therapy may not be optimal as a first-line treatment for community-acquired pneumonia when it follows influenza. PMID:19113989
Karlström, Asa; Boyd, Kelli L; English, B Keith; McCullers, Jonathan A
Patient-reported outcome measures (PROMs) are used routinely in NHS. Traditional pen-and-paper questionnaire collection can be time-consuming for both patients and clinic staff. The purpose of the current study was to determine whether a web-based PROMs system has the potential to provide satisfactory patient compliance and whether compiled data are equivalent to pen-and-paper PROMs data. A series of 82 patients who had joint replacement surgery was identified. Each patient was contacted by letter to register on the myClinicalOutcomes.co.uk website and to follow the instructions to render an Oxford score. A second request was sent to those failing to initially register. Telephone contact was then made with non-responders to identify the reason for failed registration. Successfully collated online Oxford scores were compared with previously recorded pen-and-paper scores for each patient from a prospectively updated database. Of the 82 patients identified, 61 (74%) received a letter or were otherwise contacted by telephone. Of these, 27 (44%) patients confirmed that they had access to the Internet. A total of 21 complete sets of data were collected. On review, the available secure online Oxford outcome scores demonstrated a mean of 30.1 (SD 11.4, range: 9-47). This mean score was comparable to the pen-and-paper database mean score of 29.1 (SD 11.8, range: 9-48) for the respective patients. Of the 27 respondents with Internet access, 21 (78%) produced complete scores that were available for real-time review. Available online scores were comparable to those collected via traditional means. With increased Internet availability and improved communication, remote web-based collection of patient reported outcomes may facilitate enhanced and efficient follow-up of patients. PMID:24266443
Gakhar, H; McConnell, B; Apostolopoulos, Alexandros P; Lewis, P
Measurement is a foundational topic in secondary school physics that must be taught to all beginning secondary education students in Kenya. The secondary level offers education for students who are aged between 12-and 18-years-old. Physics teachers in the Rift Valley province identified the topic of measurement as an area that is difficult to…
Measurement is a foundational topic in secondary school physics that must be taught to all beginning secondary education students in Kenya. The secondary level offers education for students who are aged between 12- and 18-years-old. Physics teachers in the Rift Valley province identified the topic of measurement as an area that is difficult to…
Objectives. Considering the influence of different motor and nonmotor features of Parkinson's disease (PD), it is important to evaluate the psychosocial functioning of the patients. For this purpose, the scales for outcomes in Parkinson's disease-psychosocial questionnaire (SCOPA-PS) has been previously designed. The aim of our study was to assess the cross-cultural validation and psychometric properties of the Persian version of the SCOPA-PS. Methods. One hundred and ten nondemented idiopathic Parkinson's disease (IPD) patients were consecutively recruited from an outpatient referral movement disorder clinic. Eligible patients filled up a number of questionnaires including the Persian version of SCOPA-PS during the face-to-face interview session and clinical examination to measure disease severity, nonmotor psychiatric symptoms, and health-related quality of life (HRQoL). Results. The highest and lowest correlation coefficients of internal consistency were reported for item 7 on “asking for help” (r = 0.765) and item 5 on “sexual problems” (r = 0.553). Cronbach's alpha reliability coefficient of the entire scale was 0.87 (95% CI: 0.83–0.90). The Hoehn and Yahr stage (r = 0.34, P < 0.001), Schwab and England ADL scale (r = ?0.55, P < 0.001), anxiety (r = 0.64, P < 0.001), depression (r = 0.71, P < 0.001), and fatigue (r = 0.35, P < 0.001) were significantly correlated with the total score of the SCOPA-PS questionnaire. Conclusions. The Persian version of SCOPA-PS is a highly reliable and valid scale to measure psychosocial functioning in IPD patients with different sex, age-group, and educational level, which could be applied in future researches. Disease severity scales, depression, anxiety, fatigue, and different domains of HRQoL were all associated with psychosocial functioning in PD patients.
Farhadi, Farzaneh; Hadizadeh, Hasti; Delbari, Ahmad; Lokk, Johan
Objective Secondary glaucoma is a serious complication in patients with transthyretin (TTR)-related familial amyloidotic polyneuropathy (FAP). We assessed the long-term outcomes and complications of trabeculectomy with mitomycin C (MMC) for secondary glaucoma associated with FAP. Methods Medical case records of Kumamoto University Hospital were retrospectively reviewed. Twenty-one eyes of 13 patients (10 with FAP ATTR Val30Met; 3 with FAP ATTR Tyr114Cys) underwent trabeculectomy with MMC and follow-up of at least 2 years. The primary outcome measure was Kaplan-Meier survival, with failure of this treatment being defined as an intraocular pressure (IOP) of ?5 mm Hg or ?22 mm Hg on two consecutive visits or as additional operations needed to reduce IOP. Secondaryoutcome measures included complications, bleb characteristics, and additional postoperative interventions required. Results The mean postoperative follow-up period was 5.7 years (range, 2.2–12.7 years). Kaplan-Meier analysis indicated probabilities of success of 0.76, 0.67, and 0.53 at 1, 2, and 3 years after operation, respectively. Significant complications included ocular decompression retinopathy in 7 eyes (33%) and bleb encapsulation in 10 eyes (48%). Twelve eyes (57%) needed additional surgery, such as bleb revision or trabeculectomy with MMC, to reduce IOP. Conclusions Trabeculectomy with MMC may not be optimal for patients with FAP-related glaucoma and may have several significant complications.
Secondary antibody deficiency can occur as a result of haematological malignancies or certain medications, but not much is known about the clinical and immunological features of this group of patients as a whole. Here we describe a cohort of 167 patients with primary or secondary antibody deficiencies on immunoglobulin (Ig)-replacement treatment. The demographics, causes of immunodeficiency, diagnostic delay, clinical and laboratory features, and infection frequency were analysed retrospectively. Chemotherapy for B cell lymphoma and the use of Rituximab, corticosteroids or immunosuppressive medications were the most common causes of secondary antibody deficiency in this cohort. There was no difference in diagnostic delay or bronchiectasis between primary and secondary antibody deficiency patients, and both groups experienced disorders associated with immune dysregulation. Secondary antibody deficiency patients had similar baseline levels of serum IgG, but higher IgM and IgA, and a higher frequency of switched memory B cells than primary antibody deficiency patients. Serious and non-serious infections before and after Ig-replacement were also compared in both groups. Although secondary antibody deficiency patients had more serious infections before initiation of Ig-replacement, treatment resulted in a significant reduction of serious and non-serious infections in both primary and secondary antibody deficiency patients. Patients with secondary antibody deficiency experience similar delays in diagnosis as primary antibody deficiency patients and can also benefit from immunoglobulin-replacement treatment.
Duraisingham, Sai S.; Buckland, Matthew; Dempster, John; Lorenzo, Lorena; Grigoriadou, Sofia; Longhurst, Hilary J.
Background Several instruments have been developed to assess psychosocial workload. We compared two of these instruments, the Effort-Reward Imbalance (ERI) model and the Copenhagen Psychosocial Questionnaire (COPSOQ) with regard to congruent validity and internal validity. Methods This analysis is based on a population-based sample of the baseline examination of 2,783 employees from the Gutenberg Health Study (GHS). About half of the participants completed the ERI questionnaire (n?=?1,342), the other half completed the COPSOQ (n?=?1,441). First, the two samples were compared and descriptive analyses were carried out calculating mean values for both instruments in general, then separately for age, gender and main occupational groups. Second, we analyzed the relationship between ERI and COPSOQ scales on the workplace situation and on the workplace outcomes: job satisfaction, general health, burnout, satisfaction with life, by applying stepwise logistic regression analysis. Results and discussion For the majority of occupations, high effort as reflected by the ERI corresponded with high demands as reflected by the COPSOQ. Comparably, high reward (according to ERI) yielded a good agreement with high “influence and development” (according to COPSOQ). However, we could also find differences between ERI and COPSOQ concerning the intensity of psychosocial workload in some occupations (e.g., physicians/pharmacists or warehouse managers/warehousemen/transport workers). These differences point to differing theoretical concepts of ERI and COPSOQ. When the ability of ERI and COPSOQ was examined to determine the associations with health and work outcomes, burnout could be better predicted by the COPSOQ; this might be due to the fact that COPSOQ comprises the constructs “work-privacy conflict” and “emotional demand”, which are closely related to burnout. However, methodological differences between these instruments limit their direct comparability. Conclusions The ERI and COPSOQ instrument yielded similar results for most occupational groups. The slightly stronger association between psychosocial workload as assessed by COPSOQ and burnout might be explained by its broader approach. The ability of the ERI and COPSOQ instrument to reflect relevant risk factors for clinically manifest disorders (e.g., coronary heart disease) will be derived from subsequent prospective analyses of the GHS with the follow-up data.
Patient with TMJ ankylosis are affected with mandibular hypoplasia which in turn causes functional and esthetic problems. Restoration of normal function and esthetics is the prime goal in treatment of such patients with distraction becoming an important treatment option. The present study also was conducted on patients with mandibular hypoplasia secondarily to TMJ ankylosis treated with distraction. Since function and esthetics improvement was the prime aim behind the treatment with distraction, evaluation of functional and esthetics outcome becomes an important aspect. Thus the study was indigenously designed and aimed at qualitative evaluation of the functional and esthetic outcome after correction of mandibular hypoplasia secondary to temporomandibular ankylosis with Distraction osteogenesis. Patients treated with distraction were evaluated on the basis of parameters for function and esthetics. Parameters for function were occlusion, airway, mouth opening and chewing-biting perception of patient pre and post distraction. Parameters for esthetics used were patient and panel perception. All parameters for function and occlusion improved with distraction in all the patients except one in whom occlusion and chewing- biting pattern worsened. It is concluded that distraction is a good option for improving patients functional and esthetic outcome in cases of mandibular hypoplasia secondary to temporomandibular ankylosis as the results achieved are stable with negligible chances of relapse. PMID:24822007
We present two patients with myelodysplasia in association with Takayasu's arteritis (TA). In both patients intensive immunosuppressive treatment could not control the vascular inflammation. Subsequently both patients developed myelodysplasia, rapidly progressing to secondary acute myelogenous leukaemia. One patient had a peripheral blood stem cell transplant from a compatible sibling donor, but died of refractory leukaemia 5 months later. The other patient died of fungal sepsis. These are the first two patients reported to have TA associated with myelodysplasia/secondary leukaemia. PMID:15144132
Amberger, C; Denzlinger, C; Janzen, J; Müller-Schimpfle, M; Mohren, M; Kötter, I
The morbidity of osteoporosis is caused by fractures. Vertebral fractures lead to pain and disability and a decrease in quality of life. A Working Party of the European Foundation for Osteoporosis has developed a specific questionnaire for patients with established vertebral osteoporosis. This questionnaire is intended for use in clinical trials. The questionnaire consists of questions and visual analogue scales
P. Lips; C. Cooper; D. Agnusdei; F. Caulin; P. Egger; O. Johnell; J. A. Kanis; U. Liberman; H. Minne; J. Reeve; J. Y. Reginster; M. C. de Vernejoul; I. Wiklund
Objectives The effect of web-based interventions for depression on suicide ideation in callers to helplines is not known. The aim of this study was to determine if web-based Cognitive Behaviour Therapy (CBT) with and without telephone support is effective in reducing suicide ideation in callers to a helpline compared with treatment as usual (TAU). A secondary aim was to examine the factors that predict change in suicide ideation. Putative predictors included level of baseline depression, suicide behaviour, baseline anxiety and type of intervention. Design Randomised controlled trial. Setting Lifeline, Australia's 24?h telephone counselling service participants: 155 callers to a national helpline service with moderate-to-high psychological distress. Interventions Participants were recruited and randomised to receive either 6?weeks of internet CBT plus weekly telephone follow-up; internet CBT only; weekly telephone follow-up only or a wait-list TAU control group. Primary and secondaryoutcome measures Suicidal ideation was measured using four items from the 28-item General Health Questionnaire. Predictors of change in ideation were tested using logistic regression analysis. Results Regardless of the intervention condition, participants showed significant reductions in suicidal ideation over 12?months (p<0.001). Higher baseline suicidal behaviour decreased the odds of remission of suicidal ideation at postintervention (OR 0.409, p<0.001). However, change in depression over the course of the interventions was associated with improvement in suicide ideation (OR 1.165, p<0.001). Conclusions Suicide ideation declines with and without proactive intervention. Improvements in depression are associated with the resolution of suicide ideation. Specific interventions focusing on suicide ideation should be further investigated. Trial registration Controlled-Trials.com ISRCTN93903959.
Christensen, Helen; Farrer, Louise; Batterham, Philip J; Mackinnon, Andrew; Griffiths, Kathleen M; Donker, Tara
BACKGROUND: Recent healthcare policy has shifted the management of musculoskeletal conditions in the UK away from secondary care towards Clinical Assessment and Treatment Services at the primary-secondary care interface. However, little is known about the outcome of patients with musculoskeletal conditions referred from primary care to Clinical Assessment and Treatment Services or how best to identify those patients at high
Edward Roddy; Irena Zwierska; Peter Dawes; Samantha L Hider; Kelvin P Jordan; Jon Packham; Kay Stevenson; Elaine Hay
Background: A conversation currently exists regarding secondary curriculum (e.g. academics, functional) for students with moderate/severe intellectual disability (ID) without a large research base connecting curriculum to outcomes. Method: This study represented a secondary analysis of the National Longitudinal Transition Study-2 (NLTS2) data to…
Sympatric character displacement is one possible mechanism that prevents competitive exclusion. This mechanism is thought to be behind the radiation of Darwin's finches, where character displacement is assumed to have followed secondary contact of ecologically similar species. We use a model to evaluate under which ecological and environmental conditions this mechanism is likely. Using the adaptive dynamics theory, we analyse different ecological models embedded in the secondary contact scenario. We highlight two necessary conditions for character displacement in sympatry: (i) very strong premating isolation between the two populations, and (ii) secondary contact to occur at an evolutionary branching point. Character displacement is then driven by adaptation to interspecific competition. We determine how ecological and environmental parameters influence the probability of ecological divergence. Finally, we discuss the likelihood of sympatric character displacement under disruptive selection in natural populations. PMID:22873436
Aguilée, Robin; de Becdelièvre, Benoît; Lambert, Amaury; Claessen, David
In November of 2007, Alberta Advanced Education and Technology contracted Insightrix Research, Inc. to conduct a survey of individuals who graduated from post-secondary institutions in Alberta in the fall of 2005 or the spring of 2006 (excluding apprenticeship graduates, who are surveyed through a separate initiative). The purpose of the survey is…
Sympatric character displacement is one possible mechanism that prevents competitive exclusion. This mechanism is thought to be behind the radiation of Darwin's finches, where character displacement is assumed to have followed secondary contact of ecologically similar species. We use a model to evaluate under which ecological and environmental conditions this mechanism is likely. Using the adaptive dynamics theory, we analyse
Robin Aguilée; Benoît de Becdelièvre; Amaury Lambert; David Claessen
Co-teaching is a frequently suggested service delivery model for meeting the needs of students with learning disabilities (LD) in an inclusive environment. However, there is currently little empirical research to support these suggestions. In this study, general and special educators at one secondary site taught ninth-grade English in four…
Adolescent development involves a complex interplay between genetics, biology, and social and emotional relationships within multiple contexts of home, school and the broader community. The transition from primary to secondary school, coupled with the onset of puberty, can therefore be a difficult period for young people to negotiate at a critical…
Waters, Stacey K.; Lester, Leanne; Wenden, Elizabeth; Cross, Donna
Prior research has suggested that almost half of rape victims are treated by law enforcement in ways that they experience as upsetting (termed "secondary victimization"). However, it remains unknown why some victims have negative experiences with law enforcement and others do not. The purpose of this study is to explore victims' experiences with…
This report presents data from the 1996 Census of Canada concerning educational attainment, educational success, and labor market outcomes among Aboriginal people and others in Canada. There has been clear educational progress among registered Indians over the past decade, particularly in high school completion and postsecondary participation.…
While it seems many music educators share an enthusiasm for music festivals, others do not. Discrepancies seem to be rooted in the perceived educational outcomes in terms of musical knowledge gained, motivation, competition, psychological impact and social considerations. Advocates believe competitive festivals provide a "superlative" motivational…
Purpose Health related quality of life (HRQoL) is an important outcome in cancer care, although it is not well reported in surgical uro-oncology. Radical cystectomy (RC) with lymph-node dissection is the standard treatment of muscle-invasive bladder cancer and high-risk noninvasive bladder cancer. A wide range of impairments are reported postsurgery. The aims were to evaluate whether a standardized pre- and postoperative physical exercise program and enhanced mobilization can impact on HRQoL and inpatient satisfaction in RC, as defined by the European Organisation for Research and Treatment of Cancer (EORTC). Materials and methods Patients were randomized to fast-track RC and intervention (nI=50) or fast-track standard treatment (nS=57). HRQoL and inpatient satisfaction was measured using valid questionnaires: EORTC Quality of Life Questionnaire Core 30 (QLQ-C30) combined with the disease-specific EORTC BLS24 (baseline), and EORTC BLM30 (follow-up), and IN-PATSAT32 inpatient-satisfaction survey at discharge. Efficacy was defined as the differences in HRQoL-scores between treatment groups at the 4-month follow-up. Results The intervention group significantly improved HRQoL scores in dyspnea (P?0.05), constipation (P<0.02), and abdominal flatulence (P?0.05) compared to the standard group. In contrast, the standard group reported significantly reduced symptoms in sleeping pattern (P?0.04) and clinically relevant differences in role function, body function, and fatigue. The intervention did not compromise inpatient satisfaction. Conclusion We found no overall impact on global HRQoL due to a physical rehabilitation program. However, pre- and postoperative physical rehabilitation can significantly and positively impact on HRQoL aspects related to bowel management and respiratory function (dyspnea) without compromising inpatient satisfaction. These results highlight the role of multimodal rehabilitation, including physical exercises in fast-track RC.
Cereal crops such as wheat, rice and barley underpin the staple diet for human consumption globally. A multitude of threats to stable and secure yields of these crops exist including from losses caused by pathogens, particularly fungal. Plants have evolved complex mechanisms to resist pathogens including programmed cell death responses, the release of pathogenicity-related proteins and oxidative bursts. Another such mechanism is the synthesis and release of secondary metabolites toxic to potential pathogens. Several classes of these compounds have been identified and their anti-fungal properties demonstrated. However the lack of suitable analytical techniques has hampered the progress of identifying and exploiting more of these novel metabolites. In this review, we summarise the role of the secondary metabolites in cereal crop diseases and briefly touch on the analytical techniques that hold the key to unlocking their potential in reducing yield losses.
In patients with chronic renal failure, secondary hyperparathyroidism (sHPT) is a common problem requiring surgical parathyroidectomy (PTX) if medical treatment with active vitamin D and calcimimetics fails. To minimize the risk for recurrence, we perform total PTX (tPTX) without autotransplantation. From October 1997 to January 2004, 46 patients (31 men and 15 women) underwent tPTX without autotransplantation (median age 51
Sylvia Stracke; Frieder Keller; Gerald Steinbach; Doris Henne-Bruns; Peter Wuerl
Background Patients with acute coronary syndromes (ACS) are at increased risk of further acute cardiac events. Secondary prevention aims to decrease morbidity and mortality post-ACS. Depression is related to increased risk in this population, and to poorer secondary prevention activities. However, lengthy depression assessment techniques preclude depression assessment in routine care. The present study investigated the relationship of briefly-assessed depression with secondary prevention outcomes one year post-ACS. Methods Following ethics committee approval, hospitals recruited patients for a national survey of ACS. Consenting patients with ACS completed a brief depression scale during hospitalisation. The predictive validity of two brief scales was independently assessed, with groups combined for the overall sample. Participants then completed a one-year longitudinal follow-up postal survey of secondary prevention activities. Results The response rate for follow-up was 86% (n = 681). Proportions taking anti-platelet (88% v 87%; p = 0.334) and lipid-lowering (83% v 84%; p = 0.437) therapies remained unchanged. Prevalence of smoking (40% v 22%; p < 0.001), and median number of cigarettes smoked (20 v 10; p < 0.001) were significantly reduced at one year. Fifty-six per cent of patients reported attending cardiac rehabilitation programmes. Of those aged <65 years at baseline, 54% had returned to work at one year. A majority (56%) reported feeling physically better. Prevalence of depression was unchanged in those who completed a depression scale at both time points (15% v 17%; p = 0.434). Baseline depression did not predict taking anti-platelet, blood pressure or cholesterol medications (all p > 0.05), but did predict continuation of smoking (OR = 2.3, 95% CI 1.3–4.0, p = 0.003), a higher (above median) number of general practitioner visits (OR = 2.1, 95% CI 1.3–3.4, p = 0.005), failure to return to work (OR = 0.4, 95% CI 0.2–0.8, p = 0.015), and not feeling better (OR = 0.6, 95% CI 0.3–1.0, p = 0.05) at one year. Conclusion Rapid depression assessment can be used to help identify patients with ACS at risk of a range of poorer secondary prevention outcomes. The results provide support for the routine screening of depression in acute settings. Strategies to increase rates of smoking cessation, return to work, general well-being and decrease health service use by depressed patients may need to incorporate some element of treatment for depression.
McGee, Hannah M; Doyle, Frank; Conroy, Ronan M; De La Harpe, Davida; Shelley, Emer
Additional chromosomal aberrations occur frequently in Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) of childhood. The treatment outcome of these patients is heterogeneous. This study assessed whether such clinical heterogeneity could be partially explained by the presence and characteristics of additional chromosomal abnormalities. Cytogenetic descriptions were available for 249 of 326 children with Ph+ ALL, diagnosed and treated by 10 different study groups/large single institutions from 1986 to 1996. Secondary aberrations were present in 61% of the cases. Chromosomes 9, 22, 7, 14, and 8 were most frequently abnormal. Most (93%) karyotypes were unbalanced. Three main cytogenetic subgroups were identified: no secondary aberrations, gain of a second Ph and/or >50 chromosomes, or loss of chromosome 7, 7p, and/or 9p, while other secondary aberrations were grouped as combinations of gain and loss or others. Of the three main cytogenetic subgroups, the loss group had the worst event-free survival (P=0.124) and disease-free survival (P=0.013). However, statistical significance was not maintained when adjusted for other prognostic factors and treatment. Karyotypic analysis is valuable in subsets of patients identified by molecular screening, to assess the role of additional chromosomal abnormalities and their correlation with clinical heterogeneity, with possible therapeutic implications. PMID:15044926
Heerema, N A; Harbott, J; Galimberti, S; Camitta, B M; Gaynon, P S; Janka-Schaub, G; Kamps, W; Basso, G; Pui, C-H; Schrappe, M; Auclerc, M-F; Carroll, A J; Conter, V; Harrison, C J; Pullen, J; Raimondi, S C; Richards, S; Riehm, H; Sather, H N; Shuster, J J; Silverman, L B; Valsecchi, M G; Aricò, M
Background. Recurrent ischemic stroke is associated with adverse neurological outcome in patients with atrial fibrillation. There is very scarce information regarding the neurological outcome of atrial fibrillation patients undergoing repeated systemic thrombolysis after early recurrent ischemic stroke. Clinical Case and Discussion. We describe a case of a 76-year-old woman with known paroxysmal atrial fibrillation who was admitted because of an acute right middle cerebral artery ischemic stroke and who underwent repeated systemic thrombolysis within 110 hours. The patient underwent systemic thrombolysis after the first ischemic stroke with almost complete neurological recovery. On the fourth day after treatment, an acute left middle cerebral artery ischemic stroke was diagnosed and she was treated with full-dose intravenous recombinant tissue plasminogen activator. A hemorrhagic transformation of the left middle cerebral artery infarction was noted on follow-up cranial computed tomographic scans. The patient did not recover from the second cerebrovascular event and died 25 days after admission. Conclusion. To the best of our knowledge, this is the second case reporting the adverse neurological outcome of a patient with diagnosis of atrial fibrillation undergoing repeated systemic thrombolysis after early recurrent ischemic stroke. Our report represents a contribution to the scarce available evidence suggesting that repeated systemic thrombolysis for recurrent ischemic stroke should be avoided.
Sposato, Luciano A.; Salutto, Valeria; Beratti, Diego E.; Monti, Paula; Riccio, Patricia M.; Mazia, Claudio
Objective To establish occurrence, method of injury, length of stay (LOS), psychiatric diagnosis, rehabilitation outcome, and demographic data for those admitted to a Scottish Spinal Injuries Rehabilitation Unit as a consequence of deliberate self-harm (DSH). Design A retrospective audit of case-notes and electronic databases of admissions and rehabilitation outcome in a spinal cord injury (SCI) unit where the mechanism of injury was (DSH). Results Forty-six (44 having detailed data available) patients were identified with 95% of injuries resulting from falls. Thirty-six people had pre-existing mental health problems (82%) with 15 (34%) having this diagnosis established shortly after admission. Seventy-five per cent received follow-up from mental health services. Ninety-five per cent returned to their pre-injury (or similar) residence. LOS and functional independence measure (FIM) for the DSH group were compared with a non-DSH group. No differences were found in those with SCI. LOS was significantly longer in the patients with vertebral fracture and no neurological impairment (32 versus 22 days). Sixty-four per cent of those who had self-harmed had substance dependence problems. The predominance of falls (63%) occurred in a residential setting. Annual admissions due to individuals self-harming were stable across the studied period. Conclusions Spinal column fracture in the DSH group is predominantly caused by falls. High levels of mental health and substance abuse problems are noted necessitating formal mental health assessment and follow-up. DSH as a mechanism for injury appears to have a significant impact on LOS only if the patient has fracture without SCI. Immediate rehabilitation outcomes are similar to that of non-DSH group.
This study examined the reliability and validity evidence drawn from the scores of the Spanish version of the Achievement Goal Tendencies Questionnaire (AGTQ) using a sample of 2,022 (51.1% boys) Spanish students from grades 7 to 10. Confirmatory factor analysis replicated the correlated three-factor structure of the AGTQ in this sample: Learning…
Ingles, Candido J.; Garcia-Fernandez, Jose M.; Castejon, Juan L.; Valle, Antonio; Delgado, Beatriz; Marzo, Juan C.
Background The efficacy of antihypertensive (AH) treatment after stroke has been investigated in several randomized clinical trials. However, non-adherence to AH medication is common for stroke patients in “real world” setting. The purpose of this study was to assess the impact of persistence with AH agents on ischemic stroke (IS) outcomes. Methods and Results Using the China National Stroke Registry, we analyzed data from 8409 IS patients with hypertension. Persistence with AH therapy (high persistence ?75%, low persistence <75%) was measured by patient self-report at 3, 6, and 12 months after stroke. Multivariate logistic regression model was used to assess the relationship between persistence and IS outcomes (stroke recurrence, combined vascular events and death) at 12 months. Of the 8409 patients in this study, 40.0% were female and the mean age at study entry was 66.7 years. 31.6% of patients had high persistence with AH drugs, and 68.4% had low persistence during 1 year after stroke onset. High persistence with AH drugs significantly decreased the risk of stroke recurrence (odds ratio, 0.78; 95% CI, 0.68 to 0.89), combined vascular events (0.71; 0.63–0.81) and death (0.44; 0.36–0.53) compared with low persistence. Conclusions Our study reinforces the benefits of AH medications in routine clinical practice and highlights the importance of persistence with AH therapy among IS patients known to be hypertensive within the first year of an event.
Background Zheng represents pattern differentiation in Traditional Chinese Medicine (TCM), as the basic unit and a key concept in TCM therapeutic theory, is based on the physiology and pathology of TCM. None of the outcome measurements of atopic dermatitis (AD) are Zheng-specific. The effectiveness of TCM is likely to be underestimated without a Zheng-related symptom-specific instrument. The aim of this study was to develop an instrument for measuring the Zheng-related symptom-specific status of patients with AD. Methods We followed standard methodology to develop the instrument, including item generation and selection, item reduction and presentation, and pretesting, and recruited 188 patients with AD involved in a six-center randomized-controlled trial (ChiCTR-TRC-08000156) to validate the questionnaire. We conducted construct validity, reliability, and responsiveness analysis. The standardized effect size (SES) and standardized response mean (SRM) were used to calculate the responsiveness of additional items and the total score for the rating items. Results ZRADSQ has 15 items, with 12 rating items and 3 additional items. The 12 rating items fall within three domains: AD symptoms (n?=?6 items); Heat (n?=?4 items) and Mood (n?=?2 items). Confirmatory factor analysis provided good support for a three-factor model (d.f.?=?51, x2=97.11, RMSEA?=?0.07, CFI?=?0.96), and the Pearson’s correlation coefficient between ZRADSQ and Severity Scoring of Atopic Dermatitis (SCORAD) was 0.40 (P?0.001). The reliability was also good, with a Cronbach’s alpha value for ZRADSQ of 0.84, a split-half coefficient of 0.75, and a test-retest reliability coefficient of 0.98. The standardized effect size and standardized response mean were close to or larger than 1, which indicated moderate to good responsiveness. Conclusions The ZRADSQ demonstrates promising reliability, validity, and responsiveness. It can be used to determine whether Zheng-specific or symptom-specific treatments relieve the symptom that is most bothersome the patient.
Amyloid fibrils can affect vascular structure through deposition and by causing nitric oxide depletion and increase of asymmetric dimethyl arginine. Patients with amyloidosis are prone to development of hypotension. Hypotension may also affect the maturation of arteriovenous fistula (AVF) and may set the stage for formation of thrombosis and fistula failure. Thus, we aimed to evaluate effects of secondary amyloidosis on AVF outcomes and intradialytic hypotension. This is a case-control study which included 20 hemodialysis patients with amyloidosis and 20 hemodialysis patients without amyloidosis as control group. All patients underwent Doppler ultrasound of AVF. A thorough fistula history and baseline laboratory values along with episodes of intradialytic hypotension and blood pressure measurements were recorded. There was no difference between the groups regarding age, gender, body mass index, presence of comorbidities, hypertension, and drug use. Systolic and diastolic blood pressures were similar (119?±?28/75?±?17 and 120?±?14/75?±?10?mmHg for patients with and without amyloidosis, respectively). Intradialytic hypotension episodes were also similar. Patients with amyloidosis had significantly lower serum albumin and higher C-reactive protein values compared to control hemodialysis patients. AVF sites and total number of created fistulas were similar in both groups. Flow rates of current functional AVFs were not different between the groups (1084?±?875 and 845?±?466?mL/minute for patients with and without amyloidosis, respectively, p:0.67). Patency duration of first AVF was not different between the groups. Clinical fistula outcomes and rate of intradialytic hypotension episodes were not significantly different between patients with and without secondary systemic amyloidosis. PMID:22360544
Background “Referral” characterises a significant area of interaction between primary and secondary care. Despite advantages, it can be inflexible, and may lead to duplication. Objective To examine the outcomes of an integrated model that lends weight to general practitioner (GP)?led evidence based care. Design A prospective, non?random comparison of two services: women attending the new (Bridges) pathway compared with those attending a consultant?led one?stop menstrual clinic (OSMC). Patients' views were examined using patient career diaries, health and clinical outcomes, and resource utilisation. Follow?up was for 8?months. Setting A large teaching hospital and general practices within one primary care trust (PCT). Results Between March 2002 and June 2004, 99 women in the Bridges pathway were compared with 94 women referred to the OSMC by GPs from non?participating PCTs. The patient career diary demonstrated a significant improvement in the Bridges group for patient information, fitting in at the point of arrangements made for the patient to attend hospital (ease of access) (p<0.001), choice of doctor (p?=?0.020), waiting time for an appointment (p<0.001), and less “limbo” (patient experience of non?coordination between primary and secondary care) (p<0.001). At 8?months there were no significant differences between the two groups in surgical and medical treatment rates or in the use of GP clinic appointments. Significantly fewer (traditional) hospital outpatient appointments were made in the Bridges group than in the OSMC group (p<0.001). Conclusion A general practice?led model of integrated care can significantly reduce outpatient attendance while improving patient experience, and maintaining the quality of care.
AIM To evaluate the predictors of visual improvement in eyes with naive choroidal neovascularization secondary to age-related macular degeneration (CNV -AMD) treated with intravitreal bevacizumab (IVB) monotherapy. METHODS Fifty eyes with naive CNV- AMD with pretreatment best-corrected visual acuity (BCVA) better than 20/200 and treated with IVB monotherapy were evaluated. Several variables including age, sex, pre-treatment BCVA, CNV type and lesion size on fluorescein angiogram as well as SD-OCT parameters including pre-treatment central macular thickness (CMT), inner-segment/outer-segment (IS/OS) junction integrity, and external limiting membrane (ELM) integrity were analyzed to predict visual outcome. RESULTS On univariate regression, pretreatment ELM damage was associated with less visual improvement after treatment (P=0.0145). However, ELM damage predicted only 10% of the visual outcome. On multivariate regression, pretreatment BCVA, IS/OS junction, and ELM integrity on SD-OCT were the significant predictors for the treatment effect and together predicted 37% of visual improvement. CONCLUSION Pretreatment BCVA, ELM and IS/OS junction integrity on SD-OCT are of significant value in predicting the visual improvement in naive wet AMD patients treated with IVB monotherapy.
Chhablani, Jay; Kim, Jae Suk; Freeman, William R; Kozak, Igor; Wang, Hai-Yan; Cheng, Lingyun
The CHOIR trial in anemic patients with chronic kidney disease compared epoetin-alfa treatment with low (11.3 g/l) and high (13.5 g/l) hemoglobin targets on the composite end point of death, hospitalization for heart failure, stroke, and myocardial infarction. However, other anemia management trials in patients with chronic kidney disease found there was increased risk when hemoglobin is targeted above 13 g/dl. In this secondary analysis of the CHOIR trial, we compared outcomes among the subgroups of patients with diabetes and heart failure to describe the comparative relationship of treatment to these two different hemoglobin goals. By Cox regression analysis, there was no increased risk associated with the higher hemoglobin target among patients with heart failure. In patients without heart failure, however, the hazard ratio (1.86) associated with the higher target was significant. Comparing survival curves in an unadjusted model, patients with diabetes did not have a greater hazard associated with the higher target. Subjects without diabetes had a significantly greater hazard in the high as compared to the low target, but the interaction between diabetes and the target was not significant. We suggest that the increased risks associated with higher hemoglobin targets are not clinically apparent among subgroups with greater mortality risk. These differential outcomes underscore the need for dedicated trials in these subpopulations. PMID:19890274
Szczech, Lynda A; Barnhart, Huiman X; Sapp, Shelly; Felker, G Michael; Hernandez, Adrian; Reddan, Donal; Califf, Robert M; Inrig, Jula K; Patel, Uptal D; Singh, Ajay K
A study examined the outcomes for 140 graduates of the Threshold Program at Lesley University, Massachusetts, a non-degree post-secondary program which aims to help young adults with severe learning disabilities and low-average IQ develop independent living skills. Sixty-nine percent of graduates are living independently and 82 percent are…
ObjectiveThis paper describes the development and validation of the Health Education Impact Questionnaire (heiQ). The aim was to develop a user-friendly, relevant, and psychometrically sound instrument for the comprehensive evaluation of patient education programs, which can be applied across a broad range of chronic conditions.
Richard H. Osborne; Gerald R. Elsworth; Kathryn Whitfield
This study aimed to determine whether primary surgical closure of patent ductus arteriosus (PDA) is a risk factor for morbidity and mortality compared with secondary surgical ligation. The study enrolled 178 very-low-birth-weight infants. The surgical group included 34 patients who did not respond to pharmacologic intervention and eventually required ligation of their PDA as well as 35 patients who underwent direct ligation because of contraindications to the use of oral ibuprofen. The overall outcomes for the primary and secondary ligation groups were compared. The outcome during hospitalization showed no statistically significant difference in terms of morbidity and mortality between the two groups. The group that had primary ligation for PDA experienced more complications associated with premature birth such as lower gestational age and birth weight. The two groups did not differ significantly in terms of overall outcomes. PMID:24370764
Objective To develop and validate a comprehensive patient-reported outcomes instrument focusing on the impact of dry eye on everyday life (IDEEL). Methods Development and validation of the IDEEL occurred in four phases: 1) focus groups with 45 dry eye patients to develop a draft instrument, 2) item generation, 3) pilot study to assess content validity in 16 patients and 4) psychometric validation in 210 subjects: 130 with non-Sjögren's keratoconjunctivitis sicca, 32 with Sjögren's syndrome and 48 controls, and subsequent item reduction. Results Focus groups identified symptoms and the associated bother, the impact of dry eye on daily life and the patients' satisfaction with their treatment as the central concepts in patients' experience of dry eye. Qualitative analysis indicated that saturation was achieved for these concepts and yielded an initial 112-item draft instrument. Patients understood the questionnaire and found the items to be relevant indicating content validity. Patient input, item descriptive statistics and factor analysis identified 55 items that could be deleted. The final 57-item IDEEL assesses dry eye impact constituting 3 modules: dry eye symptom-bother, dry eye impact on daily life comprising impact on daily activities, emotional impact, impact on work, and dry eye treatment satisfaction comprising satisfaction with treatment effectiveness and treatment-related bother/inconvenience. The psychometric analysis results indicated that the IDEEL met the criteria for item discriminant validity, internal consistency reliability, test-retest reliability and floor/ceiling effects. As expected, the correlations between IDEEL and the Dry Eye Questionnaire (a habitual symptom questionnaire) were higher than between IDEEL and Short-Form-36 and EuroQoL-5D, indicating concurrent validity. Conclusion The IDEEL is a reliable, valid and comprehensive questionnaire relevant to issues that are specific to dry eye patients, and meets current FDA patient-reported outcomes guidelines. The use of this questionnaire will provide assessment of the impact of dry eye on patient dry eye-related quality of life, impact of treatment on patient outcomes in clinical trials, and may aid in treatment effectiveness evaluation.
Background Pre-eclampsia has an immense adverse impact on maternal and perinatal health especially in low- and middle-income settings. We aimed to estimate the associations between pre-eclampsia/eclampsia and its risk factors, and adverse maternal and perinatal outcomes. Methods We performed a secondary analysis of the WHO Global Survey on Maternal and Perinatal Health. The survey was a multi-country, facility-based cross-sectional study. A global sample consisting of 24 countries from three regions and 373 health facilities was obtained via a stratified multi-stage cluster sampling design. Maternal and offspring data were extracted from records using standardized questionnaires. Multi-level logistic regression modelling was conducted with random effects at the individual, facility and country levels. Results Data for 276,388 mothers and their infants was analysed. The prevalence of pre-eclampsia/eclampsia in the study population was 10,754 (4%). At the individual level, sociodemographic characteristics of maternal age ?30 years and low educational attainment were significantly associated with higher risk of pre-eclampsia/eclampsia. As for clinical and obstetric variables, high body mass index (BMI), nulliparity (AOR: 2.04; 95%CI 1.92–2.16), absence of antenatal care (AOR: 1.41; 95%CI 1.26–1.57), chronic hypertension (AOR: 7.75; 95%CI 6.77–8.87), gestational diabetes (AOR: 2.00; 95%CI 1.63–2.45), cardiac or renal disease (AOR: 2.38; 95%CI 1.86–3.05), pyelonephritis or urinary tract infection (AOR: 1.13; 95%CI 1.03–1.24) and severe anemia (AOR: 2.98; 95%CI 2.47–3.61) were found to be significant risk factors, while having >8 visits of antenatal care was protective (AOR: 0.90; 95%CI 0.83–0.98). Pre-eclampsia/eclampsia was found to be a significant risk factor for maternal death, perinatal death, preterm birth and low birthweight. Conclusion Chronic hypertension, obesity and severe anemia were the highest risk factors of preeclampsia/eclampsia. Implementation of effective interventions prioritizing risk factors, provision of quality health services during pre-pregnancy and during pregnancy for joint efforts in the areas of maternal health are recommended.
Bilano, Ver Luanni; Ota, Erika; Ganchimeg, Togoobaatar; Mori, Rintaro; Souza, Joao Paulo
Sexual function outcomes were analyzed in a group of women (n = 78) presenting for vaginal rejuvenation/vaginoplasty procedure for a chief complaint of vaginal laxity and decreased sensation with intercourse. Outcomes were analyzed utilizing the validated Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) before and at least 6 months after repair with vaginal rejuvenation/vaginoplasty procedure (VR). Mean age was 43.6 ± 7.9 (range 25-62), and 19 patients (24.3%) were found to have prolapse at time of initial exam and underwent vaginal vault suspension in addition to VR. Compared preoperatively and postoperatively, the overall sexual function (Total PISQ-12) statistically improved (30.3 ± 6.6 vs. 38.2 ± 5.2, P < 0.001). All individual scores statistically improved except in 3 categories in which there was no change (Q1-desire, Q5-pain, and Q11- partner premature ejaculation). Overall sexual satisfaction improved as well as subcategories of increased sexual excitement during intercourse and overall increase in intensity of orgasms. Pain with intercourse subscores were found to be no different from preoperatively to postoperatively. Previous studies have shown that sexual function improves with repair of prolapse; however, this is the first study to show improved function using a validated questionnaire in patients undergoing VR for laxity. PMID:24700228
Moore, Robert D; Miklos, John R; Chinthakanan, Orawee
In the Netherlands, educational attainment is the result of a sequence of separate educational transitions. Because of the tracked nature of the Dutch educational system, students do not make binary stay-or-leave-decisions at each transition. After having entered one track of secondary education, students can change tracks during the entire…
This cross sectional observational study was done in Department of Obs & Gynae, General Hospital Tangail, to find out the maternal and fetal outcome of eclamptic admitted patient in secondary care hospital in Bangladesh. Study period was Jan 2008 to Dec 2008. Sample size was 100. During this period total 4727 patients were admitted among them 124(2.62%) were eclamptic patients. From that 124 patients 100 cases were randomly included. Among all patients 80% had age <25 years and 62% were primigravidae. Maximum (75%) patients had antepartum eclampsia. Postpartum and intrapartum eclampsia were 18% and 7% accordingly. Among all patients, 45% had primary education and 36% were illiterate. Most of the patients (73%) were from below average class family. Fifty two percent (52%) patients had >37 weeks completed pregnancy. Maximum patients (91%) had no or infrequent antenatal check-up. All the patients had convulsion before admission and 85% were unconscious. Among total patients 55% were delivered by lower uterine caesarian section and 45% were delivered by vaginal route. Maximum 74(74%) patients could not reached hospital within 4 hours of first convulsion. Time interval between the first convulsion and delivery was <12 hours in 72% cases. In 98(98%) cases magnesium sulphate (MgSO?) and in 2% of cases diazepam was used as anticonvulsant. Complications of eclampsia were found in 30% cases. Complications were pulmonary edema, PPH, CVA, HELLP syndrome, obstetric shock, DIC, acute renal failure. Among all 9(9%) patients were expired. Causes of maternal death were pulmonary edema, heart failure, CVA, HELLP syndrome. Maternal morbidities after delivery were observed in 53% cases. Recorded morbidities were infection, CVA and hypertension. Among 100 cases 87 were live born and 13 were still born. Out of 87 live born babies 50 were needed admission. Among admitted neonates 11 were died in the first week. Causes of early neonatal death were perinatal asphyxia, septicemia and prematurity. Among 100 deliveries 66% had low birth weight (LBW). Among 11 neonatal death, 9(81%) had low birth weight. In this study we observe maternal mortality, still born, early neonatal death and perinatal mortality rates are still high. So, this study implicates to improve the existing management of eclampsia. PMID:23982543
Parna, F H; Latif, T; Sultana, N; Ali, M A; Chowdhury, S B
Aims: A low level of response (LR), or low sensitivity, to alcohol as established by alcohol challenges has been shown to predict future heavier drinking, alcohol-related problems and alcohol use disorders. To date, only one study has evaluated the predictive validity of a second measure of LR as determined by the Self-Report of the Effects of Alcohol (SRE) Questionnaire. The current analyses evaluate the ability of SRE scores as determined at age 12 to predict heavier drinking and alcohol-related problems 2 years later in a sample from the United Kingdom. Methods: The subjects were 156 boys (54.5%) and girls from the Avon Longitudinal Study of Parents and Children (ALSPAC) who had reported consuming one or more standard drinks by age 12 and who were followed up 2 years later. Results: The age 12 SRE scores correlated with the number of drinks per week, maximum drinks and the number of alcohol problems both at baseline and at age 14 follow-ups. In these evaluations, a larger number of drinks required for effects on the SRE (i.e. a lower LR per drink consumed) related to heavier intake and alcohol-related difficulties. Simultaneous entry multiple regression analyses revealed that the age 12 SRE score maintained a significant relationship with age 14 higher number of drinks per week and the number of alcohol problems even when the age 12 values for alcohol intake and problems were used as covariates. Conclusion: The SRE scores appear to have value in predicting future heavier drinking and alcohol problems in 12-year olds that go beyond the information offered by the earlier drinking pattern alone.
Schuckit, Marc A.; Smith, Tom L.; Trim, Ryan S.; Heron, Jon; Horwood, Jeremy; Davis, John; Hibbeln, Joseph
It has long been assumed that schools which were "effective" with respect to one set of outcomes (usually academic performance) were generally more "effective" in relation to others. This article reviews the last three decades of British evidence across a range of affective, social and other non-cognitive outcomes including: pupils' attitudes to…
This prospective study was carried out at the Cleft Lip and Palate Centre at King Abdullah University Hospital and Maxillofacial Unit at Jordan University of Science and Technology during the period of 2000 to 2006. The sample consisted of 77 secondary alveolar bone grafts (62 patients), which were performed according to the same standardized surgical technique by a single maxillofacial surgeon. The objective was to assess the outcome of secondary alveolar bone grafting (SABG) before (early SABG) and after (late SABG) the eruption of the permanent maxillary canine in unilateral and bilateral Jordanian cleft subjects. Patients were divided into four groups: early unilateral SABG (22), late unilateral SABG (25), early bilateral SABG (8), and late bilateral SABG (7). Follow-up period ranged from 6 months to 5 years. Periapical or occlusal radiographs were used to assess the outcome of SABG. The degree of bony fill in the cleft area was assessed using the 4-point Kindelan scale. Only Grade 1 (more than 75% bony fill) cases were considered successful. Early unilateral SABG had a success rate of 90% while late unilateral SABG rate was 80%. The overall success rate of the unilateral SABG (85%) was higher than the rate for the bilateral cases (56%). Our findings support the conclusion that the outcome of early SABG is superior to late SABG. The overall success rate of SABG sample (74%) compared relatively well with other published results. PMID:17993877
Background Postal questionnaires are simple and economical for collecting outcome data for randomised controlled trials (RCTs) but are prone to non-response. In the RECORD trial (a large pragmatic publicly funded RCT in UK) non-responders were sent a reminder and another questionnaire at 1 year, of which 40% were returned. In subsequent years we investigated the effect of an advance telephone call to non-responders on responses rate to reminder questionnaires and the next questionnaire 4 months later. Methods Non-responders to annual questionnaires were randomised to receive a telephone call from the trial office ahead of the reminder questionnaire in addition to the usual reminder schedule (n?=?390) or to a control group that received the usual reminder schedule only (n?=?363). The primary outcome was response to the reminder questionnaire within 21 days; secondaryoutcomes were response to a questionnaire 4 months later; completeness of quality of life instruments; and the number of participants declining further follow-up. Results are presented as odds ratios from a logistic regression intention-to-treat (ITT) analysis and then percentage difference and 95% confidence intervals (CI) for both ITT and average treatment effect on the treated (ATT) analyses. Results The proportions that responded were 67.8% (265/390) in the intervention group compared to 62.5% (227/363) in the control group. The ITT estimate was a 5.4% increase (95% CI ?1.4 to 12.2). Four months later percentages responding were 51.8% (202) and 42.7% (155). The ITT estimate was a 9.1% increase (95% CI 2.0 to 16.2). In the intervention group 12.3% (48/390) of participants were not telephoned because questionnaires were returned before the scheduled telephone call. ATT estimates adjusting for this were 6.2% (95% CI ?1.6 to 14.0) and 10.4% (95% CI 2.2 to 18.5), respectively. Conclusions The telephone call resulted in a slight increase in response to the reminder questionnaire, however at 4 months later the proportion in the telephoned group responding was greater. This study suggests that pre-notification telephone calls may only be worthwhile if further questionnaires are to be sent out soon after reminder questionnaires. Trial registration Current Clinical Trials ISRCTN51647438
Background. We analyzed the public STAR*D database to better characterize the baseline clinical characteristics and functional outcomes of patients with major depressive disorder (MDD) who experienced partial response in order to better understand the burden associated with this outcome. Method. Patients (n=2,876) received treatment with citalopram. The last available Quick Inventory of Depressive Symptoms (QIDS-SR) from the 12-week treatment period was used to assign subjects to one of three groups: remitters QIDS-SR?5; non-responders QIDS-SR >5 and <25% reduction from baseline; and partial responders QIDS-SR >5 and ?25% reduction from baseline. Baseline sociodemographic and clinical characteristics were compared across groups, as well as functional outcomes at Level 1 exit. Results. Of the 2,876 patients, 943 patients (33%) were classified as remitters, 1069 (37%) as partial responders, and 854 (30%) as non-responders. The groups differed on a number of pre-treatment course of illness variables and comorbidities. In addition, remitters, partial responders, and non-responders all separated on posttreatment quality of life and functional outcomes at Level 1 exit. Conclusion. Partial responders demonstrated significant functional impairment at Level 1 exit, differing significantly from the patients who remitted on quality of life, mental and physical functioning, and social and work-related impairment. Adjusted outcomes showed similar differences. Differences in baseline rates of suicidality, comorbidity, and atypical presentations of depression were also observed between outcome groups. Given the substantial clinical and economic burden associated with functional impairment in depression, the need to fully treat partially responding patients to achieve depression remission and restoration of functioning is highlighted by this work. (Journal of Psychiatric Practice 2014;20:178-187). PMID:24847991
Dennehy, Ellen B; Marangell, Lauren B; Martinez, James; Balasubramani, G K; Wisniewski, Stephen R
We examined the association between the therapeutic alliance and treatment outcomes among 223 women with posttraumatic stress disorder (PTSD) and substance use disorders who participated in a multisite clinical trial of group treatments for trauma and addictions in the United States throughout 2004 and 2005. General linear models indicated that women who received Seeking Safety, a cognitive-behavioral treatment, had significantly higher alliance ratings than those in Women's Health Education, a control group. Alliance was related to significant decreases in PTSD symptoms and higher attendance in both interventions. Alliance was not related to substance use outcomes. Implications and limitations of the findings are discussed.
Ruglass, Lesia M.; Miele, Gloria M.; Hien, Denise A.; Campbell, Aimee N. C.; Hu, Mei-Chen; Caldeira, Nathilee; Jiang, Huiping; Litt, Lisa; Killeen, Therese; Hatch-Maillette, Mary; Najavits, Lisa; Brown, Chanda; Robinson, James A.; Brigham, Gregory S.; Nunes, Edward V.
Background Individual work performance is an important outcome measure in studies in the workplace. Nevertheless, its conceptualization and measurement has proven challenging. To overcome limitations of existing scales, the Individual Work Performance Questionnaire (IWPQ) was recently developed. The aim of the current study was to gain insight into the responsiveness of the IWPQ. Methods Data were used from the Be Active & Relax randomized controlled trial. The aim of the trial was to investigate the effectiveness of an intervention to stimulate physical activity and relaxation of office workers, on need for recovery. Individual work performance was a secondaryoutcome measure of the trial. In total, 39 hypotheses were formulated concerning correlations between changes on the IWPQ scales and changes on similar constructs (e.g., presenteeism) and distinct constructs (e.g., need for recovery) used in the trial. Results 260 Participants completed the IWPQ at both baseline and 12 months of follow-up. For the IWPQ scales, 23%, 15%, and 38%, respectively, of the hypotheses could be confirmed. In general, the correlations between change scores were weaker than expected. Nevertheless, at least 85% of the correlations were in the expected direction. Conclusions Based on results of the current study, no firm conclusions can be drawn about the responsiveness of the IWPQ. Several reasons may account for the weaker than expected correlations. Future research on the IWPQ’s responsiveness should be conducted, preferably in other populations and intervention studies, where greater changes over time can be expected.
Additional chromosomal aberrations occur frequently in Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) of childhood. The treatment outcome of these patients is heterogeneous. This study assessed whether such clinical heterogeneity could be partially explained by the presence and characteristics of additional chromosomal abnormalities. Cytogenetic descriptions were available for 249 of 326 children with Ph+ ALL, diagnosed and treated by
N A Heerema; J Harbott; S Galimberti; B M Camitta; P S Gaynon; G Janka-Schaub; W Kamps; G Basso; C-H Pui; M Schrappe; M-F Auclerc; A J Carroll; V Conter; C J Harrison; J Pullen; S C Raimondi; S Richards; H Riehm; H N Sather; J J Shuster; L B Silverman; M G Valsecchi; M Aricò
Objectives Though it is the largest county in the lower United States, minimal attention has been given to the elevated rates of poor perinatal outcomes and infant mortality in San Bernardino County. This study sought to analyze adverse birth outcomes such as low birth weight, and infant mortality as an outcome of specific proxy maternal sociodemographic factors. Methods Data from the California Department of Health Services Office of Vital Statistics birth cohort of mothers delivering between 1999 and 2001 (N = 1,590,876 participants) were analyzed. Of those, 5.5% (n = 86,736) were births in San Bernardino County. Low birth weight, very low birth weight, death in infants less than one year of age, and other maternal sociodemographic factors were explored. All events of low birth weight and deaths among infants less than one year of age were used as significant variables in statistical models. Results Black mothers experienced more than twice the rate of very low birth weight (3.89) than their White counterparts (1.39). The most significant contributors to adverse birth outcomes among Black women were length of gestation and maternal education, whereas the most significant predictor of infant mortality was birth weight. Conclusions This study demonstrates that traditional risk factors such as length of gestation and maternal age only partially explain adverse birth outcomes. These findings highlight the need to advocate for the systematic collection of data on maternal education and length gestation and for the promotion of public health initiatives that address these inequities in our most vulnerable of populations. PMID:17690961
Nanyonjo, Rebecca D; Montgomery, Susanne B; Modeste, Naomi; Fujimoto, Edward
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 potential…
Background The cost to the NHS of missed or inappropriate hospital appointments is considerable. Alternative methods of appointment scheduling might be more flexible to patients’ needs without jeopardising health and service quality. The objective was to systematically review evidence of patient initiated clinics in secondary care on patient reported outcomes among patients with chronic/recurrent conditions. Methods Seven databases were searched from inception to June 2013. Hand searching of included studies references was also conducted. Studies comparing the effects of patient initiated clinics with traditional consultant led clinics in secondary care for patients with long term chronic or recurrent diseases on health related quality of life and/or patient satisfaction were included. Data was extracted by one reviewer and checked by a second. Results were synthesised narratively. Results Seven studies were included in the review, these covered a total of 1,655 participants across three conditions: breast cancer, inflammatory bowel disease and rheumatoid arthritis. Quality of reporting was variable. Results showed no significant differences between the intervention and control groups for psychological and health related quality of life outcomes indicating no evidence of harm. Some patients reported significantly more satisfaction using patient-initiated clinics than usual care (p 0.001). Conclusions The results show potential for patient initiated clinics to result in greater patient and clinician satisfaction. The patient-consultant relationship appeared to play an important part in patient satisfaction and should be considered an important area of future research as should the presence or absence of a guidebook to aid self-management. Patient initiated clinics fit the models of care suggested by policy makers and so further research into long term outcomes for patients and service use in this area of practice is both relevant and timely.
Laparoscopic surgery has been demonstrated as a valid approach in almost all gynaecologic procedures including malignant diseases. Benefits of the minimally invasive approach over traditional open surgery have been well demonstrated in terms of minimal perioperative morbidity and reduced postoperative pain and hospital stay duration, with consequent quick postoperative recovery (Medeiros et al. (2009)). Single-port surgery resurfaced in gynaecology surgery in recent years and renewed interest among other surgeons and within the industry to develop this field (Podolsky et al. (2009)). Patient satisfaction is emerging as an increasingly important measure of quality which represents a complex entity that is dependent on patient demographics, comorbidities, disease, and, to a large extent, patient expectations (Tomlinson and Ko (2006)). It can be broadly thought to refer to all relevant experiences and processes associated with health care delivery (Jackson et al. (2001)). In this study we aim to compare single-port surgery (SPS) with conventional laparoscopy in terms of patient satisfaction using the EORTC IN-PATSAT32 questionnaire. We also evaluate the main surgical outcomes of both minimally invasive approaches.
Laparoscopic surgery has been demonstrated as a valid approach in almost all gynaecologic procedures including malignant diseases. Benefits of the minimally invasive approach over traditional open surgery have been well demonstrated in terms of minimal perioperative morbidity and reduced postoperative pain and hospital stay duration, with consequent quick postoperative recovery (Medeiros et al. (2009)). Single-port surgery resurfaced in gynaecology surgery in recent years and renewed interest among other surgeons and within the industry to develop this field (Podolsky et al. (2009)). Patient satisfaction is emerging as an increasingly important measure of quality which represents a complex entity that is dependent on patient demographics, comorbidities, disease, and, to a large extent, patient expectations (Tomlinson and Ko (2006)). It can be broadly thought to refer to all relevant experiences and processes associated with health care delivery (Jackson et al. (2001)). In this study we aim to compare single-port surgery (SPS) with conventional laparoscopy in terms of patient satisfaction using the EORTC IN-PATSAT32 questionnaire. We also evaluate the main surgical outcomes of both minimally invasive approaches. PMID:24371418
Aim To determine the 2-year outcomes of intravitreal bevacizumab (IVB) injections in eyes with macular oedema (ME) following branch retinal vein occlusion (BRVO). Methods Of 105 consecutive eyes (105 treatment-naïve patients) with ME following BRVO, 89 eyes were followed for 2?years after the first injection. During the 2-year follow-up period, patients were examined at least every 3?months and received an IVB injection (1.25?mg/0.05?mL) if they met prespecified retreatment criteria. Rescue grid laser was permitted based on the findings of the Branch Vein Occlusion Study. Results The baseline logarithm of the minimum angle of resolution visual acuity (VA) was 0.64±0.24 (mean±SD), which significantly (p=0.001) improved 1?month after the first injection to 0.39±0.22. One year after the first injection, VA improved significantly (p=0.001) to 0.33±0.21 and remained 0.34±0.21 until 2?years after the first injection (p=0.001). The changes in foveal thickness were correlated with those of VA during the 2-year follow-up period with a mean of 3.8±1.5 injections (including the first injection). Conclusions This relatively large case series study showed favourable 2-year outcomes using bevacizumab to treat ME following BRVO. Bevacizumab provides substantial long-term benefits in the treatment of ME following BRVO.
Mechanisms governing the inflammatory response during sepsis have been shown to be complex, involving cross-talk between diverse signaling pathways. Current knowledge regarding the mechanisms underlying sepsis provides an incomplete picture of the syndrome, justifying additional efforts to understand this condition. Microarray-based expression profiling is a powerful approach for the investigation of complex clinical conditions such as sepsis. In this study, we investigate whole-genome expression profiles in mononuclear cells from survivors (n = 5) and non-survivors (n = 5) of sepsis. To circumvent the heterogeneity of septic patients, only patients admitted with sepsis caused by community-acquired pneumonia were included. Blood samples were collected at the time of sepsis diagnosis and seven days later to evaluate the role of biological processes or genes possibly involved in patient recovery. Principal Components Analysis (PCA) profiling discriminated between patients with early sepsis and healthy individuals. Genes with differential expression were grouped according to Gene Ontology, and most genes related to immune defense were up-regulated in septic patients. Additionally, PCA in the early stage was able to distinguish survivors from non-survivors. Differences in oxidative phosphorylation seem to be associated with clinical outcome because significant differences in the expression profile of genes related to mitochondrial electron transport chain (ETC) I-V were observed between survivors and non-survivors at the time of patient enrollment. Global gene expression profiles after seven days of sepsis progression seem to reproduce, to a certain extent, patterns collected at the time of diagnosis. Gene expression profiles comparing admission and follow-up samples differed between survivors and non-survivors, with decreased expression of genes related to immune functions in non-survivors. In conclusion, genes related to host defense and inflammatory response ontology were up-regulated during sepsis, consistent with the need for a host response to infection, and the sustainability of their expression in follow-up samples was associated with outcomes. PMID:24667684
Mechanisms governing the inflammatory response during sepsis have been shown to be complex, involving cross-talk between diverse signaling pathways. Current knowledge regarding the mechanisms underlying sepsis provides an incomplete picture of the syndrome, justifying additional efforts to understand this condition. Microarray-based expression profiling is a powerful approach for the investigation of complex clinical conditions such as sepsis. In this study, we investigate whole-genome expression profiles in mononuclear cells from survivors (n?=?5) and non-survivors (n?=?5) of sepsis. To circumvent the heterogeneity of septic patients, only patients admitted with sepsis caused by community-acquired pneumonia were included. Blood samples were collected at the time of sepsis diagnosis and seven days later to evaluate the role of biological processes or genes possibly involved in patient recovery. Principal Components Analysis (PCA) profiling discriminated between patients with early sepsis and healthy individuals. Genes with differential expression were grouped according to Gene Ontology, and most genes related to immune defense were up-regulated in septic patients. Additionally, PCA in the early stage was able to distinguish survivors from non-survivors. Differences in oxidative phosphorylation seem to be associated with clinical outcome because significant differences in the expression profile of genes related to mitochondrial electron transport chain (ETC) I–V were observed between survivors and non-survivors at the time of patient enrollment. Global gene expression profiles after seven days of sepsis progression seem to reproduce, to a certain extent, patterns collected at the time of diagnosis. Gene expression profiles comparing admission and follow-up samples differed between survivors and non-survivors, with decreased expression of genes related to immune functions in non-survivors. In conclusion, genes related to host defense and inflammatory response ontology were up-regulated during sepsis, consistent with the need for a host response to infection, and the sustainability of their expression in follow-up samples was associated with outcomes.
Studies have shown strong associations between intimate partner violence (IPV) and both posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Despite these linkages, research on the dual diagnosis of PTSD-SUD and its relationship to IPV is in an early stage, and little is known about how PTSD-SUD treatment might influence IPV outcomes. The current study is a secondary analysis of a larger NIDA Clinical Trials Network study exploring the effectiveness of two behavioral interventions for women with comorbid PTSD-SUD. Participants (n =288) were randomly assigned to Seeking Safety (SS), a cognitive-behavioral treatment that focuses on trauma and substance abuse symptoms, or to Women’s Health Education, a psychoeducational group. Logistic regressions were used to examine how treatment condition, identified risk factors and their interactions were related to IPV. Results showed that participants who were abstinent at baseline were significantly less likely to experience IPV over the 12-month follow-up period, whereas participants living with someone with an alcohol problem were significantly more likely to experience IPV over follow-up. Findings also showed that at a trend level participants with recent interpersonal trauma at baseline and higher total of lifetime trauma exposures were more likely to report IPV during follow-up. Although there was no main effect for treatment condition, a significant interaction between treatment condition and baseline abstinence was found. Participants who were abstinent at baseline and in the SS condition were significantly less likely to report IPV over follow-up. These findings indicate that an integrated treatment for PTSD and SUD was associated with significantly better IPV outcomes for a subset of individuals. The possibility that women with PTSD-SUD may differentially benefit from SS has important clinical implications. Further research examining the intersection of PTSD, SUD and IPV, and the impact of treatment on a range of outcomes is needed.
Cohen, Lisa R.; Field, Craig; Campbell, Aimee N. C.; Hien, Denise A.
Objective Esophageal tuberculosis (ET) is a rare disorder often easily misdiagnosed. The aim of this study is to evaluate the clinical features and to highlight the surgical role in treatment and complication management for undiagnosed ET. Methods Between June 2006 and June 2011, six esophageal tuberculosis cases were retrospectively reviewed for their clinical presentations, radiological findings, endoscopic views, surgical treatment and outcome. Results The prevalent rate of ET was 0.30%. All patients, aged from 28 to 71 years, presented with dysphagia in six, weight loss in four, and each of retrosternal pain, epigastric pain, fever with cough in one. The duration ranged from two weeks to two months. Involvement of esophagus observed at middle segment in five patients, and at lower segment in one. Endoscopy demonstrated diverticulum with polyps in one patient, ulcer formation in one, and extraneous compression with intact mucosa in four. Five patients underwent video-assisted thoracoscopic surgery (VATS) and one was performed thoracotomy perforation repair for esophagopleural fistula. Diagnoses of all cases were confirmed by histopathological examination and acid-fast bacilli culture. Drug sensitivity test revealed multidrugs resistant mycobacterium tuberculous in one case. All patients discharged and recovered by antituberculous treatment with follow-up time ranged from 12 to 45 months. Conclusions ET should be considered as a causative factor for dysphagia. Surgery should be applied in undiagnosed ET. VATS is useful in improving rate of confirmative diagnosis, and relieving symptom of dysphagia. Thoracotomy repair is reserved for complications of ET.
Introduction This report describes the case mix and outcomes of patients with oesophageal cancer admitted to adult critical care units following elective oesophageal surgery in England, Wales and Northern Ireland. Methods Admissions to critical care following elective oesophageal surgery for malignancy were identified using data from the Intensive Care National Audit and Research Centre (ICNARC) Case Mix Programme Database. Information on admissions between December 1995 and September 2007 were extracted and the association between in-hospital mortality and patient characteristics on admission to critical care was assessed using multiple logistic regression analysis. The performance of three prognostic models (Simplified Acute Physiology Score (SAPS) II, Acute Physiology and Chronic Health Evaluation (APACHE) II and the ICNARC physiology score) was also evaluated. Results Between 1995 and 2007, there were 7227 admissions to 181 critical care units following oesophageal surgery for malignancy. Overall mortality in critical care was 4.4% and in-hospital mortality was 11%, although both declined steadily over time. Eight hundred and seventy-three (12.2%) patients were readmitted to critical care, most commonly for respiratory complications (49%) and surgical complications (25%). Readmitted patients had a critical care unit mortality of 24.7% and in-hospital mortality of 33.9%. Overall in-hospital mortality was associated with patient age, and various physiological measurements on admission to critical care (partial pressure of arterial oxygen (PaO2):fraction of inspired oxygen (FiO2) ratio, lowest arterial pH, mechanical ventilation, serum albumin, urea and creatinine). The three prognostic models evaluated performed poorly in measures of discrimination, calibration and goodness of fit. Conclusions Surgery for oesophageal malignancy continues to be associated with significant morbidity and mortality. Age and organ dysfunction in the early postoperative period are associated with an increased risk of death. Postoperative serum albumin is confirmed as an additional prognostic factor. More work is required to determine how this knowledge may improve clinical management.
The study aimed to ascertain the outcome of adolescent onset eating disorders in a representative cohort of females. The design was a seven wave cohort study conducted over 6 years. 982 female participants from a total sample of 2032 secondary school students initially aged 14-15 years at 44 schools in the state of Victoria Australia. Branched questionnaires (BET) were used
Objective To summarise and compare the efficacy and safety of various oral anticoagulants (dabigatran, rivaroxaban, apixaban, and vitamin K antagonists) and antiplatelet agents (acetylsalicylic acid) for the secondary prevention of venous thromboembolism. Design Systematic review and network meta-analysis. Data sources Literature search using Medline (1950 to present), Embase (1980 to present), and the Cochrane Register of Controlled Trials using the OVID interface. Publications from potentially relevant journals were also searched by hand. Review methods Randomised controlled trials of patients receiving anticoagulants, antiplatelet drugs, or placebo or observation for secondary prevention of venous thromboembolism. Selected outcomes were rates of recurrent venous thromboembolism and major bleeding. Two reviewers independently extracted data onto standardised forms. Results 12 articles met our inclusion criteria, with 11?999 patients evaluated for efficacy and 12?167 for safety. All treatments reduced the risk of recurrent venous thromboembolism. Compared with placebo or observation, vitamin K antagonists at a standard adjusted dose (target international normalised ratio 2.0-3.0) showed the highest risk difference (odds ratio 0.07; 95% credible interval 0.03 to 0.15) and acetylsalicylic acid showed the lowest risk difference (0.65; 0.39 to 1.03). Risk of major bleeding was higher with a standard adjusted dose of vitamin K antagonists (5.24; 1.78 to 18.25) than with placebo or observation. Fatal recurrent venous thromboembolism and fatal bleeding were rare. Detailed subgroup and individual patient level data were not available. Conclusions All oral anticoagulants and antiplatelet agents investigated in this analysis were associated with a reduced recurrence of venous thromboembolism compared with placebo or observation, although acetylsalicylic acid was associated with the lowest risk reduction. Vitamin K antagonists given at a standard adjusted dose was associated with the greatest risk reduction in recurrent venous thromboembolism, but also the greatest risk of major bleeding.
To minimize the secondary brain damage, we analyzed the effect of cerebral perfusion pressure—orientated management and tried to find factors of clinical management and biochemical findings that influence clinical, cognitive, and psychosocial outcome. Management at intensive care unit was standardized. A standardized (short form 36 health survey) and nonstandardized split questionnaire explored long-term outcome. Glutamic-oxaloacetic-transaminase, creatine kinase MB or glucose
Thomas Kapapa; Kathrin König; Ulrike Pfister; Michael Sasse; Dieter Woischneck; Hans Heissler; Eckhard Rickels
Although hemophagocytic syndrome (HS) featuring secondary hemophagocytic lymphohistiocytosis (HLH) has a grave prognosis, little is known about the natural course of the disease. Patients who showed the clinical features of HLH as well as tissue-proven hemophagocytosis when seen at Asan Medical Center between 1999 and 2010 were included in this analysis. Patients with proven lymphoma were excluded. The median age of our 23 study patients was 49 years. Epstein-Barr virus was suspected to have caused HS in 16 (70%) patients and hepatitis A virus in one patient. Twenty-two patients were treated, 13 according to the HLH protocol and nine using immunosuppressive agents such as corticosteroid and/or cyclosporine. Five patients undertook allogeneic hematopoietic cell transplantation (HCT) during their treatment-dependent relapse (n = 4) or responsive status (n = 1). After the median follow-up of 180 days, 17 (74%) died and six (26%) were alive. The median time from initial presentation until death was 41 days among those patients who died. The serum fibrinogen level ?166 mg/dL determined at the initial visit was significantly associated with the survival time according to univariate analysis. The low histiocyte proportion in bone marrow and early initiation of treatment tended to correlate with a favorable outcome. On multivariate analysis, serum fibrinogen ?166 mg/dL (hazard ratio, 0.175, P = 0.018) was an independent clinical factor for determining the patient survival time. Despite appropriate patient management, the outcome of HS featuring HLH was grave. The serum fibrinogen level at the initial presentation was significant, and selected patients obtained some benefit from allogeneic HCT. PMID:22147006
Park, Han-Seung; Kim, Dae-Young; Lee, Je-Hwan; Lee, Jung-Hee; Kim, Sung-Doo; Park, Young-Hun; Lee, Jae Seok; Kim, Bo Youn; Jeon, Mijin; Kang, Young-Ah; Lee, Young-Shin; Seol, Miee; Lee, Yeon-Joo; Lim, Young-Suk; Jang, Seongsoo; Park, Chan-Jeoung; Chi, Hyun-Sook; Lee, Kyoo-Hyung
Introduction This report describes the case mix, outcome and activity (duration of intensive care unit [ICU] and hospital stay, inter-hospital transfer, and readmissions to the ICU) for admissions to ICUs for acute severe asthma, and investigates the effect of case mix factors on outcome. Methods We conducted a secondary analysis of data from a high-quality clinical database (the Intensive Care National Audit and Research Centre [ICNARC] Case Mix Programme Database) of 129,647 admissions to 128 adult, general critical care units across England, Wales and Northern Ireland over the period 1995–2001. Results Asthma accounted for 2152 (1.7%) admissions, and in 57% mechanical ventilation was employed during the first 24 hours in the ICU. A total of 147 (7.1%) patients died in intensive care and 199 (9.8%) died before discharge from hospital. The mean age was 43.6 years, and the ratio of women to men was 2:1. Median length of stay was 1.5 days in the ICU and 8 days in hospital. Older age, female sex, having received cardiopulmonary resuscitation (CPR) within 24 hours before admission, having suffered a neurological insult during the first 24 hours in the ICU, higher heart rate, and hypercapnia were associated with greater risk for in-hospital death after adjusting for Acute Physiology and Chronic Health Evaluation II score. CPR before admission, neurological insult, hypoxaemia and hypercapnia were associated with receipt of mechanical ventilation after adjusting for Acute Physiology and Chronic Health Evaluation II score. Conclusion ICU admission for asthma is relatively uncommon but remains associated with appreciable in-hospital mortality. The greatest determinant of poor hospital survival in asthma patients was receipt of CPR within 24 hours before admission to ICU. Clinical management of these patients should be directed at preventing cardiac arrest before admission.
Gupta, Dheeraj; Keogh, Brian; Chung, Kian Fan; Ayres, Jon G; Harrison, David A; Goldfrad, Caroline; Brady, Anthony R; Rowan, Kathy
Allogeneic hematopoietic stem cell transplantation (HSCT) with reduced-intensity conditioning (RIC) offers a potential cure for patients with myelodysplastic syndrome (MDS) who are ineligible for standard-intensity regimens. Previously published data from our institution suggest excellent outcomes at 1 yr using a uniform fludarabine, busulfan, and alemtuzumab-based regimen. Here we report long-term follow-up of 192 patients with MDS and acute myelogenous leukemia (AML) secondary to MDS (MDS-AML) transplanted with this protocol, using sibling (n = 45) or matched unrelated (n = 147) donors. The median age of the cohort was 57 yr (range, 21 to 72 yr), and median follow-up was 4.5 yr (range, 0.1 to 10.6 yr). The 5-yr overall survival (OS), event-free survival, and nonrelapse mortality were 44%, 33%, and 26% respectively. The incidence of de novo chronic graft-versus-host disease (GVHD) was low at 19%, illustrating the efficacy of alemtuzumab for GVHD prophylaxis. Conversely, the 5-yr relapse rate was 51%. For younger patients (age <50 yr), the 5-yr OS and relapse rates were 58% and 39%, respectively. On multivariate analysis, advanced age predicted significantly worse outcomes, with patients age >60 yr having a 5-yr OS of 15% and relapse rate of 66%. Patients receiving preemptive donor lymphocyte infusions had an impressive 5-yr OS of 67%, suggesting that this protocol may lend itself to the incorporation of immunotherapeutic strategies. Overall, these data demonstrate good 5-yr OS for patients with MDS and MDS-AML undergoing alemtuzumab-based RIC-HSCT. The low rate of chronic GVHD is encouraging, and comparative studies with other RIC protocols are warranted. PMID:24216184
Potter, Victoria T; Krishnamurthy, Pramila; Barber, Linda D; Lim, Ziyi; Kenyon, Michelle; Ireland, Robin M; de Lavallade, Hugues; Dhouri, Abdel; Marsh, Judith C W; Marcus, Robert; Devereux, Stephen; Ho, Aloysius; Pagliuca, Antonio; Mufti, Ghulam J
Background Conflicting relationships have been described between anemia correction using erythropoiesis-stimulating agents (ESAs) and progression of chronic kidney disease (CKD). This study was undertaken to examine the impact of target hemoglobin on progression of kidney disease in the CHOIR (Correction of Hemoglobin and Outcomes in Renal Insufficiency) trial. Study design Secondary analysis of a randomized controlled trial Setting and participants 1432 participants with CKD and anemia Intervention Participants were randomized to target hemoglobin of 13.5 vs 11.3 gm/dL with the use of epoetin-alfa. Outcomes and measurements Cox regression was used to estimate hazard ratios for progression of CKD (a composite of doubling of creatinine, initiation of renal replacement therapy (RRT), or death). Interactions between hemoglobin target and select baseline variables (estimated glomerular filtration rate (eGFR), proteinuria, diabetes, heart failure, and smoking history) were also examined. Results Participants randomized to higher hemoglobin targets experienced a shorter time to progression of kidney disease in both univariate (HR, 1.25; 95% CI, 1.03–1.52; p=0.02) and multivariable models (HR, 1.22; 95% CI, 1.00–1.48; p=0.05). These differences were attributable to higher rates of RRT and death among participants in the high hemoglobin arm. Hemoglobin target did not interact with eGFR, proteinuria, diabetes, or heart failure (p>0.05 for all). In the multivariable model, hemoglobin target interacted with tobacco use (p=0.04) such that the higher target had a greater risk of CKD progression among participants that currently smoked (HR, 2.50; 95% CI, 1.23–5.09; p=0.01) which was not present among those who did not currently smoke (HR, 1.15; 95% CI 0.93–1.41; p=0.2). Limitations A post-hoc analysis and thus cause- effect cannot be determined. Conclusions These results suggest that high hemoglobin target is associated with a greater risk of progression of CKD. This risk may be augmented by concurrent smoking. Further defining the mechanism of injury may provide insight into methods to optimize outcomes in anemia management.
Inrig, Jula. K.; Barnhart, Huiman X.; Reddan, Donal; Patel, Uptal D.; Sapp, Shelly; Califf, Robert M.; Singh, Ajay K.; Szczech, Lynda A.
Abstract This study describes the use of a neuroplasticity-principled speech treatment approach (LSVT(®)LOUD) with children who have dysarthria secondary to cerebral palsy. To date, the authors have treated 25 children with mild-to-severe dysarthria, a continuum of gross and fine motor functions, and variable cognitive abilities. From this data set, two case studies are presented that represent as weak or strong responders to LSVT LOUD. These case studies demonstrate how individual and environmental features may impact immediate and lasting responses to treatment. Principles that drive activity-dependent neuroplasticity are embedded in LSVT LOUD and may contribute to positive therapeutic and acoustic outcomes. However, examination of the response patterns indicated that intensity (within and across treatment sessions) is necessary but not sufficient for change. Weak responders may require a longer treatment phase, better timing (e.g., developmentally, socially), and a more prominent desire to communicate successfully during daily activities. Strong responders appear to benefit from the intensity and saliency of treatment as well as from intrinsic and extrinsic rewards for using the trained skills for everyday communication. Finally, possibilities are presented for technological solutions designed to promote accessibility to the intensive task repetition and maintenance required to drive lasting changes. PMID:25011399
Five questionnaires based on Ronald Edmonds' work on "effective schools" were developed for elementary and secondary students, teachers, principals, and parents. They were designed to assess the perceptions of each group on the five areas identified by Edmonds as distinguishing effective and ineffective schools for students from low-income…
Austin Independent School District, TX. Office of Research and Evaluation.
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.
A comprehensive functional assessment requires thorough and careful inquiry, which is difficult to accomplish in most busy\\u000a clinical practices. This paper examines the reliability and validity of the Functional Status Questionnaire (FSQ), a brief,\\u000a standardized, self-administered questionnaire designed to provide a comprehensive and feasible assessment of physical, psychological,\\u000a social and role function in ambulatory patients. The FSQ can be completed
Alan M. Jette; Allyson R. Davies; Paul D. Cleary; David R. Calkins; Lisa V. Rubenstein; Arlene Fink; Jacqueline Kosecoff; Roy T. Young; Robert H. Brook; Thomas L. Delbanco
OBJECTIVE--To develop a single, short, acceptable, and validated postal questionnaire for assessing patients' experiences of the process and outcome of day surgery. DESIGN--Interviews and review of existing questionnaires; piloting and field testing of draft questionnaires; consistency and validity checks. SETTING--Four hospitals, in Coventry (two), Swindon, and Milton Keynes. PATIENTS--373 patients undergoing day surgery in 1990. MAIN MEASURES--Postoperative symptoms, complications, health
This paper provides a theoretical review of self-rated competences questionnaires. This topic is influenced by the ongoing world-wide reform of higher education, which has led to a focus on the learner outcomes of higher education. Consequently, questionnaires on self-rated competences have increasingly been employed. However, self-ratings are…
Braun, Edith; Woodley, Alan; Richardson, John T. E.; Leidner, Bernhard
As part of the instrumentation to assess the effectiveness of the Schools Without Failure (SWF) program in 10 elementary schools in the New Castle, Pa. School District, the Philosophy of Glasser Questionnaire was developed. This 15-item scale measuring attitudes toward the philosophy of William Glasser had a coefficient alpha reliability of .77…
To construct a questionnaire, a set tau of permissible questions is drawn up, i.e. questions which can be realized in practice and each of which makes sense in relationship to set E of events or a certain subset of this set. If under the fixed conditions ...
NATIONAL INSTITUTES OF HEALTH Diet History Questionnaire Today's date: MONTH DAY YEAR |___|___| 0 0 1 1 2 2 3 3 4 5 6 7 8 01 Jan 02 Feb 03 Mar 04 Apr 05 May 06 Jun 07 Jul 08 Aug 09 Sep 10 Oct 11 Nov 12
This article describes the development of the Gay Identity Questionnaire (GIQ) which was derived from tenets of the Homosexual Identity Formation (HIF) model proposed by Cass in 1979. The GIQ is a brief measure that may be used by clinicians and researchers for identifying gay males in the various stages of homosexual identity formation. The test construction procedures included the
Adult community norms were derived from 261 adults who completed the Social Phobia and Anxiety Inventory and 267 adults who completed the Beck Anxiety Inventory, the Fear Questionnaire, and the Penn State Worry Questionnaire. Percentile scores are provided for all measures, and their usefulness in assessing therapy outcomes is discussed. (SLD)
Despite its high prevalence, nonulcer dyspepsia is still difficult to study, due to the lack of adequate tools to measure significant outcomes. The objective of this study was to develop and validate a symptom-focused, disease-specific questionnaire to evaluate patients with nonulcer dyspepsia. For that, the questionnaire was carefully written following widely accepted terminology, so as to facilitate translation and validation
Guilherme Becker Sander; Luiz Edmundo Mazzoleni; Carlos Fernando Magalhães Francesconi; André Castagna Wortmann; Eduardo André Ott; Alexandro Theil; Vicenzo Da Cruz Piccoli; Ângela Cristiane Da Silva; Leandro Oliveira; Simone Beheregaray; Simone Matioti; Gustavo Somm; José Roberto Goldim
The purpose of this study was to describe the validation of a new instrument called the Teacher Communication Behavior Questionnaire (TCBQ). This instrument is meant for use in assessing students' perceptions of their interactions with their teacher by focusing on their teachers' communicating behaviors. The study described in this paper occurred…
Objectives?To evaluate the impact of maternal BMI on intrapartum interventions and adverse outcomes that may influence choice of planned birth setting in healthy women without additional risk factors. Design?Prospective cohort study. Setting?Stratified random sample of English obstetric units. Sample?17 230 women without medical or obstetric risk factors other than obesity. Methods?Multivariable log Poisson regression was used to evaluate the effect of BMI on risk of intrapartum interventions and adverse maternal and perinatal outcomes adjusted for maternal characteristics. Main outcome measures?Maternal intervention or adverse outcomes requiring obstetric care (composite of: augmentation, instrumental delivery, intrapartum caesarean section, general anaesthesia, blood transfusion, 3rd/4th degree perineal tear); neonatal unit admission or perinatal death. Results?In otherwise healthy women, obesity was associated with an increased risk of augmentation, intrapartum caesarean section and some adverse maternal outcomes but when interventions and outcomes requiring obstetric care were considered together, the magnitude of the increased risk was modest (adjusted RR 1.12, 95% CI 1.02–1.23, for BMI > 35 kg/m2 relative to low risk women of normal weight). Nulliparous low risk women of normal weight had higher absolute risks and were more likely to require obstetric intervention or care than otherwise healthy multiparous women with BMI > 35 kg/m2 (maternal composite outcome: 53% versus 21%). The perinatal composite outcome exhibited a similar pattern. Conclusions?Otherwise healthy multiparous obese women may have lower intrapartum risks than previously appreciated. BMI should be considered in conjunction with parity when assessing the potential risks associated with birth in non-obstetric unit settings.
Hollowell, J; Pillas, D; Rowe, R; Linsell, L; Knight, M; Brocklehurst, P
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.
During the survey, respondents are asked to provide qualitative answers (well, adequate, needs improvement) on how well material control and accountability (MC&A) functions are being performed. These responses can be used to develop failure probabilities for basic events performed during routine operation of the MC&A systems. The failure frequencies for individual events may be used to estimate total system effectiveness using a fault tree in a probabilistic risk analysis (PRA). Numeric risk values are required for the PRA fault tree calculations that are performed to evaluate system effectiveness. So, the performance ratings in the questionnaire must be converted to relative risk values for all of the basic MC&A tasks performed in the facility. If a specific material protection, control, and accountability (MPC&A) task is being performed at the 'perfect' level, the task is considered to have a near zero risk of failure. If the task is performed at a less than perfect level, the deficiency in performance represents some risk of failure for the event. As the degree of deficiency in performance increases, the risk of failure increases. If a task that should be performed is not being performed, that task is in a state of failure. The failure probabilities of all basic events contribute to the total system risk. Conversion of questionnaire MPC&A system performance data to numeric values is a separate function from the process of completing the questionnaire. When specific questions in the questionnaire are answered, the focus is on correctly assessing and reporting, in an adjectival manner, the actual performance of the related MC&A function. Prior to conversion, consideration should not be given to the numeric value that will be assigned during the conversion process. In the conversion process, adjectival responses to questions on system performance are quantified based on a log normal scale typically used in human error analysis (see A.D. Swain and H.E. Guttmann, 'Handbook of Human Reliability Analysis with Emphasis on Nuclear Power Plant Applications,' NUREG/CR-1278). This conversion produces the basic event risk of failure values required for the fault tree calculations. The fault tree is a deductive logic structure that corresponds to the operational nuclear MC&A system at a nuclear facility. The conventional Delphi process is a time-honored approach commonly used in the risk assessment field to extract numerical values for the failure rates of actions or activities when statistically significant data is absent.
Powell, Danny H [ORNL] [ORNL; Elwood Jr, Robert H [ORNL] [ORNL
The purpose of this article is to offer tips in designing quality questionnaires and on avoiding common errors. Some of the more prevalent problems in questionnaire development are identified and suggestions of ways to avoid them are offered.
ARP staff adapted the Diet History Questionnaire (DHQ) for use by Canadian populations in collaboration with the Alberta Cancer Board. This questionnaire takes into account the different food fortification polices of the US and Canada.
Applied Research Program (ARP) staff use a variety of methods to develop and test questionnaires, including established Questionnaire Design Principles, empirical methods such as Cognitive Testing and psychometric methods such as Item Response Theory Modeling.
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This package contains a copy of the software acquisition process maturity questionnaire. It is intended for those interested in performing and learning about software acquisition process appraisals. This questionnaire is not an appraisal method itself; ra...
BackgroundIndividuals with comorbid substance use and posttraumatic stress disorder may differentially benefit from integrated trauma-focused interventions based on specific presenting characteristics such as substance use type and PTSD severity. The current study is a secondary analysis of a NIDA Clinical Trials Network study exploring the effectiveness of two interventions for women with comorbid PTSD and substance use disorders.
Denise A. Hien; Aimee N. C. Campbell; Lesia M. Ruglass; Mei-Chen Hu; Therese Killeen
Research results have shown that cooperative learning methods enhanced understanding of many difficult concepts. Different kinds of cooperative methods and their efficacy have been researched into but the results of such studies have been inconclusive. Chief examiners reports of external chemistry examinations in Nigeria secondary Schools had…
The Secondary School Literacy Project (SSLiP) is a partnership between the Bay Area Coalition of Essential Schools (BayCES) and the Strategic Literacy Initiative at WestEd (SLI). SSLiP is a professional development and capacity building program for teams of teachers in the BayCES network of schools. During the 1999-2000 school year, seven school…
Multidisciplinary care, which incorporates Multidisciplinary Treatment Planning (MTP), is increasingly being adopted within oncology care settings with the intent of enhancing the quality of care delivered to patients. However, what is not known is its impact on improving patient outcomes and the quality of care being delivered. A targeted review of the literature was conducted to examine the organization and operation of the Multidisciplinary Care (MDC) team structure1. Findings revealed that a variety of implementation models exist within the health care system.
It remains controversial as to whether neonatal seizures have additional direct effects on the developing brain separate from the severity of the underlying encephalopathy. Using data collected from infants diagnosed with hypoxic-ischemic encephalopathy, and who were enrolled in an National Institute of Child Health and Human Development trial of hypothermia, we analyzed associations between neonatal clinical seizures and outcomes at
Jennifer M. Kwon; Ronnie Guillet; Seetha Shankaran; Abbot R. Laptook; Scott A. McDonald; Richard A. Ehrenkranz; Jon E. Tyson; T. Michael OShea; Ronald N. Goldberg; Edward F. Donovan; Avroy A. Fanaroff; W. Kenneth Poole; Rosemary D. Higgins; Michele C. Walsh
What are the important factors to consider when designing a survey? Would it be best conducted via telephone? Or would it be better to have a face-to-face meeting? These are but a few of the topics covered on this site created as a public service by the StatPac group. Visitors can elect to download the entire report on survey design here, or they can just click through the topics that interest them. Each topic includes a brief discussion of its relative importance, and the areas covered include questionnaire length, time considerations, question wording, and sampling methods. It's a thoughtful and helpful resource overall, and it's one that might be put to good use in an introductory statistics course in college.
Classical Burkitt lymphoma/leukemia (BL/L) presenting L3 morphology is found in 1% of childhood ALL. Recently, it has been described that secondary abnormalities could influence the prognosis of these patients. However, little information is available on these cytogenetic abnormalities and their prognostic importance in BL/L. Here, we report four new childhood BL/L cases associated with duplication within 1q or 13q, which exhibited a very unfavorable therapeutic response. We performed both classical and molecular cytogenetic analysis by multicolor chromosome banding of the secondary abnormalities involving the long arms of chromosome 1 or 13. These patients were previously treated with BFM-90 protocol. All of them died during or after the initial treatment. Here, for the first time, the exact breakpoints of the derivative chromosomes involved were determined at the cytogenetic level as 1q21 and 13q33 each. PMID:21207210
de Souza, Mariana Tavares; Mkrtchyan, Hasmik; Hassan, Rocio; Ney-Garcia, Daniela Ribeiro; de Azevedo, Alice Maria Boulhosa; da Costa, Elaine Sobral; de Figueiredo, Amanda Faria; Liehr, Thomas; Abdelhay, Eliana; Silva, Maria Luiza Macedo
Classical Burkitt lymphoma\\/leukemia (BL\\/L) presenting L3 morphology is found in 1% of childhood ALL. Recently, it has been\\u000a described that secondary abnormalities could influence the prognosis of these patients. However, little information is available\\u000a on these cytogenetic abnormalities and their prognostic importance in BL\\/L. Here, we report four new childhood BL\\/L cases\\u000a associated with duplication within 1q or 13q, which
Mariana Tavares de Souza; Hasmik Mkrtchyan; Rocio Hassan; Daniela Ribeiro Ney-Garcia; Alice Maria Boulhosa de Azevedo; Elaine Sobral da Costa; Amanda Faria de Figueiredo; Thomas Liehr; Eliana Abdelhay; Maria Luiza Macedo Silva
Objectives To investigate whether additional catheter-directed thrombolysis (CDT) improves long-term quality of life (QOL) compared with standard treatment with anticoagulation and compression stockings alone in patients with proximal deep vein thrombosis (DVT). Design Open-label randomised controlled trial. Setting 19 Hospitals in the Norwegian southeastern health region. Participants Patients (18–75?years) with a high proximal DVT, symptoms <21?days and no increased risk of bleeding were eligible. 189 of 209 recruited patients completed 24?months of follow-up. Interventions Participants were randomised to additional CDT with alteplase for 1–4?days or to standard treatment only with 6?months of anticoagulation and 24?months of compression stockings. Primary and secondaryoutcome measures Planned secondaryoutcome measures included QOL as assessed with the generic instrument EQ-5D and the disease-specific instrument VEINES-QOL/Sym. Primary outcome measure was post-thrombotic syndrome (PTS) after 24?months. Results After 24?months there were no differences in QOL between the additional CDT and standard treatment arms; mean difference for the EQ-5D index was 0.04 (95% CI ?0.10 to 0.17), for the VEINES-QOL score 0.2 (95% CI ?2.8 to 3.0) and for the VEINES-Sym score 0.5 (95% CI ?2.4 to 3.4; p values>0.37). Independent of treatment arms, patients with PTS had poorer outcomes than patient without PTS; mean difference for EQ-5D was 0.09 (95% CI 0.03 to 0.15), for VEINES-QOL score 8.6 (95% CI 5.9 to 11.2) and for VEINES-Sym score 9.8 (95% CI 7.3 to 12.3; p values<0.001). Conclusions QOL did not differ between patients treated with additional CDT compared with standard treatment alone. Patients who developed PTS reported poorer QOL and more symptoms than patients without PTS. QOL should be included as an outcome measure in clinical studies on patients at risk of PTS. Trial registration NCT00251771
Enden, Tone; Wik, Hilde Skuterud; Kvam, Ann Kristin; Haig, Ylva; Kl?w, Nils Einar; Sandset, Per Morten
Ovarian tissue cryopreservation is the only proven option for fertility preservation in female cancer patients who are prepubertal or require immediate treatment. However it remains unclear which cryopreservation protocol is best in cases where the tissue may contain cancerous cells, as these should be matured in vitro rather than autografted. This study evaluated different cryoprotectant exposure times and whether the addition of synthetic polymers (Supercool X-1000, Z-1000 and polyvinylpyrrolidone [PVP K-12]) to the vitrification solution is beneficial to tissue morphology, cellular proliferation and subsequent in vitro function of secondary follicles. Pieces of macaque (n = 4) ovarian cortex were exposed to vitrification solution containing glycerol (25%, v/v) and ethylene glycol (25%, v/v) for 3 or 8 min, without (V3, V8) or with (VP3, VP8) polymers (0.2% [v/v] X-1000, 0.4% Z-1000 and 0.2% PVP). Fresh and vitrified tissues were fixed for histology and phosphohistone H3 (PPH3) analysis, or used for secondary follicle isolation followed by encapsulated 3D culture. Five-week follicle survival and growth, as well as steroid hormones (estradiol [E2], progesterone, androstenedione) were measured weekly. Morphology of the stroma and preantral follicles as well as PPH3 expression, was preserved in all vitrified tissues. Vitrification with polymers and shorter incubation time (VP3) increased in vitro follicle survival and E2 production compared to other vitrified groups. Thus, a short exposure of macaque ovarian tissue to a vitrification solution containing synthetic polymers preserves morphology and improves in vitro function of secondary follicles.
Ting, Alison Y.; Yeoman, Richard R.; Lawson, Maralee S.; Zelinski, Mary B.
Ovarian tissue cryopreservation is the only proven option for fertility preservation in female cancer patients who are prepubertal or require immediate treatment. However it remains unclear which cryopreservation protocol is best in cases where the tissue may contain cancerous cells, as these should be matured in vitro rather than autografted. This study evaluated different cryoprotectant exposure times and whether the addition of synthetic polymers (Supercool X-1000, Z-1000 and polyvinylpyrrolidone [PVP K-12]) to the vitrification solution is beneficial to tissue morphology, cellular proliferation and subsequent in vitro function of secondary follicles. Pieces of macaque (n=4) ovarian cortex were exposed to vitrification solution containing glycerol (25%, v/v) and ethylene glycol (25%, v/v) for 3 or 8 min, without (V3, V8) or with (VP3, VP8) polymers (0.2% [v/v] X-1000, 0.4% Z-1000 and 0.2% PVP). Fresh and vitrified tissues were fixed for histology and phosphohistone H3 (PPH3) analysis, or used for secondary follicle isolation followed by encapsulated 3D culture. Five-week follicle survival and growth, as well as steroid hormones (estradiol [E(2)], progesterone, androstenedione) were measured weekly. Morphology of the stroma and preantral follicles as well as PPH3 expression, was preserved in all vitrified tissues. Vitrification with polymers and shorter incubation time (VP3) increased in vitro follicle survival and E(2) production compared to other vitrified groups. Thus, a short exposure of macaque ovarian tissue to a vitrification solution containing synthetic polymers preserves morphology and improves in vitro function of secondary follicles. PMID:22569078
Ting, Alison Y; Yeoman, Richard R; Lawson, Maralee S; Zelinski, Mary B
Background: The adult population often suffers from a number of physical and mental problems. This study was conducted to determine the proportion of mental illnesses in adult population visiting the outpatient departments at Dr. TMA Pai Rotary Hospital, Karkala and to study the socio-demographic correlates of psychiatric disorders. Materials and Methods: A cross-sectional study was conducted during March 2004 among 193 adult individuals of 18 years and above at Dr. TMA Pai Rotary Hospital, Karkala, Karnataka. Data was analyzed by the statistical package for social sciences version 10.0 for windows and results were expressed in terms of proportions and their 95% confidence intervals (CI). Chi-square test, multiple logistic regression with adjusted odds ratio and its 95% CI. Results: The proportion of psychiatric disorders in adult population was determined to be 39.9%. Proportion of psychiatric morbidity among males and females were 36.2 and 42.2%, respectively. Conclusion: This study revealed that socio-demographic correlates like age group of 50 years and above, unemployed or housewives, living alone, and a history of psychiatric illness in the family were independently associated with psychiatric disorders in adult population.
Barua, Ankur; Jacob, George P.; Mahmood, Syed Safvi
ObjectiveTo develop and validate a questionnaire to determine satisfaction with the hospital emergency department.DesignCross-sectional study to validate a telephone questionnaire designed in Spanish by a panel of experts.SettingThe emergency department of Hospital Gregorio Marañón, a tertiary level hospital of the Spanish national health system.ParticipantsA sample of 651 emergency department patients completed the questionnaire.Main Outcome MeasuresThe psychometric properties of the questionnaire
Susana Granado de la Orden; Ana Chacón García; Lorena Flavia Rodríguez Gijón; Cristina Rodríguez Rieiro; Concepción Sanchidrian de Blas; Paz Rodríguez Pérez
The aim of this study was to evaluate whether a new low-cost strategy for the introduction of magnesium sulphate (MgSO4) for preeclampsia and eclampsia in low-resource areas will result in improved maternal and perinatal outcomes. Doctors and midwives from ten hospitals in Kano, Nigeria, were trained on the use of MgSO4. The trained health workers later conducted step-down training at their health facilities. MgSO4, treatment protocol, patella hammer, and calcium gluconate were then supplied to the hospitals. Data was collected through structured data forms. The data was analyzed using SPSS software. From February 2008 to January 2009, 1,045 patients with severe preeclampsia and eclampsia were treated. The case fatality rate for severe preeclampsia and eclampsia fell from 20.9 % (95 % CI 18.7-23.2) to 2.3 % (95 % CI 1.5-3.5). The perinatal mortality rate was 12.3 % as compared to 35.3 % in a center using diazepam. Introduction of MgSO4 in low-resource settings led to improved maternal and fetal outcomes in patients presenting with severe pre-eclampsia and eclampsia. Training of health workers on updated evidence-based interventions and providing an enabling environment for their practice are important components to the attainment of the Millennium Development Goals (MDG) in developing countries. PMID:22956402
With the use of computers, paper questionnaires are being replaced by electronic questionnaires. The formats of traditional paper questionnaires have been found to effect a subject's rating. Consequently, the transition from paper to electronic format can subtly change results. The research presented begins to determine how electronic questionnaire formats change subjective ratings. For formats where subjects used a flow chart to arrive at their rating, starting at the worst and middle ratings of the flow charts were the most accurate but subjects took slightly more time to arrive at their answers. Except for the electronic paper format, starting at the worst rating was the most preferred. The paper and electronic paper versions had the worst accuracy. Therefore, for flowchart type of questionnaires, flowcharts should start at the worst rating and work their way up to better ratings.
One explanation for risk-taking behavior despite warnings about the dangers is that anticipated positive consequences outweigh possible negative outcomes. In a five-part investigation, a new questionnaire was developed to assess outcome expectancies for the potential consequences of involvement in a variety of risky activities. Conceptual and methodological limitations of previously available questionnaires were addressed and content, construct, and criterion validity
Background Intimate partner violence (IPV) is a serious social issue in Japan. In order to start effective interventions for abused women, the appropriate method of screening for IPV in healthcare settings needs clarifying. The objective of this study was to compare the effectiveness of a face-to-face interview with a self-administered questionnaire. We used the Violence Against Women Screen (VAWS), a Japanese screening instrument for intimate partner violence (IPV), for identifying pregnant women who have experienced abuse. Methods We conducted a randomised controlled trial to screen participants at three points in time in a prenatal clinic in Tokyo, Japan. There were 328 consenting women between 14 and 25 weeks of pregnancy who were consecutively selected and randomly assigned to either the interview or self-administered questionnaire group. Both groups completed the same screening instrument three times during their pregnancy. The primary outcome was the total number of women identified by each screening method and the secondaryoutcome was the effect of the screening as measured by the women's comfort level and their expressed need to consult with the nurse. Results For all three screenings, the identification rate in the interview group was significantly lower than that for the self-administered questionnaire group (relative risk 0.66, 95% CI 0.46 to 0.97), even after controlling for smoking (adjusted odds ratio 0.59, 95% CI 0.35 to 0.98). The two groups did not differ for secondaryoutcomes. Conclusions The self-administered questionnaire identified more IPV than the face-to-face interview when screening pregnant women in a Japanese prenatal clinic. Trial Registration UMIN-CTRC000000353
Focuses on the validation of a writing strategies questionnaire and presents the various stages in the validation process. The questionnaire was validated using a qualitative and quantitative method with two groups of participants from the target population--advanced nonnative speakers of English. (VWL)
Reflective thinking is often stated as a learning outcome of baccalaureate nursing education, and as a characteristic of a competent professional; however, no consistent method exists to assess the extent to which students engage in reflective thinking. To address this need, Kember and Leung developed and tested a self-report questionnaire based…
The relationship between parent behaviors, child development and subsequent child behavior outcomes has been examined. However, few tools have been developed and utilized to assess and quantify parenting behaviors in relationship to parent and child demographic characteristics. This study uses the Parenting Behaviors Questionnaire (PBQ), to examine whether parent and child backgrounds influence parents' perceptions of their parenting. Specifically, the
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,
The Short Form-36 (SF-36) health questionnaire has been put forward as a general measure of outcome in health care and has been evaluated in several recent studies in the UK. We report its use in three groups of patients after spinal operations and have compared it with the Oswestry and Low Back Pain disability scales. There was a significant correlation
Michael Grevitt; Rabi Khazim; John Webb; Robert Mulholland; John Shepperd
The report is from a USAC series produced by the Franklin Institute Research Laboratories designed to explore IMIS impacts on city administrative organization and behavior. The Key Person Questionnaire, which forms the basis for this report, examines basi...
The Brunel Lifestyle Physical Activity Questionnaire a4 If you add together each session of pre-planned physical activity that you engage in during a normal week, how much time would you estimate that you spend in total?
The outcome expectancies of 250 respondents were examined using the Food Expectancy Questionnaire (FEQ), comparing expectancies about four different foods: fruit, vegetables, chocolate and sweets and plain biscuits. These expectancies were related to diet as assessed by a Food Frequency Questionnaire. As with alcohol expectancies [Jones, B. T., Corbin, W. & Fromme, K. (2001). A review of expectancy theory and alcohol consumption. Addiction, 96, 57-72], on which this research was modelled, positive and negative outcomes were the main factors for all foods, accounting jointly for between 33 and 40% of expectancy variance in factor analysis and predicting as much as 16% of the variance in relevant food intake measures by linear regression. Expected positive and negative outcomes of eating were predominantly immediate psychological after-effects, rather than including orosensory experiences, or longer-term effects on health or well-being. Other expectancies varied from food to food. FEQ expectancies for different foods have similar factor structure and were related to self-reported diet, the FEQ therefore shows promise as a means of modelling cognitions about eating. PMID:15949872
The data needs questionnaire is an element in the project design study for the Michigan Resource Inventory Act and is aimed at gathering information on what inventory information is required by land use planners throughout the state. Analysis of questionnaire responses is discussed. Some information on current use categories was tabulated. The respondents selected a broad range of categories at all levels of detail. Those most frequently indicated were urban categories.
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.
Powell, Danny H [ORNL] [ORNL; Elwood Jr, Robert H [ORNL] [ORNL
Parkinsonism - secondary; Atypical Parkinson disease ... to be less responsive to medical therapy than Parkinson's disease. ... Unlike Parkinson disease, secondary parkinsonism may stabilize or even improve if the underlying cause is treated. Brain problems, such ...
Objectives The Manchester–Oxford Foot Questionnaire (MOXFQ) is a validated 16-item, patient-reported outcome measure for evaluating outcomes of foot or ankle surgery. The original development of the instrument identified three domains. This present study examined whether the three domains could legitimately be summed to provide a single summary index score. Methods The MOXFQ and Short-Form (SF)-36 were administered to 671 patients before surgery of the foot or ankle. Data from the three domains of the MOXFQ (pain, walking/standing and social interaction) were subjected to higher order factor analysis. Reliability and validity of the summary index score was assessed. Results The mean age of the participants was 52.8 years (sd 15.68; 18 to 89). Higher order principle components factor analysis produced one factor, accounting for 74.7% of the variance. The newly derived single index score was found to be internally reliable (? = 0.93) and valid, achieving at least moderate correlations (r ? 0.5, p < 0.001) with related (pain/function) domains of the SF-36. Conclusions Analyses indicated that data from the MOXFQ can be presented in summary form. The MOXFQ summary index score (MOXFQ-Index) provides an overall indication of the outcomes of foot and ankle surgery. Furthermore, the single index reduces the number of statistical comparisons, and hence the role of chance, when exploring MOXFQ data.
Aim: The purpose of this article is to review modification and outcome of secondary rhinoplasty along with Abbé flap for correction of secondary bilateral cleft lip deformity. Materials and Methods: A total of thirteen patients of secondary bilateral cleft lip-nose deformity having tight upper lip, lack of acceptable philtral column, Cupid's bow definition, irregular lip scars, and associated nasal deformity were selected. All the patients received Abbé flap and simultaneous nasal correction. All cases were treated during a period of three years. Mean patient age at the time of the operation was 21 years, and ranged from 16 to 27 years. The average follow-up period was three years. Results: Assessment of results was based on comparing preoperative and postoperative clinical photographs done by surgeon and patient relatives and patient satisfaction questionnaires. The columellar lengthening and upper lip vermillion correction achieved was satisfactory. There were no perioperative complications such as airway obstruction, bleeding, infection, wound disruption, or flap necrosis.
This supplement describes national adaptations made to the international version of the TIMSS 2011 background questionnaires. This information provides users with a guide to evaluate the availability of internationally comparable data for use in secondary analyses involving the TIMSS 2011 background variables. Background questionnaire adaptations…
Foy, Pierre, Ed.; Arora, Alka, Ed.; Stanco, Gabrielle M., Ed.
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.
Objectives To improve clinical study developments for elderly populations, we aim to understand how they transfer their experiences into validated, standardised self-completed study measurement instruments. We analysed how women (mean 78±8?years of age) participating in a randomised controlled trial (RCT) cognised study instruments used to evaluate outcomes of the intervention. Setting The interview study was nested in an RCT on chronic neck pain using common measurement instruments situated in an elderly community in Berlin, Germany, which comprised of units for independent and assisted-living options. Participants The sample (n=20 women) was selected from the RCT sample (n=117, 95% women, mean age 76 (SD±8)?years). Interview participants were selected using a purposive sampling list based on the RCT outcomes. Outcomes We asked participants about their experiences completing the RCT questionnaires. Interviews were analysed thematically, then compared with the questionnaires. Results Interviewees had difficulties in translating complex experiences into a single value on a scale and understanding the relationship of the questionnaires to study aims. Interviewees considered important for the trial that their actual experiences were understood by trial organisers. This information was not transferrable by means of the questionnaires. To rectify these difficulties, interviewees used strategies such as adding notes, adding response categories or skipping an item. Conclusions Elderly interview participants understood the importance of completing questionnaires for trial success. This led to strategies of completing the questionnaires that resulted in ‘missing’ or ambiguous data. To improve data collection in elderly populations, educational materials addressing the differential logics should be developed and tested. Pilot testing validated instruments using cognitive interviews may be particularly important in such populations. Finally, when the target of an intervention is a subjective experience, it seems important to create a method by which participants can convey their personal experiences. These could be nested qualitative studies. Trial registration number ISRCTN77108101807.
Holmberg, Christine; Karner, Julia J; Rappenecker, Julia; Witt, Claudia M
This research project aims to investigate how students in lower secondary school experience work with socioscientific issues (SSI). The six socioscientific cases developed and used in this project are relevant according to characteristics of SSI and to the national curriculum. Approximately 1,500 students in Sweden have worked with one SSI case chosen by the teachers. A questionnaire-based instrument was used to measure the affective domain of students' attitudes towards and interest in science before starting to work with the case and a second questionnaire after finishing a case. The second student questionnaire, measured the situational characteristics of the SSI work and perceived cognitive and affective outcomes. According to the students' self-reported experience, all cases were interesting and related to a current issue. Most cases were equally interesting to boys and girls, the only exception was You are what you eat, which girls found more interesting than boys did. Almost all students claim that they learnt new facts, learnt to argue for their standpoint and to search and evaluate information during the work with the cases. The girls' average scores were higher on several aspects of learning outcomes. Furthermore the students, especially the girls, perceived that the outcome of working with SSI had relevance for their future, with some cases more relevant than others. The more interesting the student found the case, the more they claimed they learnt. The students do not, however, claim that they learnt more science than during ordinary lessons.
STUDY OBJECTIVE--To develop a carer satisfaction questionnaire for use as an outcome measure in stroke, to test the measure for reliability and validity, and to survey levels of carer satisfaction with services for stroke patients. DESIGN--Postal survey of carer satisfaction with stroke services was carried out using the questionnaire we developed and tested. Internal consistency was tested and construct validation
Objective To identify methods to increase response to postal questionnaires. Design Systematic review of randomised controlled trials of any method to influence response to postal questionnaires. Studies reviewed 292 randomised controlled trials including 258?315 participants Intervention reviewed 75 strategies for influencing response to postal questionnaires. Main outcome measure The proportion of completed or partially completed questionnaires returned. Results The odds of response were more than doubled when a monetary incentive was used (odds ratio 2.02; 95% confidence interval 1.79 to 2.27) and almost doubled when incentives were not conditional on response (1.71; 1.29 to 2.26). Response was more likely when short questionnaires were used (1.86; 1.55 to 2.24). Personalised questionnaires and letters increased response (1.16; 1.06 to 1.28), as did the use of coloured ink (1.39; 1.16 to 1.67). The odds of response were more than doubled when the questionnaires were sent by recorded delivery (2.21; 1.51 to 3.25) and increased when stamped return envelopes were used (1.26; 1.13 to 1.41) and questionnaires were sent by first class post (1.12; 1.02 to 1.23). Contacting participants before sending questionnaires increased response (1.54; 1.24 to 1.92), as did follow up contact (1.44; 1.22 to 1.70) and providing non-respondents with a second copy of the questionnaire (1.41; 1.02 to 1.94). Questionnaires designed to be of more interest to participants were more likely to be returned (2.44; 1.99 to 3.01), but questionnaires containing questions of a sensitive nature were less likely to be returned (0.92; 0.87 to 0.98). Questionnaires originating from universities were more likely to be returned than were questionnaires from other sources, such as commercial organisations (1.31; 1.11 to 1.54). Conclusions Health researchers using postal questionnaires can improve the quality of their research by using the strategies shown to be effective in this systematic review. What is already known on this topicPostal questionnaires are widely used in the collection of data in epidemiological studies and health researchNon-response to postal questionnaires reduces the effective sample size and can introduce biasWhat this study addsThis systematic review includes more randomised controlled trials than any previously published review or meta-analysis no questionnaire responseThe review has identified effective ways to increase response to postal questionnairesThe review will be updated regularly in the Cochrane Library
Neighborhood Physical Activity Questionnaire (NPAQ) A1 In a USUAL WEEK, do you cycle in or around your new neighbourhood or new local area to get to or from somewhere (such as cycling to a shop or to public transport) or for recreation, health or fitness (including cycling with your dog)?
The Physical Activity Questionnaire for Elderly Japanese (PAQ-EJ) 1 Over 7 typical days, how often did you take a walk or ride a bicycle on errands such as going to or from a store or taking children to school?
Global Physical Activity Questionnaire (GPAQ) 13 Do you do any moderate-intensity sports, fitness or recreational (leisure) activities that causes a small increase in breathing or heart rate such as brisk walking, cycling, swimming, volleyball) for at least 10 minutes continuously?
The Physician Survey of Practices on Diet, Physical Activity, and Weight Control -- Adult Questionnaire is sponsored by the National Cancer Institute in collaboration with the Office of Behavioral and Social Sciences Research, the National Institute of Child Health and Human Development, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Centers for Disease Control and Prevention.
Investigations of the learned helplessness model of depression have been hampered by the modest reliability of measures of explanatory style: the habitual tendency to explain bad events with internal, stable, and global causes. We describe a new measure of explanatory style, the Expanded Attributional Style Questionnaire, and its use in a preliminary study with 140 college students. Individual dimensions of
A recent project in higher education in which evidence of falsification was found is described along with two other projects that demonstrate the possibility for falsification. An advantage of standardized questionnaires and machine techniques for scoring and reporting is the low cost, but the need to detect and prevent falsification raises…
The psychometric soundness of the Swansea Muscularity Attitudes Questionnaire (SMAQ) was examined using two independent samples of Canadian male post-secondary students (Ns=250 and 310, respectively). Exploratory and confirmatory factor analyses suggested that the final 19-item version of the SMAQ is represented by three latent constructs, which we have labeled: intention to become more muscular (eight-items), positive attributes of muscularity (nine-items),
Clinical symptoms of 32 stutterers--schoolchildren of 14-year average age were evaluated according to the questionnaire containing 45 complaints of tetanic syndrome. We found headache, fatigue, anxiety, paresthesias and hypothermia of limbs in 30 per cent of this group. More than 80 per cent of the patients had positive Chvostek sign and 60 per cent had positive ischemic and hyperventilation tests. PMID:1838877
This study examined smoking intensity among secondary school adolescent smokers. A total of 800 students, made up of 685 males and 115 females who have at least tasted a cigarette once, from twenty secondary schools (5 private and 15 public secondary schools) in Benin City, Nigeria participated in the study. A questionnaire was used in collecting…
When a drop is subjected to a surrounding dispersed phase that is moving at an initial relative velocity, aerodynamic forces\\u000a will cause it to deform and fragment. This is referred to as secondary atomization. In this paper, the abundant literature\\u000a on secondary atomization experimental methods, breakup morphology, breakup times, fragment size and velocity distributions,\\u000a and modeling efforts is reviewed and
Research with respect to traumatic brain injury (TBI) has identified differential health outcomes by gender. However, despite this, a lack of research exists regarding the impact of TBI on specific health-related issues for women. This study investigated rater agreement of a health questionnaire developed to identify health concerns among women with TBI. Thirteen women with moderate to severe brain injury completed the questionnaire twice (1 week apart) and provided feedback regarding content and ease of use. The questionnaire measures areas of menses, conception, menopause, thyroid function, and change in participation in activities after brain injury. Kappa coefficients and percentage agreement were generated to determine levels of agreement of participant responses between the two sessions. Kappa coefficients ranged from .21 to 1.00, with the highest agreement for items requiring concrete responses (e.g., yes/no) and the lowest with items requiring more subjective answers. Percentage agreement ranged from 58% to 100%. Participants rated the utility of the questionnaire as high (73%-100%). This questionnaire proved to be a reliable and useful method to gather information regarding health in women with TBI. By identifying health issues early, diagnostic and treatment intervention may be delivered in a timelier and effective manner. Further psychometric testing is required to ensure the validity of responses. PMID:21796031
Introduction. Questionnaires on Functional Health Status (FHS) are part of the assessment of oropharyngeal dysphagia. Objective. To conduct a systematic review of the literature on the psychometric properties of English-language FHS questionnaires in adults with oropharyngeal dysphagia. Methods. A systematic search was performed using the electronic databases Pubmed and Embase. The psychometric properties of the questionnaires were determined based on the COSMIN taxonomy of measurement properties and definitions for health-related patient-reported outcomes and the COSMIN checklist using preset psychometric criteria. Results. Three questionnaires were included: the Eating Assessment Tool (EAT-10), the Swallowing Outcome after Laryngectomy (SOAL), and the Self-report Symptom Inventory. The Sydney Swallow Questionnaire (SSQ) proved to be identical to the Modified Self-report Symptom Inventory. All FHS questionnaires obtained poor overall methodological quality scores for most measurement properties. Conclusions. The retrieved FHS questionnaires need psychometric reevaluation; if the overall methodological quality shows satisfactory improvement on most measurement properties, the use of the questionnaires in daily clinic and research can be justified. However, in case of insufficient validity and/or reliability scores, new FHS questionnaires need to be developed using and reporting on preestablished psychometric criteria as recommended in literature.
Speyer, Renee; Cordier, Reinie; Kertscher, Berit; Heijnen, Bas J
OBJECTIVES Excessive daytime sleeping is associated with poorer functional outcomes in rehabilitation populations and may be improved with targeted interventions. The purpose of this study was to test simple methods of screening for excessive daytime sleeping among older adults admitted for post-acute rehabilitation. DESIGN Secondary analysis of data from two clinical samples. SETTING Two post-acute rehabilitation (PAR) units in southern California. PARTICIPANTS Two hundred twenty-six patients aged > 65 years with Mini-Mental State Examination (MMSE) score > 11 undergoing rehabilitation. INTERVENTIONS N/A MEASUREMENTS The primary outcome was excessive daytime sleeping, defined as greater than 15% (1.8 hours) of daytime hours (8AM to 8PM) sleeping as measured by actigraphy. RESULTS Participants spent, on average, 16.2% (SD 12.5%) of daytime hours sleeping as measured by actigraphy. Thirty nine percent of participants had excessive daytime sleeping. The Pittsburgh Sleep Quality Index (PSQI) was significantly associated with actigraphically-measured daytime sleeping (p= 0.0038), but the Epworth Sleepiness Scale (ESS) was not (p = 0.49). Neither the ESS nor the PSQI achieved sufficient sensitivity and specificity to be used as a screening tool for excessive daytime sleeping. Two additional models using items from these questionnaires were not significantly associated with the outcome. CONCLUSIONS In an older PAR population, self-report items from existing sleep questionnaires do not identify excessive daytime sleeping. Therefore we recommend objective measures for the evaluation of excessive daytime sleeping as well as further research to identify new self-report items that may be more applicable in PAR populations.
Skibitsky, Megan; Edelen, Maria Orlando; Martin, Jennifer L.; Harker, Judith; Alessi, Cathy; Saliba, Debra
Achalasia is usually a primary disorder of esophageal motility, but has been described in association with other pathological processes, such as malignancy. A 79-year-old man with achalasia secondary to gastric adenocarcinoma is presented. The differential diagnosis of secondary achalasia includes infectious and infiltrative disease and neuropathy, but mainly malignant diseases. The clinical criteria found for achalasia secondary to malignancy included older age at diagnosis, brief duration of symptoms, and weight loss. While upper gastrointestinal x-rays and computerized tomographic scanning may be helpful, the most reliable diagnostic tool is esophago-gastro-duodenoscopy. This is a terminal disease with short life expectancy. Yet making the correct diagnosis can save the patient from futile treatment with muscle relaxants and endoscopic balloon dilatation, the accepted therapeutic measures in primary achalasia. PMID:8225085
The Minnesota Importance Questionnaire (MIQ) measures 20 vocational needs of the individual. The reliability of the MIQ, consisting of a self-administering, 210-item pair comparison questionnaire, was demonstrated in tests involving 5,358 individuals. MIQ...
Objectives To test the reliability, validity and responsiveness of the 13-item Shortness of Breath with Daily Activities (SOBDA) questionnaire, and determine the threshold for response and minimal important difference (MID). Design 6?week, randomised, double-blind, placebo-controlled study. Setting 40 centres in the USA between 29 October 2009 and 1 July 2010. Primary and secondaryoutcome measures 547 patients with chronic obstructive pulmonary disease (COPD) were enrolled and 418 entered the 2-week run-in period. Data from the run-in period were collected to test internal consistency, test–retest reliability, convergent validity and known-groups validity of the SOBDA. Three hundred and sixty six patients were randomised 2:2:1 to fluticasone propionate/salmeterol 250/50?µg, salmeterol 50?µg or placebo, twice daily. Results from the SOBDA questionnaire, Patient Global Assessment of Change Question, modified Medical Research Council Dyspnoea Scale (mMRC), Clinician Global Impression of Dysponea Severity (CGI-S), Clinician Global Impression of Change Question and Chronic Respiratory Disease Questionnaire self-administered standardised version (CRQ-SAS) were evaluated; spirometry and safety parameters were measured. Study endpoints were selected to investigate the cross-sectional and longitudinal validity of the SOBDA questionnaire in relation to the clinical criteria. Results Internal consistency of the SOBDA questionnaire (Cronbach ?) was 0.89. Test–retest reliability (intraclass correlation) was 0.94. The SOBDA weekly scores correlated with the patient-reported and clinician-reported mMRC, CGI-S and CRQ-SAS dyspnoea domain scores (0.29, 0.24, 0.24 and –0.68, respectively). The SOBDA weekly scores differentiated between the responders and the non-responders as rated by the patients and the clinicians. Anchor-based and supportive distribution-based analyses produced a range of the potential values for the threshold for the responders and MID. Conclusions The 13-item SOBDA questionnaire is reliable, valid and responsive to change in patients with COPD. On using anchor-based methods, the proposed responder threshold shows a ?0.1 to ?0.2 score change. A specific threshold value will be identified as more data are generated from future clinical trials. Trial registration NCT00984659; GlaxoSmithKline study number: ASQ112989.
Watkins, Michael L; Wilcox, Teresa K; Tabberer, Maggie; Brooks, Jean M; Donohue, James F; Anzueto, Antonio; Chen, Wen-Hung; Crim, Courtney
Abstract Objective Both self-reported indicators of stress and hormones such as cortisol and corticotrophin-releasing hormone (CRH) have been examined in relation to preterm birth. Although these hormones have been interpreted as biomarkers of stress, it is unclear whether psychosocial measures are empirically associated with biomarkers of stress in pregnant women. Methods We analyzed data from 1,587 North Carolina pregnant women enrolled in the Pregnancy, Infection, and Nutrition study during 2000–2004 who provided at least one saliva sample for cortisol measurement or blood samples for CRH at 14–19 and 24–29 weeks' gestation. Cortisol measures were limited to those taken between 8 and 10 a.m. Perceived stress, state-trait anxiety, coping style, life events, social support, and pregnancy-specific anxiety were measured by questionnaires and interviews. Spearman correlations and multiple regressions were used to describe the relationship among the measures of stress. Results No correlations larger than r?=?0.15 were seen between reported psychosocial measures and cortisol or CRH. Women with demographic characteristics associated with poor pregnancy outcomes (unmarried, African-American, young, low pre-pregnancy body mass index) reported higher levels of stress but did not consistently have higher levels of stress hormones. Pre-eclampsia was associated with higher CRH, but not with higher cortisol. Conclusions The relationship between measurements of reported stress and biomarkers is not straightforward in large epidemiological studies of pregnancy. For online Supplementary Material, see www.liebertonline.com.
Savitz, David A.; Dole, Nancy; Herring, Amy H.; Thorp, John M.
A comparison of United States secondary school science teachers who mentor high quality student research and teachers who do not mentor research was conducted using a demographic survey and the Multifactor Leadership Questionnaire-Form 5X. The major demographic difference between the two groups was a significantly greater number of years of teaching experience in the research group, a factor that correlated significantly with Extra Effort in students. Research group teachers self-reported higher mean scores than non-research group teachers on the five transformational leadership scales plus the transactional scale of Contingent Reward; however, a Multivariate Analysis of Variance found no significant difference between the groups. Independent t-tests found no significant difference between the groups based upon the remaining transactional scales. The research group was found to be significantly higher on the outcome variable of Extra Effort generated by students while the non-research group rated themselves significantly higher on Satisfaction of students. Transformational leadership in teachers should be addressed by future studies as a possible method of identifying motivational teachers.
Background Maximising response rates to neurodevelopmental follow-up is a key challenge for paediatric researchers. We have investigated the use of telephone interviews and online questionnaires to improve response rates, reduce non-response bias, maintain data completeness and produce unbiased outcomes compared with postal questionnaires when assessing neurodevelopmental outcomes at 2 years. Methods A prospective cohort study of babies born ?32 weeks gestation. Neurodevelopmental outcomes were assessed at 2 years of age using a parent questionnaire completed via post, telephone or online. Relative Risks with 95% confidence intervals (RR; 95% CI) were calculated to identify participant characteristics associated with non-response and questionnaire response mode (postal vs. telephone/online). The proportion of missing data and prevalence of adverse outcomes was compared between response modes using generalized linear models. Results Offering telephone/online questionnaires increased the study response rate from 55% to 60%. Telephone/online responders were more likely to be non-white (RR 1.6; [95% CI 1.1, 2.4]), non-English speaking (1.6; [1.0, 2.6]) or have a multiple birth (1.6; [1.1, 2.3]) than postal responders. There were no significant differences in the prevalence of adverse neurodevelopmental outcomes between those who responded via post vs. telephone/online (1.1; [0.9, 1.4]). Where parents attempted all questionnaire sections, there were no significant differences in the proportion of missing data between response modes. Conclusions Where there is sufficient technology and resources, offering telephone interviews and online questionnaires can enhance response rates and improve sample representation to neurodevelopmental follow-up, whilst maintaining data completeness and unbiased outcomes.
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.
In floating tank roofs, due to various irregularities which are often found on the inside surfaces of tank walls, it is often difficult to maintain a seal with the tank wall. One of the problems encountered is that projections on the tank wall, such as, for example, welding beads, may, upon downward movement of the tank roof, engage the secondary
Background To broaden the range of outcomes that we can measure for patients undergoing treatment for oncological and other chronic conditions, we aimed to validate a questionnaire measuring self-reported autonomic regulation (aR), i.e. to characterise a subject's autonomic functioning by questions on sleeping and waking, vertigo, morningness-eveningness, thermoregulation, perspiration, bowel movements and digestion. Methods We administered the questionnaire to 440 participants (?: N = 316, ?: N = 124): 95 patients with breast cancer, 49 with colorectal cancer, 60 with diabetes mellitus, 39 with coronary heart disease, 28 with rheumatological conditions, 32 with Hashimoto's disease, 22 with multiple morbidities and 115 healthy people. We administered the questionnaire a second time to 50.2% of the participants. External convergence criteria included the German version of the Hospital Anxiety and Depression Scale (HADS-D), a short questionnaire on morningness-eveningness, the Herdecke Quality of Life Questionnaire (HLQ) and a short version questionnaire on self-regulation. Results A principal component analysis yielded a three dimensional 18-item inventory of aR. The subscales orthostatic-circulatory, rest/activity and digestive regulation had internal consistency (Cronbach-?: r? = 0.65 – 0.75) and test-retest reliability (rrt = 0.70 – 85). AR was negatively associated with anxiety, depression, and dysmenorrhoea but positively correlated to HLQ, self-regulation and in part to morningness (except digestive aR) (0.49 – 0.13, all p < 0.05). Conclusion An internal validation of the long-version scale of aR yielded consistent relationships with health versus illness, quality of life and personality. Further studies are required to clarify the issues of external validity, clinical and physiological relevance.
Kroz, M; Feder, G; von Laue, HB; Zerm, R; Reif, M; Girke, M; Matthes, H; Gutenbrunner, C; Heckmann, C
Purpose This prospective study was aimed at assessing cleft lip and palate (CLP) patients’ opinions and attitudes towards their upper lip and nose and the number of secondary corrective surgical interventions electively undertaken to upper lip and nose that were carried out during a 2 year follow-up period. Materials and methods During a 2 year follow-up period CLP outpatients were recruited for the study who attended follow-up examinations at a cleft lip and palate craniofacial center and received a recommendation for secondary corrective facial surgery. The participants filled in a questionnaire that included questions regarding the patients’ opinions and attitudes towards appearance of lip and nose and need for secondary corrective facial surgery. During an additional interval of 2 years the rate of patients who underwent secondary corrective surgery to lip and nose was documented. Results Out of 362 CLP patients 37 (mean age 13.6?±?7.6 years) received a recommendation for secondary corrective surgery to upper lip and/or nose. 22 patients (mean age 12.6?±?6.3 years) filled in the questionnaire (response rate of 62.1%). The satisfaction with the overall facial appearance following the first corrective operation was statistically significantly better than the satisfaction with the nose (p?=?.016). The satisfaction with facial symmetry (5.6?±?2.0) did not differ statistically significantly from the overall satisfaction with the facial appearance (6.2?±?1.8; p?=?.093). Significantly fewer patients (n?=?9) opted for corrective surgery compared to the number of patients who got the recommendation to have secondary corrective surgery done (n?=?22, p?.0005). Conclusions The findings of the present study may reflect a high overall patient satisfaction with the primary treatment outcome following surgery for CLP. Perceived patient need for secondary operation for the lip/nose may be as low as 5%.
The purpose of this paper is to summarize the development and testing of the Norbeck Social Support Questionnaire (NSSQ) and to discuss several issues that have arisen in recent use of the instrument. The NSSQ is a self-administered questionnaire that measures multiple dimensions of social support. Three functional properties--affect, affirmation, and aid--from Kahn's (1979) definition of social support are measured. The network properties of size, stability (duration of relationships), and accessibility (frequency of contact) are also measured, as well as changes in the convoy or support system due to losses of relationships. Nine categories are used to determine sources of support. Graduate students of nursing (N = 130) were used as subjects for several studies to test reliability and validity, and employed adults (N = 136) were used for additional validity testing and to provide normative data. Reliability was established through analysis of internal consistency and test-retest measures taken a week apart. Very high levels of internal consistency and test-retest reliability were found for the functional and network properties, and medium levels for the loss items. At a 7-month retesting, medium levels of stability were found, and the instrument was sensitive to changes in the network composition over time. Although the network composition changed, the overall level of functional support remained stable. Validity of the NSSQ was tested in relation to response bias and concurrent, construct, and predictive validity. The results indicated that the instrument is free from the response bias of social desirability. Medium levels of concurrent validity were shown with two other social support instruments. Construct validity was demonstrated by significant associations between NSSQ measures and two interpersonal constructs expected to be related to social support, while no significant relationships were found between the NSSQ measures and an unrelated interpersonal construct. Predictive validity was tested by examining the hypothesis that social support serves as a buffer for life stress. Among the functional properties, the interaction of aid and life stress accounted for 13.2% of the variance in negative mood. Of the network properties, duration of relationships had significant main and interaction effects, accounting together for 19.3% of the variance in negative mood. Normative data from a sample of employed adults provide means and standard deviations for each subscale and variable of the NSSQ, as well as descriptive data about sources of support.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:6536338
Patient satisfaction is now recognised as an important quality of care outcome which is particularly relevant in oncology. Adapted from the EORTC In-Patsat32, the Out-Patsat35 is a 35-item satisfaction with care questionnaire measuring cancer outpatients' perception of hospital doctors and nurses, as well as aspects of care organisation and services. This study assessed the psychometric properties of this scale. Patients undergoing ambulatory chemotherapy (CT) or radiotherapy (RT) in 7 cancer centres in France were invited to complete at home the Out-Patsat35 as well as EORTC QLQ-C30 for psychometric testing. Of 416 eligible patients recruited, 96% returned the questionnaire. Most patients (71% in CT; 69% in RT) completed this scale within 15 minutes and the mean rate of item omission was only 4.4%. Confirmatory analyses revealed good convergent validity and excellent internal consistency, although some subscales within the Out-Patsat35 were relatively highly correlated. Items and subscales of the Out-Patsat35 and of the QLQ-C30 were not significantly correlated, underlying that the two questionnaires are assessing quite distinct concepts. The subscales of the Out-Patsat35 were not related to age, gender and education, suggesting a cultural evolution in French cancer patients towards a greater homogeneity in their opinion toward care. This study supports the acceptability to patients, and the psychometric properties of the EORTC Out-Patsat35 questionnaire. PMID:16567319
Poinsot, Rollon; Altmeyer, A; Conroy, T; Savignoni, A; Asselain, B; Léonard, I; Marx, E; Cosquer, M; Sévellec, M; Gledhill, J; Rodary, C; Mercier, M; Dickès, P; Fabbro, M; Antoine, P; Guerif, S; Schraub, S; Dolbeault, S; Brédart, A
Objectives To determine the prevalence of bullying and experience of bullying behaviours among postgraduate hospital dentists.Design Questionnaire survey.Setting The study was conducted among a sample of dentally qualified trainees within the UK's Hospital Dental Service.Subjects and methods Two hundred and twenty-seven postgraduate hospital dentists were sent an anonymous questionnaire by the dental deans of participating deaneries.Main outcome measures Prevalence of
L. Quine; K. Jack; D. H. Felix; J. Waumsley; L. Steadman
Background:The modified Rankin scale (mRS) is commonly employed as a measure of functional outcome after stroke. The purpose of this study was to investigate the reliability of the mRS using an expanded guidance scheme and a corresponding questionnaire on an unprecedentedly large scale. Methods:Neurologists interviewed patients with cerebral infarction on the basis of the questionnaire. These interviews were recorded on
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
Nelson Fong SooHoo; Allen P. McDonald; John Gray Seiler; Gary R. McGillivary
OBJECTIVES—The impact of stroke on the emotional outcome of patients is large. The aim was to describe the emotional outcomes among a cohort of patients which was of sufficient size to provide a precise estimate of their frequency and help identify those factors which are associated with poor outcomes after an acute stroke.?METHODS—372 surviving patients, who had been referred to a hospital and entered into a randomised trial to evaluate a stroke family care worker, were asked to complete questionnaires at a 6 month follow up. These included measures of emotional distress (general health questionnaire 30 item, hospital anxiety and depression scale) and physical functioning (modified Rankin, Barthel index). A regression analysis was used to identify factors which were independently associated with poor outcomes.?RESULTS—184 (60%) surviving patients scored more than 4 on the GHQ-30, 55 (22%) more than 8 on the HAD anxiety subscale, and 49 (20%) more than 8 on the HAD depression subscale. Patients with severe strokes resulting in physical disability were more likely to be depressed whereas there was a less strong relation between disability and anxiety. Patients with posterior circulation strokes had consistently better emotional outcomes than those with anterior circulation strokes.?CONCLUSIONS—These data may help identify those patients at greatest risk of poor emotional outcomes and thus help in planning trials and delivering appropriate interventions. ??
Dennis, M.; O'Rourke, S.; Lewis, S.; Sharpe, M.; Warlow, C.
This paper examines educational outcomes of pupils selected to secondary school types by different tracking regimes in a German state: Pupils are alternatively streamed after fourth grade or after sixth grade. Regression results indicate that, estimated on the mean, there are no negative effects of later tracking on educational outcomes in the middle of secondary school. Positive effects are observed
The National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) is the most commonly used patient-reported outcome measure to assess vision-related quality of life in patients with glaucoma. Glaucoma negatively affects the composite and several NEI-VFQ subscale scores; this effect is correlated with the severity of glaucomatous visual field loss. Contrast sensitivity, glare, and dark adaptation are potential items that could be added to the NEI-VFQ to make it more responsive to changes in vision-related quality of life in patients with glaucoma. PMID:23851305
Nassiri, Nariman; Mehravaran, Shiva; Nouri-Mahdavi, Kouros; Coleman, Anne L
Objectives Subjective questionnaires are informative in understanding the difficulties faced by patients with hearing loss. Our intent was to establish and validate a new questionnaire that encompasses situations emphasizing binaural hearing. The Spatial Hearing Questionnaire is a self-report assessment tool utilizing eight subscales representing questions pertaining to the perception of male, female, and children’s voices, music in quiet, source localization, understanding speech in quiet, and understanding speech in noise. Design The Spatial Hearing Questionnaire, composed of 24 items, is scored from 0–100. It was administered to 142 subjects using one or two cochlear implants. Speech perception and localization abilities were measured, and the Speech, Spatial and Other Qualities (SSQ) questionnaire was completed to evaluate validity of the questionnaire. Psychometric tests were done to test the reliability and factor structure of the Spatial Hearing Questionnaire. Results Results showed high internal consistency reliability (Cronbach’s ? = 0.98) and good construct validity (correlations between the Spatial Hearing Questionnaire and other test measures, including the SSQ, were significant). A preliminary factor analysis revealed scores loaded on three factors, representing the following conditions: localization, speech in noise and music in quiet, and speech in quiet, explaining 64.9, 13.0, and 5.3% of the variance, respectively. Most of the questionnaire items (12/24) loaded onto the first factor which represents the subscale related to source localization. Mean scores on the Spatial Hearing Questionnaire were higher for subjects with bilateral cochlear implants over subjects with a unilateral cochlear implant, consistent with other research and supporting construct validity. Conclusions The Spatial Hearing Questionnaire is a reliable and valid questionnaire which can be completed independently by most patients in about 10 minutes. It is likely to be a valuable tool for clinicians and researchers to measure spatial hearing abilities.
The purpose of this study was to investigate teachers' perceptions of the role computers play in their workplace performance. Subjects were 142 secondary public school teachers who responded to a 71-item questionnaire. Follow-up telephone interviews were conducted with 15 carefully selected subjects to provide more depth. Data were analyzed to…
A survey was made by Texas Technological College of secondary school teacher education programs in the United States to determine the various checkpoints and screening procedures of teacher candidates enrolled in those programs. A 13-item questionnaire designed to elicit these data was responded to by 43 institutions in 32 states, and responses…
Introduction Raynaud’s phenomenon is episodic vasospasm of the peripheral vessels, causing pallor followed by cyanosis and redness with pain and sometimes paraesthesia, and, rarely, ulceration of the fingers and toes. It presents as episodic colour changes of the digits, usually in response to cold exposure or stress. The classic triphasic colour change is white (ischaemia), then blue (deoxygenation), then red (reperfusion). Raynaud’s phenomenon can be primary (idiopathic) or secondary to several different conditions and causes. This review deals with secondary Raynaud’s phenomenon. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of self-help measures for secondary Raynaud’s phenomenon? What are the effects of drug treatments for secondary Raynaud’s phenomenon? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2007 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 25 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: alpha-blockers; angiotensin-converting enzyme (ACE) inhibitors; angiotensin II receptor antagonists; antithrombotics/inhibitors of platelet aggregation; biofeedback; calcium channel blockers; endothelin-1 receptor antagonists; glyceryl trinitrate (transdermal); hand exercises; inositol nicotinate; moxisylyte; naftidrofuryl oxylate; phosphodiesterase inhibitors; prostaglandins (oral, intravenous); relaxation therapy; serotonin reuptake inhibitors (SRIs); smoking cessation; and warming hands and feet.
Background: Rehabilitation programs for criminal offenders target primary outcomes such as effects on criminogenic needs and secondaryoutcomes of reducing recidivism. Most evaluation studies focus only on one type of outcome. This study evaluated outcomes on both primary and secondary targets of the Reasoning and Rehabilitation (R&R) program for…
Following treatment of six cases of primary orgasmic dysfunction and six cases of secondary orgasmic dysfunction, an analysis of assessment and outcome data indicated that (1) clients with secondary orgasmic dysfunction and those with primary orgasmic dysfunction did not differ significantly in most aspects of sexual behavior before treatment; (2) before treatment, secondary orgasmic dysfunction tended to be associated with
Kevin B. McGovern; Rita C. Stewart; Joseph LoPiccolo
This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to…
Rothon, Catherine; Head, Jenny; Klineberg, Emily; Stansfeld, Stephen
This article presents the results of a survey study of secondary students' perceptions of useful and challenging characteristics of Web-based learning environments. Data were collected using a modified version of a questionnaire from earlier studies. More specifically, the author focuses on what Web-based learning looks like for secondary…
This study was designed to find out why secondary school students changed schools, the trends and the frequency of change of school among them. The data was collected by means of a set of questionnaires administered to 251 final-year students who had moved from one school to another in the course of their secondary education. Analysis showed that…
This study examines secondary school students' perceptions of inhibiting factors in seeking counselling. Responses to a questionnaire completed by 1346 secondary school students were analysed using quantitative and qualitative methods. Exploratory factor analysis highlighted that within 21 pre-defined inhibiting factors, items loaded strongly on…
Purpose: The purpose of this paper is to measure and compare the performance of Portuguese secondary schools. Design/methodology/approach: Some data on the schools were collected via an electronic questionnaire sent to 103 secondary schools of the centre region of Portugal; other needed data were available through the Centre Regional Education…
Sarrico, Claudia S.; Rosa, Maria J.; Coelho, Ines P.
The purpose of the present study was to develop a questionnaire to assess student attitudes towards school by describing the factors that affect these attitudes. For this purpose, a sample of 362 (11-13 years-old) elementary-school students was used. Both exploratory and confirmatory factor analyses were carried out. The questionnaire consists of…
The Cuban Behavioral Identity Questionnaire is a short, eight-item questionnaire answerable in a seven-point Likert-scale format. It inquires as to the frequency with which respondents engage in several ethnic behaviors and the degree to which they are familiar with Cuban idiomatic expressions and Cuban artists/musicians. (Author/NQ)
This short document guides the user through the stages of creating and implementing an effective questionnaire. The types of questions and how they should be worded are addressed, and many good examples of the different types of questions that could go into a questionnaire are presented. This resource is intended for novice evaluators.
This article discusses measuring learning strategies by means of questionnaires. In "multi-method" research, in which think-aloud measures are compared with questionnaires, low or moderate correlations are found. A conclusion often drawn is that learners are not able to verbally report on their learning activities. Alternative explanations concern…
The development, norming, and validation of the Preschool Behavior Questionnaire (PBQ) are described. The questionnaire was developed to be a screening instrument for use by mental health professionals for the early detection of children's behavior problems. The scale was standardized on a group of preschoolers aged three to six, including male…
This supplement describes national adaptations made to the international version of the PIRLS/prePIRLS 2011 background questionnaires. This information provides users with a guide to evaluate the availability of internationally comparable data for use in secondary analyses involving the PIRLS/prePIRLS 2011 background variables. Background…
This article reports the adaptation and analysis of Pintrich's Motivated Strategies for Learning Questionnaire (MSLQ) in Hong Kong. First, this study examined the psychometric qualities of the existing Chinese version of MSLQ (MSLQ-CV). Based on this examination, this study developed a revised Chinese version of MSLQ (MSLQ-RCV) for junior secondary students in Hong Kong. Confirmatory factor analysis and Graded Response
The primary purpose of this study was to obtain estimates of the human attribute requirements of the job elements of the Position Analysis Questionnaire (PAQ). A secondary purpose was to explore the reliability of job-related ratings as a function of the number of raters. A taxonomy of 76 human attributes was used and ratings of the relevance of…
Although relationships have been found between maternal psychological characteristics and cognitive and emotional outcomes in children, the behaviors which may mediate these relationships are seldom examined. This is especially true for adolescent mothers, whose children are thought to be at high risk for adverse outcomes. In this study, adolescent mothers in two special programs completed questionnaires measuring perception of the
Linda LeResche; Donna Strobino; Peggy Parks; Pamela Fischer; Vincent Smeriglio
Questionnaire is a general and indispensable method frequently and widely used in many academic, engineering, medical, commercial, and political survey research activities to obtain systematic data and information. Ubiquitous questionnaire, i.e., to provide users with E-questionnaire services anytime and anywhere such that one can use E-questionnaire servers without even thinking about them, is an ideal ubiquitous service in service-oriented computing.
Objective: Robotic surgical systems offer better workplace in order to relieve surgeons from prolonged physical efforts and improve their surgical outcomes. However, robotic surgery could produce musculoskeletal disorders due to the prolonged sitting position of the operator, the fixed position of the console viewer and the movements of the limbs. Until today, no one study has been reported concerning the association between robotics and musculoskeletal pain. The aim of this work was verify the prevalence of musculoskeletal disorders among Italian robotic surgeons. Material and methods: Between July 2011 and April 2012 a modified Standardized Nordic Questionnaire was delivered to thirty-nine Italian robotic centres. Twentytwo surgeons (56%) returned the questionnaires but only seventeen questionnaires (43.5%) were evaluable. Results: Seven surgeons (41.2%) reported musculoskeletal disorders, by since their first use of the robot which significantly persisted during the daily surgical activity (P < 0.001). Regarding the body parts affected, musculoskeletal disorders were mainly reported in the cervical spine (29.4%) and in the upper limbs (23.5%). Six surgeons (35.3%) defined the robotic console as less comfortable or neither comfortable/uncomfortable with a negative influence on their surgical procedures. Conclusions: In spite of some important limitations, our data showed musculoskeletal disorders due to posture discomfort with negative impact on daily surgical activity among robotic surgeons. These aspects could be due to the lack of ergonomic seat and to the fixed position of the console viewer which could have produced an inadequate spinal posture. The evaluation of these postural factors, in particular the development of an integrated and more ergonomic chair, could further improve the comfort feeling of the surgeon at the console and probably his surgical outcomes. PMID:25017587
Giberti, Claudio; Gallo, Fabrizio; Francini, Luca; Signori, Alessio; Testa, Marco
High dropout rates from treatment for alcohol-related problems are a problem for treatment delivery. Outcome expectations of treatment attendance are motivational aspects of treatment adherence. Since no method to put such expectations into operation has been found, we developed the Psychosocial Treatment Expectations Questionnaire (PTEQ) to assess the expectations of people receiving such psychosocial treatments. PTEQ development and early validation
José Carlos de Carvalho Leite; Nédio Seminotti; Paulo Fontoura Freitas; Maria de Lourdes Drachler
BACKGROUND: The Boston Carpal Tunnel Questionnaire (BCTQ) is a disease-specific measure of self-reported symptom severity and functional status. It is frequently used in the reporting of outcomes from trials into interventions for carpal tunnel syndrome. We conducted a systematic review of published studies on the psychometric properties of the BCTQ to determine the level of evidence on the instrument's validity,
Given the potential benefits of understanding how climate may influence individuals' motivational outcomes, there exists a need for instrumentation measuring exercise setting climates. The purpose of this study was to validate further the psychometric properties of the Perceived Motivational Climate in Exercise Questionnaire (Huddleston, Fry &…
Previous studies have shown that job strain, a combination of high psychological demands and low decision latitude, may be involved in the development of cardiovascular diseases and other health outcomes. In 1985, Karasek recommended a standard questionnaire to measure psychological demands (nine items) and job decision latitude (nine items). The internal consistency, factorial validity, discriminant validity, and 1-year stability of
Chantal Brisson; Caty Blanchette; Chantal Guimont; Guylaine Dion; Jocelyne Moisan; Michel Vézina; Gilles R. Dagenais; Lousie M?sse
Because severe ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening iatrogenic complication, much effort is made to prevent it and the anticipated pregnancy naturally becomes of secondary importance. There are many publications on OHSS, but very few on pregnancy outcomes. This work is to review the effect of OHSS on pregnancy outcome along the pregnancy course. Hospitalized patients with severe
Background Therapists who work with trauma clients are impacted both positively and negatively. However, most studies have tended to focus on the negative impact of the work, the quantitative evidence has been inconsistent, and the research has primarily been conducted outside the United Kingdom. Objectives This study aimed to assess the prevalence of, and identify predictor variables for, compassion satisfaction, burnout, and secondary traumatic stress in a group of UK therapists (N=253) working with adult trauma clients. Method An online questionnaire was developed which used The Professional Quality of Life Scale (Version 5) to assess compassion satisfaction, burnout, and secondary traumatic stress and collect demographics and other pertinent information. Results Whilst the majority of therapists scored within the average range for compassion satisfaction and burnout, 70% of scores indicated that therapists were at high risk of secondary traumatic stress. Maturity, time spent engaging in research and development activities, a higher perceived supportiveness of management, and supervision predicted higher potential for compassion satisfaction. Youth and a lower perceived supportiveness of management predicted higher risk of burnout. A higher risk of secondary traumatic stress was predicted in therapists engaging in more individual supervision and self-care activities, as well as those who had a personal trauma history. Conclusions UK therapists working with trauma clients are at high risk of being negatively impacted by their work, obtaining scores which suggest a risk of developing secondary traumatic stress. Of particular note was that exposure to trauma stories did not significantly predict secondary traumatic stress scores as suggested by theory. However, the negative impact of working with trauma clients was balanced by the potential for a positive outcome from trauma work as a majority indicated an average potential for compassion satisfaction.
Sodeke-Gregson, Ekundayo A.; Holttum, Sue; Billings, Jo
Background: Recent reports have described resuscitation-induced, “secondary” abdominal compartment syndrome (ACS) in trauma patients without intra-abdominal injuries. We have diagnosed secondary ACS in a variety of nontrauma as well as trauma patients. The purpose of this review is to characterize patients who develop secondary ACS.Methods: Our prospective ACS database was reviewed for cases of secondary ACS. Physiologic parameters and outcomes
Walter L Biffl; Ernest E Moore; Jon M Burch; Patrick J Offner; Reginald J Franciose; Jeffrey L Johnson
Evaluating and improving methods for measuring cancer outcomes is critically important for NCI's initiatives to enhance the quality of cancer care, reduce cancer-related health disparities, and better understand the individual and population burden of disease. The Applied Research Program’s initiatives in this area include developing resources for researchers to learn about psychometric and other tools that aid in assessing and developing outcomes measures.
Wareham NJ, Jakes RW, Rennie KL et al. Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.
Generic Questionnaire for Biopharmaceutical Production Candidates Involving Recombinant Organisms Principal Investigator: Institution: What amount(s) of delivered product(s) is desired? A. Non-GMP (laboratory grade) B. cGMP (clinical grade) Please
This database contains questionnaire items and a list of validation studies for standardized items concerning walking and biking from multiple national and international physical activity questionnaires (PAQs). The purpose of this database is to provide easy access to a large number of items assessing duration and frequency of walking and bicycling in the non-disabled adult population. We also briefly review the results of validation studies identified for some of the PAQs.
The present studies compared the psychometric properties of two self-report measures of spider fear: Fear of Spiders Questionnaire (FSQ) and Spider Phobia Questionnaire (SPQ). In the first study, adequate test-retest stability and internal consistency was found for both FSQ and SPQ. In the second study, both instruments were able to differentiate between phobic and non-phobic subjects. Furthermore, FSQ as well
Summary This is a validation of a self-rating questionnaire designed to detect disorders of the mother-infant relationship. 125 subjects\\u000a filled in the questionnaire, and were also interviewed using the 5th Edition of the Birmingham Interview for Maternal Mental Health. On the basis of these interviews and the case records, we\\u000a made consensus diagnoses of various forms and degrees of mother infant
The purpose was to design a self-report measure of behavioral tendencies that frequently accompany body-image disturbance. The result was a 19-item questionnaire that dealt with avoidance of situations that provoke concern about physical appearance, such as avoidance of tight-fitting clothes, social outings, and physical intimacy. The Body Image Avoidance Questionnaire had adequate internal consistency and test–retest reliability. The measure correlated
James C. Rosen; Debra Srebnik; Elayne Saltzberg; Sally Wendt
There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures’ psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth OutcomeQuestionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against standards of feasibility and psychometric credibility in relation to use for practice and policy.
Depression, somatisation and pain beliefs influence outcome of several painful musculoskeletal disorders. Their influence\\u000a on the postoperative outcome of total hip replacement was investigated. A total of 79 patients who underwent primary total\\u000a hip replacement completed questionnaires preoperatively and six weeks postoperatively addressing depression (Hospital Anxiety\\u000a and Depression Scale–German version), pain beliefs (Pain Beliefs Questionnaire) and somatisation (Screening of Somatoform\\u000a Disorders-2)
Wolfgang Riediger; Stephan Doering; Martin Krismer
Childhood overweight and obesity are a growing concern globally, and environments, including the home and school, can contribute to this epidemic. This paper assesses the reliability of two questionnaires (parent and teacher) used in the evaluation of a community-based childhood obesity prevention intervention, the eat well be active (ewba) Community Programs. Parents and teachers were recruited from two primary schools and they completed the same questionnaire twice in 2008 and 2009. Data from both questionnaires were classified into outcomes relevant to healthy eating and activity, and target outcomes, based on the goals of the ewba Community Programs, were identified. Fourteen and 12 outcomes were developed from the parent and teacher questionnaires, respectively. Sixty parents and 28 teachers participated in the reliability study. Intraclass correlation coefficients for outcomes ranged from 0.37 to 0.92 (parent) (P < 0.05) and from 0.42 to 0.86 (teacher) (P < 0.05). Internal consistency, measured by Cronbach's alpha, of teacher scores ranged from 0.11 to 0.91 and 0.13 to 0.78 for scores from the parent questionnaire. The parent and teacher questionnaires are moderately reliable tools for simultaneously assessing child intakes, environments, attitudes, and knowledge associated with healthy eating and physical activity in the home and school and may be useful for evaluation of similar programs.
Childhood overweight and obesity are a growing concern globally, and environments, including the home and school, can contribute to this epidemic. This paper assesses the reliability of two questionnaires (parent and teacher) used in the evaluation of a community-based childhood obesity prevention intervention, the eat well be active (ewba) Community Programs. Parents and teachers were recruited from two primary schools and they completed the same questionnaire twice in 2008 and 2009. Data from both questionnaires were classified into outcomes relevant to healthy eating and activity, and target outcomes, based on the goals of the ewba Community Programs, were identified. Fourteen and 12 outcomes were developed from the parent and teacher questionnaires, respectively. Sixty parents and 28 teachers participated in the reliability study. Intraclass correlation coefficients for outcomes ranged from 0.37 to 0.92 (parent) (P < 0.05) and from 0.42 to 0.86 (teacher) (P < 0.05). Internal consistency, measured by Cronbach's alpha, of teacher scores ranged from 0.11 to 0.91 and 0.13 to 0.78 for scores from the parent questionnaire. The parent and teacher questionnaires are moderately reliable tools for simultaneously assessing child intakes, environments, attitudes, and knowledge associated with healthy eating and physical activity in the home and school and may be useful for evaluation of similar programs. PMID:23936636
Background The purpose of the present study is to translate and validate the “Hip and Knee OutcomesQuestionnaire”, developed in English, into Spanish. The ‘Hip and Knee OutcomesQuestionnaire is a questionnaire planned to evaluate the impact in quality of life of any problem related to the human musculoskeletal system. 10 scientific associations developed it. Methods The questionnaire underwent a validated translation/retro-translation process. Patients undergoing primary knee arthroplasty, before and six months postoperative, tested the final version in Spanish. Psychometric properties of feasibility, reliability, validity and sensitivity to change were assessed. Convergent validity with SF-36 and WOMAC questionnaires was evaluated. Results 316 patients were included. Feasibility: a high number of missing items in questions 3, 4 and 5 were observed. The number of patients with a missing item was 171 (51.35%) in the preoperative visit and 139 (44.0%) at the postoperative. Internal validity: revision of coefficients in the item-rest correlation recommended removing question 6 during the preoperative visit (coefficient <0.20). Convergent validity: coefficients of correlation with WOMAC and SF-36 scales confirm the questionnaire’s validity. Sensitivity to change: statistically significant differences were found between the mean scores of the first visit compared to the postoperative. Conclusion The proposed translation to Spanish of the ‘Hip and Knee Questionnaire’ is found to be reliable, valid and sensible to changes produced at the clinical practice of patients undergoing primary knee arthroplasty. However, some changes at the completion instructions are recommended. Level of evidence: Level I. Prognostic study.
Assessment instruments that are not responsive to change are unsuitable as outcome tools in cardiac rehabilitation because they underestimate the psychosocial benefits of program attendance. Nine questionnaires were assessed for responsiveness with the standardized response mean (SRM). Questionnaires were allocated into 3 batteries, and each…
Background Little is known about the association between financial stress and health care outcomes. Our objective was to examine the association between self-reported financial stress during initial hospitalization and long-term outcomes after acute myocardial infarction (AMI). Materials and Methods We used Prospective Registry Evaluating Myocardial Infarction: Event and Recovery (PREMIER) data, an observational, multicenter US study of AMI patients discharged between January 2003 and June 2004. Primary outcomes were disease-specific and generic health status outcomes at 1 year (symptoms, function, and quality of life (QoL)), assessed by the Seattle Angina Questionnaire [SAQ] and Short Form [SF]-12. Secondaryoutcomes included 1-year rehospitalization and 4-year mortality. Hierarchical regression models accounted for patient socio-demographic, clinical, and quality of care characteristics, and access and barriers to care. Results Among 2344 AMI patients, 1241 (52.9%) reported no financial stress, 735 (31.4%) reported low financial stress, and 368 (15.7%) reported high financial stress. When comparing individuals reporting low financial stress to no financial stress, there were no significant differences in post-AMI outcomes. In contrast, individuals reporting high financial stress were more likely to have worse physical health (SF-12 PCS mean difference ?3.24, 95% Confidence Interval [CI]: ?4.82, ?1.66), mental health (SF-12 MCS mean difference: ?2.44, 95% CI: ?3.83, ?1.05), disease-specific QoL (SAQ QoL mean difference: ?6.99, 95% CI: ?9.59, ?4.40), and be experiencing angina (SAQ Angina Relative Risk?=?1.66, 95%CI: 1.19, 2.32) at 1 year post-AMI. While 1-year readmission rates were increased (Hazard Ratio?=?1.50; 95%CI: 1.20, 1.86), 4-year mortality was no different. Conclusions High financial stress is common and an important risk factor for worse long-term outcomes post-AMI, independent of access and barriers to care.
Shah, Sachin J.; Krumholz, Harlan M.; Reid, Kimberly J.; Rathore, Saif S.; Mandawat, Aditya; Spertus, John A.; Ross, Joseph S.
This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to achieve the appropriate academic achievement benchmark for their age group and bullied boys (but not girls) were more likely to exhibit depressive symptoms compared to those not bullied. High levels of social support from family were important in promoting good mental health. There was evidence that high levels of support from friends and moderate (but not high) family support was able to protect bullied adolescents from poor academic achievement. Support from friends and family was not sufficient to protect adolescents against mental health difficulties that they might face as a result of being bullied. More active intervention from schools is recommended.
Rothon, Catherine; Head, Jenny; Klineberg, Emily; Stansfeld, Stephen
The study's purpose was to determine if parental dental functional health literacy related to child oral health. A secondary aim was to assess if errors in completing the questionnaire related to FHL and child oral health. Parents of pediatric clinic children (N = 101) completed questionnaires and dental caries indices were recorded. Higher FHL was negatively correlated with worse child caries (r = -0.23), but not subjective oral health. Mean FHL seemed to differ by skip pattern (p = 0.087), indicating it may be a potential FHL proxy. PMID:22685950
ABSTRACT Objectives: To examine factors associated with treatment outcome satisfaction in a group of adolescent patients. Materials and Methods: One hundred and twenty patients (60 girls and 60 boys; mean age, 14.3 years; standard deviation [SD], 1.73 years) were consecutively recruited. The inclusion criteria for all patients were as follows: adolescents with a permanent dentition in need of orthodontic treatment and a treatment plan involving extractions (two or four premolars) followed by fixed appliances in both jaws. Questionnaire 1, concerning treatment motivation and expectations, was assessed prior to treatment start. Questionnaire 2 was assessed after active treatment and included questions about satisfaction with treatment outcome, quality of care and attention, and perceived pain and discomfort during active treatment. Results: One hundred and ten patients completed the trial (54 boys and 56 girls; mean age, 16.9 years; SD, 1.78 years). Median values for satisfaction with treatment outcome were generally high. There was a clear correlation (P ? .001) between satisfaction with treatment outcome and patients' perception of how well they had been informed and cared for during treatment. Pain and discomfort during treatment also strongly affected treatment satisfaction. Sex, treatment time, and Peer Assessment Rating index pre- and posttreatment as well as expectations for future treatment showed no correlation with treatment satisfaction. Conclusions: Care and attention was the variable showing the highest correlation with satisfaction with treatment outcome. Patients' perceptions of pain and discomfort during treatment had an overall negative correlation with treatment satisfaction. Satisfaction with treatment outcome is a complex issue and requires further exploration in future research. PMID:24423202
Objective: To explore the long-term outcomes of CONECSI (COping with NEuropathiC Spinal cord Injury pain), a multidisciplinary cognitive behavioural treatment programme in persons with spinal cord injury. Design: Long-term follow-up pre-post-intervention design. Subjects: A total of 29 subjects with a spinal cord injury and chronic neuropathic pain from 4 Dutch rehabilitation centres. Methods: Primary outcomes were pain intensity and pain-related disability (Chronic Pain Grade questionnaire). Secondaryoutcomes were mood (Hospital Anxiety and Depression Scale), participation in activities (Utrecht Activities List), and life satisfaction (Life Satisfaction Questionnaire). Random coefficient analysis was used for the analyses of measurements before (t1), immediate post-intervention (t2), and 6 (t3), 9 (t4), and 12 (t5) months follow-up. Results: The analyses showed significant improvements on pain intensity (t1-t2 and t1-t5) and pain-related disability (t1-t2, t1-t4, and t1-t5), anxiety and participation in activities (t1-t2, t1-t3, and t1-t5). Conclusion: This exploratory study suggests that a multidisciplinary cognitive behavioural programme might have lasting improvements on pain intensity, pain-related disability, anxiety, and participation in activities in people with chronic neuropathic spinal cord injury pain and highlights the potential of such programmes. PMID:24818861
Heutink, Matagne; Post, Marcel Wm; Luthart, Peter; Schuitemaker, Marijke; Slangen, Sandra; Sweers, Jolante; Vlemmix, Lonneke; Lindeman, Eline
At the beginning of the 21st century, education seems dominated by talk about educational outcomes and their assessment. This chapter serves to demystify these topics. This free selection includes the Preface, Table of Contents, an About the Author page, and the Alphabetical List of the 88 Education Terms.
An outcomes charting method was used to evaluate effects of a 12-year-old interdisciplinary summer institute for health professionals. Primary outcomes were academic publications, and a case management guide and videotapes. Secondaryoutcomes included improved clinical service and an undergraduate course on case management. (SK)
...2009-04-01 false Circulation of draft questionnaires. 207.63 Section 207.63...207.63 Circulation of draft questionnaires. (a) The Director shall circulate draft questionnaires to the parties for comment in...
...2010-04-01 false Circulation of draft questionnaires. 207.63 Section 207.63...207.63 Circulation of draft questionnaires. (a) The Director shall circulate draft questionnaires to the parties for comment in...
...2013-04-01 false Circulation of draft questionnaires. 207.63 Section 207.63...207.63 Circulation of draft questionnaires. (a) The Director shall circulate draft questionnaires to the parties for comment in...
The Technician Walkthrough questionnaire data set contains information about each household as determined during a walkthrough by trained technicians. The information is from 403 technician walkthrough questionnaires for 80 households across 6 cycles. The questionnaire includes...
The Baseline Questionnaire data set provides information about the household using the primary resident (IRN 01) and other residents who chose to participate. The information is from 1106 Baseline Questionnaires for 534 households. The Baseline Questionnaire was administered to...
Background Previous studies have demonstrated that adverse events occur during chiropractic treatment. However, because of these studies design we do not know the frequency and extent of these events when compared to sham treatment. The principal aims of this study are to establish the frequency and severity of adverse effects from short term usual chiropractic treatment of the spine when compared to a sham treatment group. The secondary aim of this study is to establish the efficacy of usual short term chiropractic care for spinal pain when compared to a sham intervention. Methods One hundred and eighty participants will be randomly allocated to either usual chiropractic care or a sham intervention group. To be considered for inclusion the participants must have experienced non-specific spinal pain for at least one week. The study will be conducted at the clinics of registered chiropractors in Western Australia. Participants in each group will receive two treatments at intervals no less than one week. For the usual chiropractic care group, the selection of therapeutic techniques will be left to the chiropractors' discretion. For the sham intervention group, de-tuned ultrasound and de-tuned activator treatment will be applied by the chiropractors to the regions where spinal pain is experienced. Adverse events will be assessed two days after each appointment using a questionnaire developed for this study. The efficacy of short term chiropractic care for spinal pain will be examined at two week follow-up by assessing pain, physical function, minimum acceptable outcome, and satisfaction with care, with the use of the following outcome measures: Numerical Rating Scale, Functional Rating Index, Neck Disability Index, Minimum Acceptable OutcomeQuestionnaire, Oswestry Disability Index, and a global measure of treatment satisfaction. The statistician, outcome assessor, and participants will be blinded to treatment allocation. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000542998
Personality traits are known to be associated with a host of important life outcomes, including interpersonal dysfunction. The interpersonal circumplex offers a comprehensive system for articulating the kinds of interpersonal problems associated with personality traits. In the current study, traits as measured by the Multidimensional Personality Questionnaire in a sample of 124 young women were correlated with interpersonal dysfunction as measured by the Inventory of Interpersonal Problems-Circumplex. Results suggest that Multidimensional Personality Questionnaire traits vary in their associations with interpersonal distress and in their coverage of specific kinds of interpersonal difficulties among women undergoing the transition to adulthood. PMID:22064504
Hopwood, Christopher J; Burt, S Alexandra; Keel, Pamela K; Neale, Michael C; Boker, Steven M; Klump, Kelly L
Background Back pain in children is common and early onset of back pain has been shown to increase the risk of back pain significantly in adulthood. Consequently, preventive efforts must be targeted the young population but research relating to spinal problems in this age group is scarce. Focus has primarily been on the working age population, and therefore specific questionnaires to measure spinal pain and its consequences, specifically aimed at children and adolescents are absent. The purpose of this study was to develop a questionnaire for schoolchildren filling this gap. Methods The Young Spine Questionnaire (YSQ) was developed in three phases – a conceptualisation, development and testing phase. The conceptualisation phase followed the Wilson and Cleary model and included questions regarding spinal prevalence estimates, pain frequency and intensity, activity restrictions, care seeking behaviour and influence of parental back trouble. Items from existing questionnaires and the “Revised Faces Pain Scale” (rFPS) were included during the development phase. The testing phase consisted of a mixed quantitative and qualitative iterative method carried out in two pilot tests using 4th grade children and focusing on assessment of spinal area location and item validity. Results The testing phase resulted in omission of the pain drawings and the questions and answer categories were simplified in several questions. Agreement between the questionnaire prevalence estimates and the interviews ranged between 83.7% (cervical pain today) and 97.9% (thoracic pain today). To improve the understanding of the spinal boundaries we added bony landmarks to the spinal drawings after pilot test I. This resulted in an improved sense of spinal boundary location in pilot test II. Correlations between the rFPS and the interview pain score ranged between 0.67 (cervical spine) and 0.79 (lumbar spine). Conclusions The Young Spine Questionnaire contains questions that assess spinal pain and its consequences. The items have been tested for content understanding and agreement between questionnaire scores and interview findings among target respondents. These preliminary results suggest that the YSQ is feasible, has content validity and is a well understood questionnaire to be used in studies of children aged 9 to 11 years.
The Arab Teens Lifestyle Study (ATLS) is a multicenter project for assessing the lifestyle habits of Arab adolescents. This study reports on the convergent validity of the physical activity questionnaire used in ATLS against an electronic pedometer. Participants were 39 males and 36 females randomly selected from secondary schools, with a mean age of 16.1 ± 1.1 years. ATLS self-reported questionnaire was validated against the electronic pedometer for three consecutive weekdays. Mean steps counts were 6,866 ± 3,854 steps/day with no significant gender difference observed. Questionnaire results showed no significant gender differences in time spent on total or moderate-intensity activities. However, males spent significantly more time than females on vigorous-intensity activity. The correlation of steps counts with total time spent on all activities by the questionnaire was 0.369. Relationship of steps counts was higher with vigorous-intensity (r = 0.338) than with moderate-intensity activity (r = 0.265). Pedometer steps counts showed higher correlations with time spent on walking (r = 0.350) and jogging (r = 0.383) than with the time spent on other activities. Active participants, based on pedometer assessment, were also most active by the questionnaire. It appears that ATLS questionnaire is a valid instrument for assessing habitual physical activity among Arab adolescents.
Al-Hazzaa, Hazzaa M.; Al-Sobayel, Hana I.; Musaiger, Abdulrahman O.
Describes the development of the Agoraphobic Cognitions Questionnaire and the Body Sensations Questionnaire, companion measures for assessing aspects of fear of fear (panic attacks) in agoraphobics. The instruments were administered to 175 agoraphobics (mean age 37.64 yrs) and 43 controls (mean age 36.13 yrs) who were similar in sex and marital status to experimental Ss. Results show that the instruments
Dianne L. Chambless; G. Craig Caputo; Priscilla Bright; Richard Gallagher
This article states the PA questionnaire used is the same as that used in the Singh 1996 validation study (which does appear to be the Paffenbarger). But in fact, the two questionnaires (which are provided in both articles) don’t appear to be the same; and the Singh 2001 version does not ask specific walking questions.
To discover factors which contribute to a high response rate for questionnaire surveys, the preferences of 150 college teachers and teaching assistants were studied. Four different questionnaire formats using 34 common items were sent to the subjects: open-ended; Likert-type (five points, from "strong influence to return," to "strong influence not…
The structural and external validity of the Tridimensional Personality Questionnaire (TPQ) and the relations among TPQ lower-order and higher-order scales and those of the Multidimensional Personality Questionnaire were examined. Results for 1,236 adults support the TPQ's validity but indicate its failure to operationalize portions of the…
Melioidosis is an infective condition which is common in South East Asia. It can present in various forms like cutaneous abscess, pneumonia and severe septicaemia. However, melioidosis causing abdominal aortic pseudoaneurysms is extremely rare and a difficult condition to diagnose and treat. We present our management of two cases of abdominal aortic pseudoaneurysms secondary to melioidosis and their subsequent outcomes. PMID:19321406
The feasibility of heart transplantation for infants has now been established. Clinical outcome data is necessary to assist in targeting areas for improvement and for counseling families considering this option. This report describes clinical outcome in 29 infant heart transplant recipients who have survived at least 10 years. A query of the transplant database, referring physicians and parental questionnaire was
Objectives: The present study examined the psychometric properties of the Chinese Virtues Questionnaire (CVQ). The reliability, factor structure, construct validity, and temporal stability of the inventory were examined. Method: A university student sample ("n" = 878) and a working adult sample ("n" = 153) were recruited.…
Duan, Wenjie; Ho, Samuel M. Y.; Bai, Yu; Tang, Xiaoqing
This introductory manual for the College Student Satisfaction Questionnaire (CSSQ) includes a description of the test, tentative norms, a summary of findings to date regarding psychometric characteristics of the instrument, and suggestions for possible uses. The manual is intended to supply sufficient material for the practical needs of most test…
We examined the psychometric properties of a German translation of the Child Global Report version of the Alabama Parenting Questionnaire (APQ). A total of 1219 German school-children (644 boys and 575 girls), ages 10-14 years participated in the study. The APQ was subjected to exploratory and confirmatory factor analysis. Exploratory factor…
Essau, Cecilia A.; Sasagawa, Satoko; Frick, Paul J.
The psychometric properties of the Selective Mutism Questionnaire (SMQ) are evaluated using a clinical sample of children with selective mutism (SM). The study shows that SMQ is useful in determining the severity of a child's nonspeaking behaviors, the scope of these behaviors and necessary follow up assessment.
Letamendi, Andrea M.; Chavira, Denise A.; Hitchcock, Carla A.; Roesch, Scott C.; Shipon-Blum, Elisa; Stein, Murray B.
A deterministic questionnaire method for zygosity determination is developed for use in epidemiological studies of adult twins. It is based on the answers of both members of a twin pair to two questions on similarity and confusion in childhood. The algorithm of the method is used to determine the zygosity status of a twin pair at two different levels of
Seppo Sarna; Jaakko Kaprio; Pertti Sistonen; Markku Koskenvuo
The development of a Menstrual Distress Questionnaire (MDQ) is described. Each of 839 women rated their experience of 47 symptoms on a six-point scale separately for the menstrual, premenstrual, and intermenstrual phases of her most recent menstrual cycle and for her worst menstrual cycle. The 47 symptoms were intercorrelated and factor analyzed separately for each phase, and eight basically replicated
Surveys are an important part of marketing and customer relationship management, and open answers (i.e., answers to open questions) in particular may contain valuable information and provide an important basis for making business decisions. We have developed a text mining system that provides a new way for analyzing open answers in questionnaire data. The product is able to perform the
A questionnaire measure of Sexual Interest is described; in construction and scoring, the authors have borrowed from the Sexual Orientation Method. Five subscale scores relating to different areas of sexual behavior can be measured, and an overall Sexual Interest score obtained. The measure is fully described, and preliminary data on internal consistency, reliability, and validity are presented. Applications of the
J. J. M. Harbison; P. Joan Graham; J. T. Quinn; H. McAllister; R. Woodward
Resource Purpose: This information acquired via the questionnaire is used to support development of the effluent guidelines for the Iron and Steel Point Source Category (40CFR Part 420). One of the statutory decision criteria for the adoption of a best available treatment t...
This questionnaire assesses drug use practices in high school drop-outs. The 79 items (multiple choice or apply/not apply) are concerned with demographic data and use, use history, reasons for use/nonuse, attitudes toward drugs, availability of drugs, and drug information with respect to narcotics, amphetamines, LSD, Marijuana, and barbiturates.…
Governor's Citizen Advisory Committee on Drugs, Salt Lake City, UT.
The Social coping Questionnaire (SCQ) measures strategies used by gifted adolescents to minimize the negative effect they believe their high ability has on their social interactions. Previous studies have supported the factor structure, internal consistency, and test-retest reliability of the SCQ. The current study provides construct validity…
The purpose of the present study was to test the validity evidence of the Child Sport Cohesion Questionnaire (CSCQ). To accomplish this task, convergent, discriminant, and known-group difference validity were examined, along with factorial validity via confirmatory factor analysis (CFA). Child athletes (N = 290, M[subscript age] = 10.73 plus or…
Martin, Luc J.; Carron, Albert V.; Eys, Mark A.; Loughead, Todd
The lack of systematic psychometric information on the Suicide Opinion Questionnaire (SOQ) was addressed by investigating the factor structure and reliability of the eight-factor clinical scale model (mental illness, cry for help, right to die, religion, impulsivity, normality, aggression, and moral evil), developed for interpreting responses to…
A computer-administered (CA) form of the Multidimensional Personality Questionnaire (MPQ) (A. Tellegen, 1982) was created, and scores of 126 college students were compared to those of 101 who took a paper-and-pencil MPQ. Multivariate analyses found no group differences for the CA format, and likelihood of profile validity was decreased. Results…
The mortality rate after myocardial infarction fell sharply with the advent of reperfusion methods and the use of efficient antithrombotic and antiischemic drugs. However, new infarcts, heart failure, arrythmias and sudden death remain frequent, especially in the first two years after the initial event. Large clinical studies have defined and validated therapies for secondary prevention, but the recommended measures are not always properly implemented. Patients with and without ST elevation after myocardial infarction share the same pathophysiologic mechanism, namely atherosclerotic plaque rupture or erosion, with different degrees of superimposed thrombosis and distal embolization. Secondary prevention is the same for these two patient categories. Acute coronary syndromes are associated with an increased risk of adverse cardiovascular outcomes (new myocardial ischemia, left ventricular dysfunction or sudden death) and require aggressive secondary prevention. However, risks factors such as smoking, hypertension, obesity, hypercholesterolemia and diabetes frequently persist. In addition, medical practice does not always respect consensus guidelines. Early risk stratification is necessary to detect residual myocardial ischemia in viable myocardium. After the acute phase, the prognosis depends on the degree of left ventricular dysfunction and the extent and severity of residual ischemia. Exercise and ambulatory electrocardiography, stress echocardiography, perfusion scintigraphy using vasodilator stress, magnetic resonance imaging and coronary angiography are all useful for identifying high-risk patients. Secondary prevention should include risk factor management with lifestyle modifications such as weight reduction, a reduction in saturated fats and an increase in monounsaturated fatty acids. Smoking cessation is crucial, and regular physical activity (30 min per day at least 5 days a week) is beneficial. Cardiac rehabilitation has been shown to improve exercise tolerance and cardiovascular outcome. PMID:18666472
Aim To explore the factor structure, reliability, and potential usefulness of a patient safety climate questionnaire in UK health care. Setting Four acute hospital trusts and nine primary care trusts in England. Methods The questionnaire used was the 27 item Teamwork and Safety Climate Survey. Thirty three healthcare staff commented on the wording and relevance. The questionnaire was then sent to 3650 staff within the 13 NHS trusts, seeking to achieve at least 600 responses as the basis for the factor analysis. 1307 questionnaires were returned (36% response). Factor analyses and reliability analyses were carried out on 897 responses from staff involved in direct patient care, to explore how consistently the questions measured the underlying constructs of safety climate and teamwork. Results Some questionnaire items related to multiple factors or did not relate strongly to any factor. Five items were discarded. Two teamwork factors were derived from the remaining 11 teamwork items and three safety climate factors were derived from the remaining 11 safety items. Internal consistency reliabilities were satisfactory to good (Cronbach's alpha ?0.69 for all five factors). Conclusions This is one of the few studies to undertake a detailed evaluation of a patient safety climate questionnaire in UK health care and possibly the first to do so in primary as well as secondary care. The results indicate that a 22 item version of this safety climate questionnaire is useable as a research instrument in both settings, but also demonstrates a more general need for thorough validation of safety climate questionnaires before widespread usage.
Hutchinson, A; Cooper, K L; Dean, J E; McIntosh, A; Patterson, M; Stride, C B; Laurence, B E; Smith, C M
Use these links to learn more about primary and secondary sources. 1. Explore the links below to learn about primary and secondary sources. When you have finished, you should be able to: Tell the difference between primary and secondary sources. Give at least three examples of primary sources and three examples of secondary sources. Explain why primary sources are important in research. Examples of Primary Sources Examples of Primary and Secondary Sources on the Same Topic Genres/Formats of Primary Sources 2. ...
Context It has been suggested that patients with major depressive disorder (MDD) who display pretreatment features suggestive of bipolar disorder or bipolar spectrum features might have poorer treatment outcomes. Objective To assess the association between bipolar spectrum features and antidepressant treatment outcome in MDD. Design Open treatment followed by sequential randomized controlled trials. Setting Primary and specialty psychiatric outpatient centers in the United States. Participants Male and female outpatients aged 18 to 75 years with a DSM-IV diagnosis of nonpsychotic MDD who participated in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Interventions Open treatment with citalopram followed by up to 3 sequential next-step treatments. Main Outcome Measures Number of treatment levels required to reach protocol-defined remission, as well as failure to return for the postbaseline visit, loss to follow-up, and psychiatric adverse events. For this secondary analysis, putative bipolar spectrum features, including items on the mania and psychosis subscales of the Psychiatric Diagnosis Screening Questionnaire, were examined for association with treatment outcomes. Results Of the 4041 subjects who entered the study, 1198 (30.0%) endorsed at least 1 item on the psychosis scale and 1524 (38.1%) described at least 1 recent manic-like/hypomaniclike symptom. Irritability and psychotic-like symptoms at entry were significantly associated with poorer outcomes across up to 4 treatment levels, as were shorter episodes and some neurovegetative symptoms of depression. However, other indicators of bipolar diathesis including recent maniclike symptoms and family history of bipolar disorder as well as summary measures of bipolar spectrum features were not associated with treatment resistance. Conclusion Self-reported psychoticlike symptoms were common in a community sample of outpatients with MDD and strongly associated with poorer outcomes. Overall, the data do not support the hypothesis that unrecognized bipolar spectrum illness contributes substantially to antidepressant treatment resistance.
Perlis, Roy H.; Uher, Rudolf; Ostacher, Michael; Goldberg, Joseph F.; Trivedi, Madhukar H.; Rush, A. John; Fava, Maurizio
Introduction The tobacco use among the youth, in both smoking and smokeless forms, is quite high in the South East Asian region. Tobacco use is a major proven risk factor and contributes substantially to the rising epidemic of non-communicable diseases. Objectives To estimate the prevalence of tobacco use and determine associated factors among adolescent students of Dharan municipality. Design Cross-sectional study. Setting Secondary and higher secondary schools of Dharan municipality in Sunsari district of Nepal. Participants Students in middle (14–15?years) and late adolescence (16–19?years) from grades 9, 10, 11 and 12 were included. Primary outcome measure Ever tobacco use which was defined as one who had not used any form of tobacco in the past 1?month but had tried in the past. Methodology Self-administered questionnaire adapted from Global Youth Tobacco Survey was used to assess tobacco use among the representative sample of 1312 adolescent students selected by stratified random sampling from July 2011 to July 2012. Results Out of 1454 students, 1312 students completed the questionnaires with a response rate of 90.23%. Prevalence of ever use of any tobacco product was 19.7% (95% CI 17.7 to 21.6). More than half of the tobacco users (51.9%) consumed tobacco in public places whereas almost a third (75.6%) of the consumers purchased tobacco from shops. Multivariate analysis showed that tobacco use was associated with late adolescence (OR: 1.64; 95% CI 1.17 to 2.28), male gender (OR: 12.20; 95% CI 7.78 to 19.14), type of school (OR=1.72; 95% CI 1.01 to 2.94), Janajati ethnicity (OR: 2.05; 95% CI 1.39 to 3.01) and receiving pocket money ?Nepalese rupees 500/month (OR: 1.45; 95% CI 1.04 to 2.03). Conclusions Tobacco-focused interventions are required for school/college going students to promote cessation among users and prevent initiation, focussing on late adolescence, male gender, government schools, Janajati ethnicity and higher amount of pocket money.
Pradhan, Pranil Man Singh; Niraula, Surya Raj; Ghimire, Anup; Singh, Suman Bahadur; Pokharel, Paras Kumar
The purpose of this study was to investigate the internal consistency reliability of the Stages of Concern Questionnaire (SoCQ) when the measure is administered to naive subjects as a pretest. The SoCQ was developed by G. E. Hall, A. A. George, and W. L. Rutherford (1979/1986). In the present study, the SoCQ was administered to secondary school…
Background Many patients with chronic illness are limited in their physical activities. This systematic review evaluates the content and format of patient-reported outcome (PRO) questionnaires that measure physical activity in elderly and chronically ill populations. Methods Questionnaires were identified by a systematic literature search of electronic databases (Medline, Embase, PsychINFO & CINAHL), hand searches (reference sections and PROQOLID database) and expert input. A qualitative analysis was conducted to assess the content and format of the questionnaires and a Venn diagram was produced to illustrate this. Each stage of the review process was conducted by at least two independent reviewers. Results 104 questionnaires fulfilled our criteria. From these, 182 physical activity domains and 1965 items were extracted. Initial qualitative analysis of the domains found 11 categories. Further synthesis of the domains found 4 broad categories: 'physical activity related to general activities and mobility', 'physical activity related to activities of daily living', 'physical activity related to work, social or leisure time activities', and '(disease-specific) symptoms related to physical activity'. The Venn diagram showed that no questionnaires covered all 4 categories and that the '(disease-specific) symptoms related to physical activity' category was often not combined with the other categories. Conclusions A large number of questionnaires with a broad range of physical activity content were identified. Although the content could be broadly organised, there was no consensus on the content and format of physical activity PRO questionnaires in elderly and chronically ill populations. Nevertheless, this systematic review will help investigators to select a physical activity PRO questionnaire that best serves their research question and context.
Previous research studies examining the effects of fluency interventions on the fluency and comprehension outcomes for secondary struggling readers are synthesized. An extensive search of the professional literature between 1980 and 2005 yielded a total of 19 intervention studies that provided fluency interventions to secondary struggling readers…
Wexler, Jade; Vaughn, Sharon; Edmonds, Meaghan; Reutebuch, Colleen Klein
This article describes the development of the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) questionnaire. We first address the selection of topics whose contents have to cover the knowledge available on the complex causal network of outcomes and allow comparability with similar studies. Then we deal with the "translation and adaptation of measurement instruments" including neighborhood environment rating scales, depression and anxiety disorder rating scale and a food frequency questionnaire and discuss criteria that guided "theme block sequencing". And finally we focus on the practical importance of "pretesting and pilot studies". The ELSA may provide an original contribution regarding factors that cause or aggravate the outcomes of interest in the Brazilian population, as well as protective factors. PMID:24346718
Chor, Dóra; Alves, Márcia Guimarães de Mello; Giatti, Luana; Cade, Nágela Valadão; Nunes, Maria Angélica; Molina, Maria del Carmen Bisi; Benseñor, Isabela M; Aquino, Estela M L; Passos, Valéria; Santos, Simone M; da Fonseca, Maria de Jesus Mendes; de Oliveira, Letícia Cardoso
A previous randomized, controlled trial of tai chi showed improvements in objectively measured balance and other motor-related outcomes in patients with Parkinson's disease. This study evaluated whether patient-reported outcomes could be improved through exercise interventions and whether improvements were associated with clinical outcomes and exercise adherence. In a secondary analysis of the tai chi trial, patient-reported and clinical outcomes and exercise adherence measures were compared between tai chi and resistance training and between tai chi and stretching exercise. Patient-reported outcome measures were perceptions of health-related benefits resulting from participation, assessed by the Parkinson's Disease Questionnaire (PDQ-8) and Vitality Plus Scale (VPS). Clinical outcome measures included motor symptoms, assessed by a modified Unified Parkinson's Disease Rating Scale-Motor Examination (UPDRS-ME) and a 50-foot speed walk. Information on continuing exercise after the structured interventions were terminated was obtained at a 3-month postintervention follow-up. Tai chi participants reported significantly better improvement in the PDQ-8 (-5.77 points, P?=?0.014) than did resistance training participants and in PDQ-8 (-9.56 points, P?0.001) and VPS (2.80 points, P?=?0.003) than did stretching participants. For tai chi, patient-reported improvement in the PDQ-8 and VPS was significantly correlated with their clinical outcomes of UPDRS-ME and a 50-foot walk, but these correlations were not statistically different from those shown for resistance training or stretching. However, patient-reported outcomes from tai chi training were associated with greater probability of continued exercise behavior than were either clinical outcomes or patient-reported outcomes from resistance training or stretching. Tai chi improved patient-reported perceptions of health-related benefits, which were found to be associated with a greater probability of exercise adherence. The findings indicate the potential of patient perceptions to drive exercise behavior after structured exercise programs are completed and the value of strengthening such perceptions in any behavioral intervention. PMID:24375468
In 1928, the Library of Virginia inherited a mass of materials from the Virginia War History Commission, which had spent the previous eight years gathering information on Virginia's participation in World War I. Included in this material were over 14,900 four-page questionnaires from a survey of WWI veterans in Virginia. The Library of Virginia has digitized these survey forms and created a free, fully-searchable database. Users have three search options: by word or phrase, combination, and expert/boolean. Search returns offer basic information on each individual, and users must follow the link at the bottom of the page to download the digitized images (in .tif format) of the questionnaire forms. In some cases, respondents submitted photos or additional pages with their forms and these are included in the database.
BACKGROUND: Quality of life (QoL) outcomes are useful in the assessment of physical, mental and social well-being and for informed healthcare decision making. However, few studies have evaluated QoL issues among Asian children due largely to the lack of culturally valid and reliable QoL questionnaires. Hence, we aimed to report the psychometric properties, in particular factor structure, of KINDL (Singapore)
Hwee-Lin Wee; Ulrike Ravens-Sieberer; Michael Erhart; Shu-Chuen Li
ObjectiveThe characteristics of the 36 item Medical Outcome Short Form Health Study Survey (SF-36) questionnaire, designed as a generic indicator of health status for the general population, allow it to be self-administered or used in personal or telephone interviews. The main objective of the study was to compare the telephone and self-administered modes of SF-36 for a population from Girona
María García; Izabella Rohlfs; Joan Vila; Joan Sala; Araceli Pena; Rafael Masiá; Jaume Marrugat
We performed analyses to examine the structure, validity, and responsiveness to change of the Marks Asthma Quality of Life Questionnaire (AQLQ), originally validated in Australia in a self-administered format, among 539 U.S. subjects with asthma. Subjects were interviewed twice by telephone over an 18-month period. Based on factor analyses, the subscale structure of the AQLQ was modified slightly to eliminate
Patricia P. Katz; Mark D. Eisner; Jonathan Henke; Stephen Shiboski; Edward H. Yelin; Paul D. Blanc
Classical methods for detecting outliers deal with continuous variables. These methods are not readily applicable to categorical data, such as incorrect\\/correct scores (0\\/1) and ordered rating scale scores (e.g., 0, …, 4) typical of multi-item tests and questionnaires. This study proposes two definitions of outlier scores suited for categorical data. One definition combines information on outliers from scores on all
Wobbe P. Zijlstra; L. Andries van der Ark; Klaas Sijtsma
We report on the use of the Penn State Worry Questionnaire (PSWQ) to identify individuals with generalized anxiety disorder (GAD). Fifty individuals with primary or secondary GAD and 114 individuals with social anxiety disorder (without GAD) completed the PSWQ. In receiver operating characteristic analyses, a score of 65 simultaneously optimized sensitivity and specificity in discriminating individuals with GAD from individuals
David M. Fresco; Douglas S. Mennin; Richard G. Heimberg; Cynthia L. Turk
The main purpose of this study was to estimate the level of acquisition of the Jordanian national professional standards by vocational, secondary education teachers. Two hundred teachers participated in the study. The data were collected by questionnaire and analyzed using SPSS version 15.0. Questionnaire validity was assessed by content validity,…
... Email this page Print this page Understanding outcomes data Survival outcomes data estimate how many people with ... How you and your doctor can use outcomes data Prognosis Outcomes data can help you and your ...
Primary and secondary hyperaldosteronism are conditions in which the adrenal gland releases too much of the hormone ... People with primary hyperaldosteronism have a problem with the adrenal gland that causes it to release too much aldosterone. In secondary ...
Background While evidence is available that home treatment could be effective for treating severe mental illness, there is a lack of evidence on what exactly makes home treatment effective. The study presented here aims to develop recommendations for structures and processes in home treatment that are necessary for its effectiveness. Methods/Design 14 provider networks of home treatment for severe mental illness will be analyzed and compared according to their structures, processes and patient-related outcomes. Data will be drawn from health care claims data, routine assessments of psychosocial functioning, and from questionnaires on structures and processes. The primary outcome will be psychosocial functioning; secondaryoutcomes, quality of life and days spent in hospital. The relation between structures and processes on one hand side and outcomes on the other side will be identified by multilevel analysis. In addition, focus groups with patients, relatives and network staff will be held to add further insight into relevant processes. All networks will receive individual quality reports, providing them with feedback on the results of this research and benchmarking them against the average. Based on this research, recommendations for processes and structures of home treatment will be developed. Discussion The research will use longitudinal data on outcomes routinely assessed since 2009 and claims data. Routine data is also used for the assessment of structures and processes. By way of additional questionnaires developed in discussion with providers, further relevant factors can be included. The approach of this study becomes more comprehensive by conducting focus groups with patients, relatives and providers and by having the chance to evaluate the results with the networks by providing feedback of results. Several factors such as outcomes related to regional availability of hospital beds or size of networks might limit this study.
...125.66] 7. (L,S) Combined Sewer Overflows [40 CFR 125.67(b...collection system include combined sewer overflows? b. If yes, provide...your plan for minimizing combined sewer overflows to the receiving...
...125.66] 7. (L,S) Combined Sewer Overflows [40 CFR 125.67(b...collection system include combined sewer overflows? b. If yes, provide...your plan for minimizing combined sewer overflows to the receiving...
BackgroundNursing is becoming a mobile profession. Nurse migration is multifactorial and not limited to financial incentives. Non-economic factors that might lead to migration include poor recruitment and retention strategies, poor job satisfaction and working conditions, socio-political and economic stability, and the poor social image of the nursing profession. Lebanon is facing a problem of excessive nurse migration to countries of
Secondary glomerular lesions are associated with various diseases; diabetes, systemic lupus erythematosus, primary cryoglobulinaemia, cryoglobulinemia and membranoproliferative glomerulonephritis secondary to hepatitis C virus (HCV), ANCA associated vasculitis and their forms limited to kidney (necrotic and crescentic GN), Goodpasture syndrome, HIV associated nephropathies, AL amyloidosis, AA amyloidosis (secondary amyloidosis), GN with non-amyloid organised deposits. PMID:15008219
Background: Chronic cough is a common condition which has a significant impact on quality of life. Assessment and management are hampered by the absence of well validated outcome measures. The development and validation of the Leicester Cough Questionnaire (LCQ), a self-completed health related quality of life measure of chronic cough, is presented.Methods: Patients with chronic cough were recruited from outpatient
S S Birring; B Prudon; A J Carr; S J Singh; M D L Morgan; I D Pavord
BACKGROUND: How to protect patients from harm is a question of universal interest. Measuring and improving safety culture in care giving units is an important strategy for promoting a safe environment for patients. The Safety Attitudes Questionnaire (SAQ) is the only instrument that measures safety culture in a way which correlates with patient outcome. We have translated the SAQ to
BackgroundPatient safety is fundamental to healthcare quality. Attention has recently focused on the patient safety culture of an organisation and its impact on patient outcomes. A strong safety climate appears to be an essential condition for safe patient care in the hospital. A number of instruments are used to measure this patient safety climate or culture. The Safety Attitudes Questionnaire
Els Devriendt; Koen Van den Heede; Joke Coussement; Eddy Dejaeger; Kurt Surmont; Dirk Heylen; René Schwendimann; Bryan Sexton; Nathalie I. H. Wellens; Steven Boonen; Koen Milisen
This article deals with a study on interior design standards in the secondary FCS curriculum. This study assessed the importance FCS teachers placed on content standards in the interior design curriculum to help determine the amount of time and emphasis to place on the units within the courses. A cover letter and questionnaire were sent…
Studied the impact of school variables on student political knowledge and political activity using questionnaire responses from 1,311 secondary school students in South Australia and the Australian Capital Territory. Findings show that many students have had experience with normative forms of political activity, but fewer have engaged in…
This inquiry is directed at understanding the factors related to recruitment and retention of urban secondary teachers. Data were collected via selected response questionnaires from 815 public high school teachers in a large Midwest city. The findings provide implications for urban centers in the U.S. educational system from the classroom…
This study investigated attitude toward statistical graphs among a large sample of Singapore secondary school students (n = 907) in 2003. Attitude toward Statistical Graphs (ASG) was defined in terms of five aspects: enjoyment, confidence, usefulness, critical views and learning preferences. These students (13 to 15 years old) completed a Questionnaire of Attitude toward Statistical Graphs (QASG). In general, boys
This study investigated the relationships between psychosocial factors and self-esteem for 1,672 Taiwanese senior high school students (779 boys, 893 girls). Students from Kaohsiung City, Taiwan, completed a Chinese version of the Secondary Student Questionnaire (SSQ), which measures self-esteem, depression, anxiety, stereotyped thinking,…
An investigation into the prevalence and characteristics of child sexual abuse in the Northern Province (South Africa) was conducted. A total of 414 secondary school students in standard 9 and 10 in three representative secondary schools completed a retrospective self-rating questionnaire in a classroom setting. The questionnaire asked about childhood sexual abuse and the victim–perpetrator relationship. Results shows an overall
Objective To investigate the factor structure of the Rivermead Post Concussion Symptoms Questionnaire (RPQ) among individuals seen as\\u000a part of routine follow-up following traumatic brain injury.\\u000a \\u000a \\u000a \\u000a Methods RPQ data from 168 participants was examined (mean age 35.2, SD 14.3; 89% with post traumatic amnesia duration < 24 hours)\\u000a six months after admission to an Accident & Emergency Department following TBI. Structural equation modelling was
Seb Potter; Eleanor Leigh; Derick Wade; Simon Fleminger
Purpose To develop and validate a new parental questionnaire addressing symptoms and health related quality of life (HRQL) in congenital nasolacrimal duct obstruction (NLDO). Design Cross-sectional study. Participants Children aged 6 to <48 months with and without clinical signs of NLDO. Methods A new questionnaire was developed using semi-structured interviews with parents of children with NLDO and through discussions with expert clinicians. Questionnaires were completed by parents of children with NLDO and without NLDO. Cronbach’s alpha was calculated as a measure of internal-consistency reliability. Factor analysis was used to evaluate a priori subscales; symptoms and HRQL. Discriminant construct validity was assessed by comparing questionnaire scores between children with and without NLDO and between affected and unaffected eyes of children with unilateral NLDO. Instrument responsiveness was determined by comparing pre- and post-surgical intervention scores in a subset of NLDO subjects who underwent surgical treatment. Main outcome measure NLDO questionnaire score. Results 87 children were enrolled, 56 with NLDO and 31 without. All but two questions on the questionnaire showed a good distribution of responses, a high correlation with the rest of the questionnaire and excellent discrimination between patients with and without NLDO. Cronbach’s alpha values were good for the overall questionnaire (0.95), and for two predetermined subscales; symptoms (0.95) and HRQL (0.85). On a 0 to 4 scale, NLDO patients had worse scores compared to non-NLDO patients for both symptoms (mean difference = 2.1; 95% confidence interval (CI): 1.8 to 2.4) and HRQL (mean difference 1.2; 95% CI: 0.8 to 1.5) subscales. NLDO patients had worse scores pre-intervention compared to post-intervention for both the symptoms (mean difference = 2.2; 95% CI: 1.6 to 2.9) and HRQL (mean difference = 1.4; 95% CI: 0.8 to 2.1) subscales. Finally, NLDO patients had worse symptom scores for affected eyes compared to unaffected eyes (mean difference = 2.3; 95% CI: 1.9 to 2.6). Conclusions This novel NLDO questionnaire is useful in quantifying parental perception of symptoms and HRQL in childhood NLDO. The questionnaire may have a role in future clinical studies of NLDO
Holmes, Jonathan M.; Leske, David A.; Cole, Stephen R.; Chandler, Danielle L.; Repka, Michael X.; Silbert, David I.; Tien, David Robbins; Bradley, Elizabeth A.; Sala, Nicholas A.; Levin, Erika M.; Hoover, Darron L.; Klimek, Deborah L.; Mohney, Brian G.; Laby, Daniel M.; Lee, Katherine A.; Enzenauer, Robert W.; Bacal, Darron A.; Mills, Monte D.; Beck, Roy W.
Background: This study was designed to assess the validity and reliability of the designed sexual, behavioral abstinence, and avoidance of high-risk situation questionnaire (SBAHAQ), with an aim to construct an appropriate development tool in the Iranian population. Materials and Methods: A descriptive–analytic study was conducted among female undergraduate students of Tehran University, who were selected through cluster random sampling. After reviewing the questionnaires and investigating face and content validity, internal consistency of the questionnaire was assessed by Cronbach's alpha. Explanatory and confirmatory factor analysis was conducted using SPSS and AMOS 16 Software, respectively. Results: The sample consisted of 348 female university students with a mean age of 20.69 ± 1.63 years. The content validity ratio (CVR) coefficient was 0.85 and the reliability of each section of the questionnaire was as follows: Perceived benefit (PB; 0.87), behavioral intention (BI; 0.77), and self-efficacy (SE; 0.85) (Cronbach's alpha totally was 0.83). Explanatory factor analysis showed three factors, including SE, PB, and BI, with the total variance of 61% and Kaiser–Meyer–Olkin (KMO) index of 88%. These factors were also confirmed by confirmatory factor analysis [adjusted goodness of fitness index (AGFI) = 0.939, root mean square error of approximation (RMSEA) = 0.039]. Conclusion: This study showed the designed questionnaire provided adequate construct validity and reliability, and could be adequately used to measure sexual abstinence and avoidance of high-risk situations among female students.
Najarkolaei, Fatemeh Rahmati; Niknami, Shamsaddin; Shokravi, Farkhondeh Amin; Tavafian, Sedigheh Sadat; Fesharaki, Mohammad Gholami; Jafari, Mohammad Reza
Background Early developmental interventions to prevent the high rate of neurodevelopmental problems in very preterm children, including cognitive, motor and behavioral impairments, are urgently needed. These interventions should be multi-faceted and include modules for caregivers given their high rates of mental health problems. Methods/Design We have designed a randomized controlled trial to assess the effectiveness of a preventative care program delivered at home over the first 12 months of life for infants born very preterm (<30 weeks of gestational age) and their families, compared with standard medical follow-up. The aim of the program, delivered over nine sessions by a team comprising a physiotherapist and psychologist, is to improve infant development (cognitive, motor and language), behavioral regulation, caregiver-child interactions and caregiver mental health at 24 months' corrected age. The infants will be stratified by severity of brain white matter injury (assessed by magnetic resonance imaging) at term equivalent age, and then randomized. At 12 months' corrected age interim outcome measures will include motor development assessed using the Alberta Infant Motor Scale and the Neurological Sensory Motor Developmental Assessment. Caregivers will also complete a questionnaire at this time to obtain information on behavior, parenting, caregiver mental health, and social support. The primary outcomes are at 24 months' corrected age and include cognitive, motor and language development assessed with the Bayley Scales of Infant and Toddler Development (Bayley-III). Secondaryoutcomes at 24 months include caregiver-child interaction measured using an observational task, and infant behavior, parenting, caregiver mental health and social support measured via standardized parental questionnaires. Discussion This paper presents the background, study design and protocol for a randomized controlled trial in very preterm infants utilizing a preventative care program in the first year after discharge home designed to improve cognitive, motor and behavioral outcomes of very preterm children and caregiver mental health at two-years' corrected age. Clinical Trial Registration Number ACTRN12605000492651
Much of the research on the determinants of dietary behavior has been guided by Bandura's Social Cognitive Theory (SCT), yet few studies have tested the utility of its proposed structural paths. The aim of this paper was to test the capacity of SCT to explain dietary behaviors in a sample of 357 adolescent girls (13.2±0.5 years) from 12 secondary schools located in low-income communities in New South Wales, Australia. Participants completed validated SCT scales assessing nutrition-related self-efficacy, intention, behavioral strategies, family support, situation, outcome expectations, and outcome expectancies. Participants completed a validated food frequency questionnaire, from which, the percentage of total kilojoules from core-foods, non-core foods and saturated fat were calculated. The theoretical models were tested using structural equation modeling in AMOS. The models explained 48-51% and 13-19% of the variance in intention and dietary behavior, respectively. The models provided an adequate fit to the data, and self-efficacy was positively associated with healthy eating and inversely associated with unhealthy eating. However, the pathway from intention to behavior was not statistically significant in any of the models. While this study has demonstrated the utility of SCT constructs to explain behavior in adolescents girls, the proposed structural pathways were not supported. Further study of the role that implementation intentions play in explaining adolescent girls' dietary behaviors is required. PMID:22227067
Lubans, David R; Plotnikoff, Ronald C; Morgan, Philip J; Dewar, Deborah; Costigan, Sarah; Collins, Clare E
OBJECTIVES Periodic assessment of dietary intake across a given dialysis population may help improve clinical outcomes related to such nutrients as dietary protein, phosphorus, or potassium. Whereas dietary recalls and food records are used to assess dietary intake at individual level and over shorter time periods, food frequency questionnaires (FFQ) are employed to rank subjects of a given population according to their nutrient intake over longer time periods. DESIGN To modify and refine the conventional Block’s FFQ in order to develop a dialysis patients specific FFQ. SETTING Eight DaVita outpatient dialysis clinics in Los Angeles area, which participated in the “Nutrition and Inflammation in Dialysis Patients” (NIED) Study. PATIENTS 154 maintenance hemodialysis (MHD) patients MAIN OUTCOME MEASURE Dietary intake of participating MHD patients using a 3-day food record, supplemented by a person-to-person dietary interview, to capture food intake over the last hemodialysis treatment day of the week and the 2 subsequent non-dialysis days. RESULTS Analyses of the food records identified the key contributors to the daily nutrient intake in the 154 participating MHD patients. A “Dialysis-FFQ” was developed to include approximately 100 food items representing 90% of the patients’ total food intake of the NIED Study population. Distinctions were made in several food items based on key nutritional issues in dialysis patients such as protein, phosphorus and potassium. CONCLUSIONS We have developed a “Dialysis FFQ” to compare and rank dialysis patients according to their diverse nutrient intake. Whereas, the Dialysis-FFQ may be a valuable tool to compare dialysis patients and to identify those who ingest higher or lower amounts of a given nutrient, studies are needed to examine the utility of the Dialysis-FFQ for nutritional assessment of dialysis patients.
Limited published data are available on dermatophytosis in zoo macropods, despite anecdotal reports of disease occurrence and recurrent mob outbreaks. The aim of this questionnaire study was to analyze data from Australian and international zoos to evaluate estimated disease prevalence in zoos housing macropods, affected macropod species, causative organisms, predisposing factors, clinical presentations, diagnostics, treatments, and disease risk management. Two questionnaires (initial detailed and subsequent brief) were distributed via email to zoo veterinarians, with an estimated response rate of 23%. The overall estimated disease prevalence from responding zoos was 28%, with 73% of responding Australian zoos and 14% of responding non-Australian zoos reporting disease. The first cases of confirmed and suspected dermatophytosis in several macropod species and in association with Trichophyton verrucosum and Trichophyton mentagrophytes var. nodulare are reported, with young red kangaroos (Macropus rufus) appearing predisposed. Diagnosis was most commonly based on fungal culture or presumptively on typical clinical signs of minimally/nonpruritic alopecia, crusting, and scaling distributed most frequently on the tail, pinnae, and hind limbs. Both disease resolution without treatment and resolution after an average of 1 to 2 mo of treatment were reported. PMID:24063082
Boulton, Katie Alyce; Vogelnest, Linda Jean; Vogelnest, Larry
Abstract Objective To determine health care professional and parental preferences for receiving progress letters from a pediatric mental health program between a traditional text-only format and a version in which information was presented using graphs and tables with limited text. Design Mailed survey. Setting Nova Scotia. Participants Parents (n = 98) of children who received treatment from and health care professionals (n = 74) who referred patients to the Strongest Families Program (formerly the Family Help Program) were eligible. Most of the health care professionals were family practitioners (83.8%). Main outcome measures Preference between 2 letters that contained the same content (including progress in the program, results from a questionnaire, and resolved and ongoing problems) in different formats—one using text only, the other using graphs as well as text. Results In total, 83.8% of health professionals and 76.5% of parents indicated that they preferred to receive feedback in letters containing information in graphical format. Background and demographic information did not predict preferences. Parents preferred to receive progress letters at the beginning, midway through, and at the end of treatment, and health professionals preferred to receive progress letters at the beginning and end of treatment. Conclusion When receiving progress letters from a pediatric mental health program, health care professionals and parents preferred to receive letters that used graphs to help convey information.
The origin of liposuction can be traced to an adverse event by Dujarrier in 1921 when he used a uterine curette to remove fat from the knees of a ballerina ending in an amputation secondary to damage of the femoral artery. The history of liposuction since then has been one of avoiding complications and optimising outcome. After this adverse event, liposuction was abandoned until the 1960's when Schrudde revived the practice using small stab incisions and sharp curettage with the secondary suction to aspirate the freed tissue. This technique was associated with a high incidence of complications especially seroma and skin necrosis. Illouz then replaced the curette with a blunt cannula connected to vacuum pump thus avoiding the complications of a sharp curette. Despite the presence of various techniques for liposuction, suction assisted liposuction (SAL) is still the standard technique of liposuction. This article aims to discuss literature regarding the various aspects of liposuction (SAL) and to highlight the salient points in the literature and in the senior author's experience in order to avoid unfavourable outcomes in liposuction. A literature review on avoiding complication is in liposuction including some of the seminal papers on liposuction. Liposuction is generally a safe procedure with reproducible outcome. Just like any surgical procedure it should be treated with the utmost care. Illouz published 10 commandments for liposuction in 1989 and we review these commandments to demonstrate how liposuction has evolved. PMID:24501475
The origin of liposuction can be traced to an adverse event by Dujarrier in 1921 when he used a uterine curette to remove fat from the knees of a ballerina ending in an amputation secondary to damage of the femoral artery. The history of liposuction since then has been one of avoiding complications and optimising outcome. After this adverse event, liposuction was abandoned until the 1960's when Schrudde revived the practice using small stab incisions and sharp curettage with the secondary suction to aspirate the freed tissue. This technique was associated with a high incidence of complications especially seroma and skin necrosis. Illouz then replaced the curette with a blunt cannula connected to vacuum pump thus avoiding the complications of a sharp curette. Despite the presence of various techniques for liposuction, suction assisted liposuction (SAL) is still the standard technique of liposuction. This article aims to discuss literature regarding the various aspects of liposuction (SAL) and to highlight the salient points in the literature and in the senior author's experience in order to avoid unfavourable outcomes in liposuction. A literature review on avoiding complication is in liposuction including some of the seminal papers on liposuction. Liposuction is generally a safe procedure with reproducible outcome. Just like any surgical procedure it should be treated with the utmost care. Illouz published 10 commandments for liposuction in 1989 and we review these commandments to demonstrate how liposuction has evolved.
The present investigation examined whether smoking outcome expectancies, as measured by the Smoking Consequences Questionnaire (SCQ; [Brandon, T.H., & Baker, T.B., (1991). The Smoking Consequences Questionnaire: The subjective expected utility of smoking in college students. Psychological Assessment, 3, 484–491.]), were incrementally related to emotional vulnerability factors among an adult sample of 202 daily cigarette smokers (44.6% women; Mage=23.78 years, SD=9.69 years). After
Kirsten A. Johnson; Michael J. Zvolensky; Erin C. Marshall; Adam Gonzalez; Kenneth Abrams; Anka A. Vujanovic
Analyzes the differences in responses of 94 bilingual South African college students to questionnaires in both English and Afrikaans. Concludes that the use of translated questionnaires need not lead to biased results. (FMW)
The Descriptive Questionnaire data set provides demographic information about each of the households and indicates the primary respondent within each residence. The information is from 1225 Descriptive Questionnaires for 1225 households. The database contains only a portion of ...
The Technician Walk-through Questionnaire data set updates information about each household from the Descriptive Questionnaire and includes relevant information regarding dwelling arrangements, as well as interior and exterior residential characteristics. The information is from...
The Descriptive Questionnaire data set contains demographic information about each of the households and indicates the primary respondent within each residence. The information is from 380 descriptive questionnaires for 80 households across 6 cycles. The data set contains only ...
A patient health questionnaire was developed for use in family practice to help identify lifestyle risk factors, assess health care needs, and better understand patients. This article discusses the questionnaire's development and practical application. Images Figure 3
Explanations for varying emphasis on teaching for higher order thinking in U.S. secondary classrooms and teacher goals are considered. Responses of 303 secondary school teachers (teaching 1,205 classes) to a questionnaire about higher order skills and instructional goals indicate that higher order skills are more emphasized in high-ability…
This study examines the difficulties biology teachers face when teaching cell division in the secondary schools of the central part of the Erzurum province in Turkey. During this research, a questionnaire was distributed to a total of 36 secondary school biology teachers. Findings of the study indicate biology teachers perceive cell division as one of the most difficult subjects. Meiosis
This paper reports the findings of a study investigating junior secondary school students' perceptions of mathematics classroom learning environments in China. An adapted 'What Is Happening In this Classroom?' questionnaire was administered to a sample of 2324 junior secondary school students from 72 classrooms in six provinces.…
This report presents the results of a study whose purpose was to determine what automation is present in the library media centers in Georgia secondary schools and how it has been funded. A three-part questionnaire was sent to the media specialists in 50% of the secondary schools in Georgia, which were randomly selected. The analysis of the…
The aim of the present study is to elicit students' understanding of the particulate nature of matter via a cross-age study ranging from secondary to tertiary educational levels. A questionnaire with five-item open-ended questions was administered to 166 students from the secondary to tertiary levels of education. In light of the findings, it can…
Based on the measuring instruments used by scholars in China and abroad, we devised a questionnaire to study occupational stress of 500 secondary and elementary school teachers in Tacheng municipality in Xinjiang and examined its negative effects on teachers. They found that the occupational stress of secondary and elementary school teachers are…
This study determined the quantity, quality and commitment of mathematics teachers to teaching in Ogun State secondary schools. Four hundred mathematics teachers randomly selected from the one hundred public secondary schools across the twenty local government areas of the state participated in the study. A questionnaire, STMQ, designed and validated by the researcher was used to collect data. Data was
This study examines the difficulties biology teachers face when teaching cell division in the secondary schools of the central part of the Erzurum province in Turkey. During this research, a questionnaire was distributed to a total of 36 secondary school biology teachers. Findings of the study indicate biology teachers perceive cell division as…
Two matched groups of 28 patients each, with femoral neck fractures treated by primary internal fixation or by secondary total hip replacement after a complication of primary treatment, were evaluated and compared five years or more after primary pin fixation or secondary total hip replacement. The Nottingham Health Profile questionnaire was sent and returned by mail and the patient groups
L. T. Nilsson; H. Franzén; B. Strömqvist; I. Wiklund
This study investigated teachers' attitudes towards proofs in the secondary school mathematics curriculum. The study was motivated by a desire to fill a gap existing in the literature in relation to teachers' attitudes towards proofs. Thirty-four secondary school mathematics teachers' responses to a Likert type questionnaire and interviews were…
Objectives To evaluate the effects of nurse led clinics in primary care on secondary prevention, total mortality, and coronary event rates after four years. Design Follow up of a randomised controlled trial by postal questionnaires and review of case notes and national datasets. Setting Stratified, random sample of 19 general practices in north east Scotland. Participants 1343 patients (673 intervention and 670 control) under 80 years with a working diagnosis of coronary heart disease but without terminal illness or dementia and not housebound. Intervention Nurse led secondary prevention clinics promoted medical and lifestyle components of secondary prevention and offered regular follow up for one year. Main outcome measures Components of secondary prevention (aspirin, blood pressure management, lipid management, healthy diet, exercise, non-smoking), total mortality, and coronary events (non-fatal myocardial infarctions and coronary deaths). Results Mean follow up was at 4.7 years. Significant improvements were shown in the intervention group in all components of secondary prevention except smoking at one year, and these were sustained after four years except for exercise. The control group, most of whom attended clinics after the initial year, caught up before final follow up, and differences between groups were no longer significant. At 4.7 years, 100 patients in the intervention group and 128 in the control group had died: cumulative death rates were 14.5% and 18.9%, respectively (P=0.038). 100 coronary events occurred in the intervention group and 125 in the control group: cumulative event rates were 14.2% and 18.2%, respectively (P=0.052). Adjusting for age, sex, general practice, and baseline secondary prevention, proportional hazard ratios were 0.75 for all deaths (95% confidence intervals 0.58 to 0.98; P=0.036) and 0.76 for coronary events (0.58 to 1.00; P=0.049) Conclusions Nurse led secondary prevention improved medical and lifestyle components of secondary prevention and this seemed to lead to significantly fewer total deaths and probably fewer coronary events. Secondary prevention clinics should be started sooner rather than later. What is already known on this topicSeveral effective interventions exist for the secondary prevention of coronary heart disease, but implementing them in practice has proved difficultSecondary prevention programmes for coronary heart disease have improved short term outcomes such as processes of care and quality of lifeWhat this study addsShort term improvements in uptake of secondary prevention produced by nurse led clinics are maintained in the longer termImproved medical and lifestyle components of secondary prevention produced by nurse led clinics seem to lead to fewer total deaths and coronary events
Murchie, Peter; Campbell, Neil C; Ritchie, Lewis D; Simpson, Julie A; Thain, Joan
Objective: This study examines the role of serial ultrasound in predicting fetal outcomes based on progress, resolution or stability of pleural effusions in primary fetal hydrothorax (PFHT). Methods: Records from consecutive cases of fetal pleural effusions referred to the fetal echocardiography unit over a 12-year period were reviewed. Study patients underwent thorough investigation to rule out secondary causes of pleural
Objectives: To assess the nature and number of unexpected withdrawal by senior house officers (SHOs) after acceptance of a hospital post at interview, and to investigate the reasons and possible solutions. Design: Postal questionnaire based study. Subjects: Medical staffing departments, accident and emergency (A&E) consultants, and withdrawing SHOs in England. Main outcome measures: Unexpected withdrawals by hospital specialty, three year trend in A&E departments, notice and reasons given, and action taken. Results: 39% of medical staffing departments reported unexpected withdrawals in a broad spectrum of specialties for February 1998. In the specialty of A&E medicine this occurred in 34% of departments. Overall 72% of A&E departments had experienced this problem over a three year period, and the trend is increasing. The majority of A&E consultants (70%) took no action, and there was a lack of consensus among all respondents on the appropriate course of action to prevent this escalating problem. Conclusions: Unexpected SHO withdrawal is a substantial issue in hospital medicine and has been increasing in A&E medicine. Measures to prevent this national problem are urgently needed.
Objectives Measurement of treatment satisfaction in diabetes is important as it has been shown to be associated with positive outcomes, reduced disease cost and better health. The aim of this study was to assess the construct validity and internal consistency reliability of the Greek version of the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Methods A sample of type II diabetes patients (N = 172) completed the DTSQ status version, the SF-36 health survey and also provided data regarding treatment method, clinical and socio-demographic status. Instrument structure, reliability (Cronbach's a) and construct validity (convergent, discriminative, concurrent and known-groups) were assessed. Results The DTSQ measurement properties were confirmed in the Greek version with confirmatory factor analysis (CFA). Scale reliability was high (Cronbach's a = 0.92). Item-scale internal consistency and discriminant validity were also good, exceeding the designated success criteria. Significant correlations were observed between DTSQ items/overall score and SF-36 scales/component scores, which were hypothesized to measure similar dimensions. Known groups' comparisons yielded consistent support of the construct validity of the instrument. Conclusions The instrument was well-accepted by the patients and its psychometric properties were similar to those reported in validation studies of other language versions. Further research, incorporating a longitudinal study design, is required for examining test-retest reliability and responsiveness of the instrument, which were not addressed in this study. Overall, the present results confirm that the DTSQ status version is a reasonable choice for measuring diabetes treatment satisfaction in Greece.
Purpose: This study determined whether there is an association between psychological and socioeconomic characteristics and the long-term outcome of operative treatment for patients with sensory neurogenic thoracic outlet syndrome (N-TOS). Methods: Clinical records, preoperative psychological testing results, and long-term follow-up questionnaire data were reviewed for consecutive patients who underwent surgery for N-TOS from 1990 to 1999. Multivariate logistic regression models
David A. Axelrod; Mary C. Proctor; Michael E. Geisser; Randy S. Roth; Lazar J. Greenfield
Introduction: the diagnosis of thoracic outlet syndrome (TOS) relies heavily on subjective rather than objective assessment criteria. Subsequently, published results after surgical decompression vary considerably. This study aimed to use a symptom-based patient-directed questionnaire to assess the outcome after decompression for TOS.Methods: sixty patients who underwent decompression procedures were identified from a prospectively maintained vascular database. Patient records were analysed
V Bhattacharya; M Hansrani; M. G Wyatt; D Lambert; N. A. G Jones
...2010-01-01 2010-01-01 false Questionnaires and survey plans. 550.31 Section... Program Management Â§ 550.31 Questionnaires and survey plans. The Cooperator...submit to the REE Agency copies of questionnaires and other forms for clearance in...
...INTERNATIONAL TRADE COMMISSION Submission of Questionnaire for OMB Review AGENCY: United States...submitted a request for approval of a questionnaire to the Office of Management and Budget...The information requested by the questionnaire is for use by the Commission in...
...2009-01-01 2009-01-01 false Questionnaires and survey plans. 550.31 Section... Program Management Â§ 550.31 Questionnaires and survey plans. The Cooperator...submit to the REE Agency copies of questionnaires and other forms for clearance in...
We examined the validity of a questionnaire designed to measure the satisfaction of users of health services, using multiple tests of construct validity. Members of 2 health insurance plans in Geneva (Switzerland) answered a mailed questionnaire in 1992 (n = 1007) and 1993 (n = 1424). Response rates were 82%, participants were 18–44 years old in 1992. The questionnaire included
This study examined the psychometric characteristics of two parenting measures: the Parent Behavior Importance Questionnaire (PBIQ) and Parent Behavior Frequency Questionnaire (PBFQ). Both research questionnaires are based on the parent development theory (PDT) and offer parent as well as non-parent respondents the opportunity to rate 38 parenting…
Objective To identify methods to increase response to postal questionnaires. Design Systematic review of randomised controlled trials of any method to influence response to postal questionnaires. Studies reviewed 292 randomised controlled trials including 258 315 participants Intervention reviewed 75 strategies for influencing response to postal questionnaires.
Phil Edwards; Ian Roberts; Mike Clarke; Carolyn DiGuiseppi; Sarah Pratap; Reinhard Wentz; Irene Kwan
This study articulates the construct of social presence and develops a social presence questionnaire for examining online collaborative learning with tests for reliability and validity. Questionnaire items were developed by revising the social presence questionnaire developed by Picciano in 2002 as well as eviewing research in the literature of…
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…
The Baseline Questionnaire data set provides information about each household and its primary respondent. The information is from 380 baseline questionnaires for 80 households across 6 cycles. The Baseline Questionnaire was administered to the primary respondent during a face-t...
The Follow-up questionnaire data set contains information concerning the activities within the household during the sampling week. The information is from 402 follow-up questionnaires for 80 households across 6 cycles. The Follow-up Questionnaire specifically addressed the time ...
The design and use of questionnaires in course and faculty evaluation are discussed and the literature reviewed. Problems of questionnaire construction and interpretation of results are described and a questionnaire developed at the Faculty of Engineering at the University of Waterloo is given as an example. (Author/MSE)
This study investigated the validity of the Baecke Questionnaire, the Five City Project Questionnaire, and the Tecumseh Community Health Study Questionnaire in 19 Flemish males, using correlation and multiple stepwise regression analyses. The three questionnaires are commonly used physical activity questionnaires in epidemiological studies. The physical activity level (PAL) as measured with the doubly labelled water method was used as the criterion. The Baecke total activity index showed the highest correlation coefficient with PAL (r = 0.69, p < 0.001). Also the sweat index from the Five City Project Questionnaire, and total daily energy expenditure from the Tecumseh Community Health Study Questionnaire showed significant associations with PAL, respectively 0.57 (p < 0.05) and 0.64 (p < 0.01). Multiple stepwise regression analyses supported the findings from the correlation study. The largest individual contribution in PAL was from the activity index (45%) for the Baecke Questionnaire, the sweat index (29%) for the Five City Project Questionnaire, and total daily energy expenditure (38%) for the Tecumseh Community Health Study Questionnaire. In conclusion, the questionnaires, and certainly the Baecke Questionnaire, can provide valid data about physical activity. Therefore they are useful in epidemiological studies. PMID:10452224
The aim of the present research is to investigate the degree to which average academic outcomes in secondary school classes are associated with the inclusion of markedly disruptive pupils. Findings are based on two separate studies among pupils in Norwegian secondary schools. The first study included a relatively large sample of 2,332 pupils from…
We present the design and experimental progress on the diamond secondary emitter as an electron source for high average power injectors. The design criteria for average currents up to 1 A and charge up to 20 nC are established. Secondary Electron Yield (SEY) exceeding 200 in transmission mode and 50 in emission mode have been measured. Preliminary results on the design and fabrication of the self contained capsule with primary electron source and secondary electron emitter will also be presented.
To address calls for context-specific measurement of social support, this article reports the development of the Athletes' Received Support Questionnaire (ARSQ) and demonstrates initial evidence for its validity. Across four studies there was support for a four-dimensional structure reflecting emotional, esteem, informational, and tangible received support. There was also support for unidimensional and higher-order models. Further, Study 3 provided some support for convergent validity, with significant correlations between the corresponding dimensions of the ARSQ and the Inventory of Socially Supportive Behaviors. Study 4 provided evidence for the nomological validity of the ARSQ. Emotional and esteem support significantly predicted self-confidence and positive affect, and tangible support significantly moderated the relationship between stress and negative affect. Collectively, these results provide initial evidence for the validity of the ARSQ, and offer researchers flexibility to adopt either a multidimensional or aggregated approach to measuring received support. PMID:24686955
Background The CCAENA questionnaire was developed to assess care continuity across levels from the patients’ perspective. The aim is to provide additional evidence on the psychometric properties of the scales of this questionnaire. Methods Cross-sectional study by means of a survey of a random sample of 1500 patients attended in primary and secondary care in three health care areas of the Catalan health care system. Data were collected in 2010 using the CCAENA questionnaire. To assess psychometric properties, an exploratory factor analysis was performed (construct validity) and the item-rest correlations and Cronbach's alpha were calculated (internal consistency). Spearman correlation coefficients were calculated (multidimensionality) and the ability to discriminate between groups was tested. Results The factor analysis resulted in 21 items grouped into three factors: patient–primary care provider relationship, patient–secondary care provider relationship and continuity across care levels. Cronbach's alpha indicated good internal consistency (0.97, 0.93, 0.80) and the correlation coefficients indicated that dimensions can be interpreted as separated scales. Scales discriminated patients according to health care area, age and educational level. Conclusion The CCAENA questionnaire has proved to be a valid and reliable tool for measuring patients’ perceptions of continuity. Providers and researchers could apply the questionnaire to identify areas for health care improvement.
Background Early treatment of COPD exacerbations has shown to be important. Despite a non-negligible negative impact on health related quality of life, a large proportion of these episodes is not reported (no change in treatment). Little is known whether (low burden) strategies are able to capture these unreported exacerbations. Methods The Clinical COPD Questionnaire (CCQ) is a short questionnaire with great evaluative properties in measuring health status. The current explorative study evaluates the discriminative properties of weekly CCQ assessment in detecting exacerbations. Results In a multicentre prospective cohort study, 121 patients, age 67.4 ± 10.5 years, FEV1 47.7 ± 18.5% pred were followed for 6 weeks by daily diary card recording and weekly CCQ assessment. Weeks were retrospectively labeled as stable or exacerbation (onset) weeks using the Anthonisen symptom diary-card algorithm. Change in CCQ total scores are significantly higher in exacerbation-onset weeks, 0.35 ± 0.69 compared to -0.04 ± 0.37 in stable weeks (p < 0.001). Performance of the ? CCQ total score discriminating between stable and exacerbation onset weeks was sufficient (area under the ROC curve 0.75). At a cut off point of 0.2, sensitivity was 62.5 (50.3-73.4), specificity 82.0 (79.3-84.4), and a positive and negative predictive value of 43.5 (35.0-51.0) and 90.8 (87.8-93.5), respectively. Using this cut off point, 22 (out of 38) unreported exacerbations were detected while 39 stable patients would have been false positively 'contacted'. Conclusions Weekly CCQ assessment is a promising, low burden method to detect unreported exacerbations. Further research is needed to validate discriminative performance and practical implications of the CCQ in detecting exacerbations in daily care.
Improving the quality of alcohol-related care requires practical approaches to assessing alcohol consumption to guide management and monitor outcomes. Given the increasing use of alcohol screening questionnaires to identify alcohol misuse it would be ideal if scores on screening questionnaires were also indicators of average alcohol consumption. However, the questionnaires were not designed for this purpose and include dimensions of drinking that may not reflect average consumption (e.g. heavy episodic drinking, alcohol-related problems). In a general population sample, scores on the AUDIT-C screen correlated with reports of alcohol consumption in detailed interviews, but the relationship is unknown for clinical populations and other questionnaires. Serum high-density lipoprotein cholesterol (HDL) is a biomarker routinely obtained in clinical care and is known to rise with average alcohol consumption. This cross-sectional study of 11,175 male U.S. Veterans Affairs patients enrolled in a primary care study used HDL as an objective biomarker to evaluate whether average alcohol consumption increased as scores increased on 3 brief alcohol screens - the AUDIT-C, AUDIT Question #3 (a single-item screen), and the CAGE questionnaire. Mean HDL progressively increased as screening scores increased for the AUDIT-C and AUDIT Question #3: about 12 mg/dL from the lowest to the highest scores. The association was much weaker for the CAGE questionnaire. Results were minimally affected by adjustment for covariates (e.g. age, race, medical comorbidity, smoking, medication count, and depression) but the association was modified (p = 0.008) and mildly attenuated by adherent use of lipid-lowering medications. This study using HDL as a biomarker of average alcohol consumption adds to evidence that some alcohol screening scores may also serve as scaled markers of average alcohol consumption. PMID:23886863
Berger, Douglas; Williams, Emily C; Bryson, Chris L; Rubinsky, Anna D; Bradley, Katharine A
Patients with secondary hyperparathyroidism experience a variety of clinical symptoms which may adversely affect physical and mental function. As part of a multicenter, open-label clinical trial, subjects completed a questionnaire that included the Medical Outcomes Study Short Form-36 and 14 kidney disease-related symptoms at multiple time points during the study. Out of the 567 subjects who received at least one dose of cinacalcet, 528 to 535 (93.8-94.4%) completed all or portions of the questionnaire at baseline. The median bioactive parathyroid hormone (PTH) was 294 pg/mL (10%, 90% range, 172-655 pg/mL). Following treatment with cinacalcet and low-dose vitamin D sterols, subjects reported significant improvement in the frequency of pain in muscles, joints and bones, stiff joints, dry skin, itchy skin, excessive thirst, and trouble with memory. At end of the efficacy assessment phase (Weeks 16 to 22), the magnitude of improvement was the greatest in joint pain, bone pain, dry skin, and excessive thirst (>5 on a 0-100 scale; P < 0.001). There were no clinically or statistically significant changes in any of the Short Form-36 subscales or in the physical or mental health composite scores. Among patients on hemodialysis with moderate to severe secondary hyperparathyroidism, treatment with cinacalcet and low-dose vitamin D sterols results in significant improvement in pain in the muscles, joints and bones, joint stiffness, dry and itchy skin, excessive thirst, and trouble with memory. PMID:22118402
Chertow, Glenn M; Lu, Z John; Xu, Xiao; Knight, Tyler G; Goodman, William G; Bushinsky, David A; Block, Geoffrey A
Impairments of retrospective memory and cases of retrograde amnesia are often seen in clinical settings. A measure of the proportion of memories retained over a specified time can be useful in clinical situations and public events questionnaires may be valuable in this respect. However, consistency of retention of public events memory has rarely been studied in the same participants. In addition, when used in a research context, public events questionnaires require updating to ensure questions are of equivalent age with respect to when the test is taken. This paper describes an approach to constructing and updating a Public Events Questionnaire (PEQ) for use with a sample that is recruited and followed-up over a long time-period. Internal consistency, parallel-form reliability, test-retest reliability, and secondary validity analyses were examined for three versions of the PEQ that were updated every 6 months. Versions 2 and 3 of the questionnaire were reliable across and within versions and for recall and recognition. Change over time was comparable across each version of the PEQ. These results show that PEQs can be regularly updated in a standardized fashion to allow use throughout studies with long recruitment periods.
Impairments of retrospective memory and cases of retrograde amnesia are often seen in clinical settings. A measure of the proportion of memories retained over a specified time can be useful in clinical situations and public events questionnaires may be valuable in this respect. However, consistency of retention of public events memory has rarely been studied in the same participants. In addition, when used in a research context, public events questionnaires require updating to ensure questions are of equivalent age with respect to when the test is taken. This paper describes an approach to constructing and updating a Public Events Questionnaire (PEQ) for use with a sample that is recruited and followed-up over a long time-period. Internal consistency, parallel-form reliability, test-retest reliability, and secondary validity analyses were examined for three versions of the PEQ that were updated every 6 months. Versions 2 and 3 of the questionnaire were reliable across and within versions and for recall and recognition. Change over time was comparable across each version of the PEQ. These results show that PEQs can be regularly updated in a standardized fashion to allow use throughout studies with long recruitment periods. PMID:24678306
The purpose of this dissertation study was to investigate the direct and interactive relationships between depression and conduct problems and substance abuse treatment outcomes in a national sample of adolescents participating in substance abuse treatment. This study involved a secondary analysis of data from the National Institute on Drug Abuse's- Drug Abuse Treatment Outcome Study for Adolescence (DATOS-A), a multi-site,
This study was designed to measure the performance of county health systems in central and western China utilizing routine healthcare data. Drawing on a literature review and expert consultation, the study established a theoretical framework and an indicator system for performance review. Questionnaires were designed and disseminated to collect empirical data on health system performance in four counties of two central and western provinces. Quantitative data were subjected to descriptive statistical analysis through SPSS12.0. Three dimensions were introduced in the performance review framework-health outcomes, financial risk protection and consumer and provider satisfaction. Health outcomes were assessed from four secondary indicators: infant mortality rate; maternal mortality rate; under-5 child mortality rate; and the incidence of Class A and Class B notifiable diseases. Financial risk was assessed using two secondary indicators: the proportion of the cost of inpatient care that was reimbursed under the New Cooperative Medical System (NCMS) insurance scheme, and the rate of NCMS funds utilization. The assessment of satisfaction was made using two secondary indicators: the overall satisfaction of local residents with healthcare services, and the satisfaction of health practitioners at the township and village level. The study indicated better health system performance in the two counties in Chongqing than those in Shanxi. It was concluded that outcome framework scores can fairly reveal performance differences among county health systems in central and western China, and can provide practical evidence for optimizing the operation and inputs of county health systems. Caution needs to be exercised in generalizing such performance outcomes as many factors such as spending and organization that contribute to county health system performance were not included in the study. PMID:21822999
Objectives To describe the plans of English NHS hospitals to implement ePrescribing systems. Design and setting Questionnaire-based survey of attendees of the National ePrescribing Forum. Participants A piloted questionnaire was distributed to all NHS and non-NHS hospital-based attendees. The questionnaire enquired about any completed or planned implementation of ePrescribing systems, the specific systems of interest, and functionality they offered. Main outcome measures Estimate of the number of NHS Trusts planning to implement ePrescribing systems. Results Ninety-one of the 166 questionnaires distributed to NHS hospital-based staff were completed and returned. Of those, six were incomplete, resulting in a total usable response rate of 51% (n = 85). Eighty-two percent (n = 46) of the 56 Trusts represented at the Forum were either ‘thinking of implementing’ or ‘currently implementing’ an ePrescribing system, such as Ascribe (13%, n = 7) and JAC (20%, n = 11). Forty percent (n = 22) of respondents specified other systems, including those procured by NHS Connecting for Health e.g. RiO, Lorenzo and Cerner. Knowledge support, decision support and computerized links to other elements of patients’ individual care records were the functionalities of greatest interest. Conclusion There is considerable reported interest and activity in implementing ePrescribing systems in hospitals across England. Whether such developments have the desired impact on improving the safety of prescribing is however, yet to be determined.
Crowe, Sarah; Cresswell, Kathrin; Avery, Anthony J; Slee, Ann; Coleman, Jamie J; Sheikh, Aziz
There is a wide range of assessment techniques for tinnitus, but no consensus has developed concerning how best to measure either the presenting features of tinnitus or the effects of tinnitus treatments. Standardization of reliable and valid tinnitus measures would provide many advantages including improving the uniformity of diagnostic and screening criteria between clinics and facilitating comparison of treatment outcomes obtained at different sites. This chapter attempts to clarify issues involved in developing self-report questionnaires for the assessment of tinnitus. While the tinnitus questionnaires that are currently available provide valuable information on which to base diagnostic and screening decisions, they were not originally developed in such a way as to maximize their sensitivity to treatment-related changes in tinnitus. As a result, their construct validity for measuring treatment benefit has not received appropriate attention. In this paper, special emphasis is devoted to the use of effect sizes as an estimate of the ability of questionnaires (and their individual items) to measure changes associated with treatment. We discuss the criteria relevant to evaluating the effectiveness of a questionnaire for diagnostic purposes vs. for treatment-evaluation purposes, and we present a detailed illustration of how the various criteria have been applied in a recent questionnaire development effort. PMID:17956815
Meikle, M B; Stewart, B J; Griest, S E; Martin, W H; Henry, J A; Abrams, H B; McArdle, R; Newman, C W; Sandridge, S A
In this AMEE Guide, we consider the design and development of self-administered surveys, commonly called questionnaires. Questionnaires are widely employed in medical education research. Unfortunately, the processes used to develop such questionnaires vary in quality and lack consistent, rigorous standards. Consequently, the quality of the questionnaires used in medical education research is highly variable. To address this problem, this AMEE Guide presents a systematic, seven-step process for designing high-quality questionnaires, with particular emphasis on developing survey scales. These seven steps do not address all aspects of survey design, nor do they represent the only way to develop a high-quality questionnaire. Instead, these steps synthesize multiple survey design techniques and organize them into a cohesive process for questionnaire developers of all levels. Addressing each of these steps systematically will improve the probabilities that survey designers will accurately measure what they intend to measure.
La Rochelle, Jeffrey S.; Dezee, Kent J.; Gehlbach, Hunter
Summers' annotated bibliographies of secondary reading (1963, 1964), "Review of Educational Research,""Journal of Reading," ERIC/CRIER, and "Research in Education" are listed as resources for all phases of reading. A shifting of trends in the nature and scope of research topics in secondary reading is noted, with diagnosis and treatment,…
Argues that the major forces related to economic factors that effect the future of secondary services are growth of primary literature and expansion of secondary products; migration of use from print products to tape products; new technology and impact on production of products and services; and redefinition of user as end user. (EJS)
BACKGROUND:Symptom assessment using questionnaires has been recommended as the primary outcome measure in clinical gastroesophageal reflux and dyspepsia trials. Questionnaires should have proven reliability, validity, and responsiveness, and may assess the frequency and\\/or severity of dyspepsia symptoms. Although a number of measures have been developed, it remains unclear which of these should be used in new trials.OBJECTIVE:To describe existing questionnaire
PURPOSE This study was designed to evaluate rectocele repair using collagen mesh.METHODS 32 female patients underwent surgical repair using collagen mesh. Outcome was assessed in 29 patients and preoperative assessment included standardized questionnaire, clinical examination, and defecography. At the six-month follow-up, patients answered a standardized questionnaire and underwent clinical examination. At the 12-month follow-up, patients answered a standardized questionnaire, underwent clinical examination,
Daniel Altman; Jan Zetterström; Annika López; Bo Anzén; Christian Falconer; Fredrik Hjern; Anders Mellgren
This report used the framework of a large European study to investigate the outcome of patients with and without an HLA-identical sibling donor on an intention-to-treat basis. After a common remission-induction and consolidation course, patients with an HLA-identical sibling donor were scheduled for allogeneic transplantation and patients lacking a donor for autologous transplantation. In all, 159 patients alive at 8 weeks from the start of treatment were included in the present analysis. In total, 52 patients had a donor, 65 patients did not have a donor and in 42 patients the availability of a donor was not assessed. Out of 52 patients, 36 (69%) with a donor underwent allogeneic transplantation (28 in CR1). Out of 65 patients, 33 (49%) received an autograft (27 in CR1). The actuarial survival rates at 4 years were 33.3% (s.e. = 6.7%) for patients with a donor and 39.0% (s.e. = 6.5%) for patients without a donor (P = 0.18). Event-free survival rates were 23.1% (s.e. = 6.2%) and 21.5% (s.e. = 5.3%), respectively (P = 0.66). Correction for alternative donor transplants did not substantially alter the survival of the group without a donor. Also, the survival in the various cytogenetic risk groups was not significantly different when comparing the donor vs the no-donor group. This analysis shows that patients with high-risk myelodysplastic syndrome and secondary acute myeloid leukemia may benefit from both allogeneic and autologous transplantation. We were unable to demonstrate a survival advantage for patients with a donor compared to patients without a donor. PMID:12750698
Oosterveld, M; Suciu, S; Verhoef, G; Labar, B; Belhabri, A; Aul, C; Selleslag, D; Ferrant, A; Wijermans, P; Mandelli, F; Amadori, S; Jehn, U; Muus, P; Zittoun, R; Hess, U; Anak, O; Beeldens, F; Willemze, R; de Witte, T
A secondary fuel delivery system for delivering a secondary stream of fuel and/or diluent to a secondary combustion zone located in the transition piece of a combustion engine, downstream of the engine primary combustion region is disclosed. The system includes a manifold formed integral to, and surrounding a portion of, the transition piece, a manifold inlet port, and a collection of injection nozzles. A flowsleeve augments fuel/diluent flow velocity and improves the system cooling effectiveness. Passive cooling elements, including effusion cooling holes located within the transition boundary and thermal-stress-dissipating gaps that resist thermal stress accumulation, provide supplemental heat dissipation in key areas. The system delivers a secondary fuel/diluent mixture to a secondary combustion zone located along the length of the transition piece, while reducing the impact of elevated vibration levels found within the transition piece and avoiding the heat dissipation difficulties often associated with traditional vibration reduction methods.
Parker, David M. (Oviedo, FL) [Oviedo, FL; Cai, Weidong (Oviedo, FL) [Oviedo, FL; Garan, Daniel W. (Orlando, FL) [Orlando, FL; Harris, Arthur J. (Orlando, FL) [Orlando, FL
Background: Epidemiological information paucity exists on musculoskeletal disorders (MSD) among secondary school students in Nigeria. We aimed to determine prevalence, pattern, and treatment seeking behaviors (TSB) of MSD in south-west Nigeria. Materials and Methods: A school-based cross sectional study was conducted in four randomly selected secondary schools in Ile-Ife in 2007. All the students were screened for MSD using interviewer-administered questionnaire and physical examination, which involved use of scoliometer and goniometer. Affected children were recommended for treatment and plain radiography taken. Results: A total of 133 students had 204 MSD representing 3.0% prevalence among the 4,441students screened. Eighty-one (60.9%) students had congenital disorders and 52 (39.1%) were acquired. The lower limbs (93.1%) were most commonly affected and 87 (65.4%) students presented with knee deformity. Other abnormalities were limb length discrepancy 6.8%, scoliosis 4.4%, pes planus 3.9%, and poliomyelitis 2.9%. One hundred students (75.2%) had no form of treatment, 18.8% receive treatment in the hospital, 3.7% in traditional healing home and 2.3% in church. Age, family, and school type were significant factors (P < 0.05) in health seeking behavior. The factors affecting treatment outcome were the place of treatment, hospital specific treatment, and reasons for stopping treatment. Conclusion: Treatable cases constitute a large proportion of MSD among secondary school students, but TSB was generally poor. Parental socio-economic and health services factors were related to the health seeking behavior. Strengthening of school health services and improved linkage with orthopedic services, community education on MSD, and education of all cadres of health professionals are recommended.
O, Adegbehingbe Olayinka; O, Fatusi Adesegun; A, Adegbenro Caleb; O, Late Adeitan Opeyemi; O, Abass Ganiyu; Akintomiwa, Akintunde
We assessed 1- and 2-year outcomes of specific seizure types, quality of life, depression, and anxiety among patients treated with vagus nerve stimulation (VNS) for refractory partial epilepsy. Patients completed a seizure questionnaire, the Quality of Life in Epilepsy—89 (QOLIE-89) questionnaire, the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI) at baseline and 1 year, and 2 years
Severine M Chavel; Michael Westerveld; Susan Spencer
Objective The aim of this study was to develop and validate a questionnaire used to assess the level of general knowledge about cervical cancer, its primary and secondary prevention, and to identify sources of information about the disease among schoolgirls and female students. Methods The questionnaire development process was divided into four phases: generation of issues; construction of a provisional questionnaire; testing of the provisional questionnaire for acceptability and relevance; field-testing, which aimed at ensuring reliability and validity of the questionnaire. Field-testing included 305 respondents of high school female Caucasian students, who filled out the final version of the questionnaire. Results After phase 1, a list of 65 issues concerning knowledge about cervical cancer and its prevention was generated. Of 305, 155 were schoolgirls (mean age±SD, 17.8±0.5) and 150 were female students (mean age±SD, 21.7±1.8). The Cronbach alpha coefficient for the whole questionnaire was 0.71 (range for specific questionnaire sections, 0.60 to 0.81). Test-retest reliability ranged from 0.89 to 0.94. Conclusion The Cervical-Cancer-Knowledge-Prevention-64 has been successfully developed to measure the level of knowledge about cervical cancer. The results confirm the validity, reliability and applicability of the created questionnaire.
Jaglarz, Katarzyna; Kamzol, Wojciech; Puskulluoglu, Miroslawa; Krzemieniecki, Krzysztof
Background Multiple sclerosis (MS) preferentially affects females at childbearing age. For this reason patients and treating physicians were frequently confronted with questions concerning family planning, pregnancy and birth. Objective The aim of this study was to evaluate the expertise about pregnancy related topics in multiple sclerosis of neurologists in private practice. Methods We developed a survey with 16 multiple choice questions about pregnancy related topics and sent it to neurologists in private practice in Berlin, Germany. Results 56 completed questionnaires were sent back. 54% of all questions were answered correctly, 21% of the questions were answered with “I don’t know”. Correct answers were more often given by physicians who treat more than 400 MS patients per year (p?=?0.001). Further positive associations were found for assumed relevance of the topic (p?=?0.002) and the degree of counseling (p<0.001). Conclusion To provide a comprehensive counseling, MS patients with desire for children should be counseled by physicians with a lot of experience in MS treatment.
Background The SRS-22 is a valid instrument for the assessment of the health related quality of life of patients with Idiopathic scoliosis. The SRS-22 questionnaire was developed in USA and has been widely used in the English speaking countries. Recently it has been translated and validated in many other languages. The purpose of this study is to evaluate the reliability and validity of the adapted Greek version of the refined Scoliosis Research Society-22 Questionnaire. Methods Following the steps of cross – cultural adaptation the adapted Greek version of the SRS-22 questionnaire and a validated Greek version of the SF-36 questionnaire were mailed to 68 patients treated surgically for Idiopathic Scoliosis. 51 out of the 68 patients returned the 1st set of questionnaires, while a second set was emailed to 30 randomly selected patients of the first time responders. 20 out of the 30 patients returned the 2nd set. The mean age at the time of operation was16,2 years and the mean age at the time of evaluation was 21,2 years. Descriptive statistics for content analysis were calculated. Reliability assessment was determined by estimating Cronbach's ? and intraclass correlation coefficient (ICC) respectively. Concurrent validity was evaluated by comparing SRS-22 domains with relevant domains in the SF-36 questionnaire using Pearson's Correlation Coefficient (r). Results The calculated Cronbach's ? of internal consistency for three of the corresponding domains (pain 0.85; mental health 0.87; self image 0.83) were very satisfactory and for two domains (function/activity 0.72 and satisfaction 0.67) were good. The ICC of all domains of SRS-22 questionnaire was high (ICC>0.70), demonstrating very satisfactory or excellent test/retest reproducibility. Considering concurrent validity all correlations were found to be statistically significant at the 0.01 level among related domains and generally demonstrated high correlation coefficient. Conclusion The adapted Greek version of the SRS-22 questionnaire is valid and reliable and can be used for the assessment of the outcome of the treatment of the Greek speaking patients with idiopathic scoliosis.
Antonarakos, Petros D; Katranitsa, Labrini; Angelis, Lefteris; Paganas, Aristofanis; Koen, Errikos M; Christodoulou, Evangelos A; Christodoulou, Anastasios G
A video questionnaire (VQ) for measuring asthma prevalence in adolescents was assessed for repeatability and validity in relation to bronchial hyperresponsiveness (BHR) (PD20 less than or equal to 7.8 mumol methacholine). Comparison was also made with a standard, self completed written questionnaire (SQ), based on the IUATLD Bronchial Symptoms Questionnaire, which included five questions seeking comparable data to those in the VQ. Both the VQ and SQ were administered to 707 schoolchildren (13-16 years), in whom English was the primary language. One hundred and six randomly selected children subsequently underwent bronchial challenge to methacholine. Both the sensitivity and specificity for BHR were higher for a combination of three or more positive responses to the VQ (0.73 and 0.88), than to the SQ (0.63 and 0.82), although these differences were not statistically significant (P = 0.24). When administered again after a two week interval, the VQ had a significantly higher (P = 0.03) coefficient of repeatability (0.79) than the SQ (0.50). We conclude that the VQ is a valid and reliable method of determining asthma prevalence, and propose that by providing data relatively free from biases due to language, culture, literacy or interviewing techniques it may be particularly useful when comparing asthma prevalence and severity in different populations. PMID:1628254
Shaw, R A; Crane, J; Pearce, N; Burgess, C D; Bremner, P; Woodman, K; Beasley, R
The aim of this systematic review was to review the quality of the translation and the measurement properties from questionnaires that assess injuries of the knee. We included questionnaires that were developed in foreign language and have been translated and validated into Portuguese. The databases used were CINAHL, SPORTDiscus, LILACS, PUBMED and SCIELO and the final search resulted in a total of 868 studies included, from which 16 were eligible. Most included questionnaires presented all steps expected in a translation process; however there were some deficiencies in measurement properties among the questionnaires. The VISA-P Brazil was the best questionnaire when analyzing translation process and measurement properties tested. It was the only questionnaire that tested all measurement properties investigated and presented adequate values for all of them. KOS-ADLS was the best questionnaire translated to Portuguese from Portugal. Among all, the VISA-P Brazil is the best questionnaire to be used with Brazilian Portuguese speakers when the condition is related to patellar tendinopathy and the LEFS is the best questionnaire for other general conditions of the knee. For Portuguese from Portugal, the best questionnaire is the KOS-ADLS, and like the LEFS it does not target any specific injury.
Nunes, Guilherme; de Castro, Lisaura Veiga; Wageck, Bruna; Kume, Vanessa; Chiesa, Gabriela Sulzbach; de Noronha, Marcos
Using OASIS data collected by all Medicare-certified home health agencies, this article first presents descriptive statistics on patient outcomes for a national agency sample in 2001, soon after Medicare prospective payment implementation. Ratios of actual to predicted outcome rates, aggregated for groups of outcomes, are considered as potential summary indicators of agency outcome performance. The aggregate ratios show promise, but
Robert E. Schlenker; Martha C. Powell; Glenn K. Goodrich
Background Utilization indices exist to measure quantity of prenatal care, but currently there is no published instrument to assess quality of prenatal care. The purpose of this study was to develop and test a new instrument, the Quality of Prenatal Care Questionnaire (QPCQ). Methods Data for this instrument development study were collected in five Canadian cities. Items for the QPCQ were generated through interviews with 40 pregnant women and 40 health care providers and a review of prenatal care guidelines, followed by assessment of content validity and rating of importance of items. The preliminary 100-item QPCQ was administered to 422 postpartum women to conduct item reduction using exploratory factor analysis. The final 46-item version of the QPCQ was then administered to another 422 postpartum women to establish its construct validity, and internal consistency and test-retest reliability. Results Exploratory factor analysis reduced the QPCQ to 46 items, factored into 6 subscales, which subsequently were validated by confirmatory factor analysis. Construct validity was also demonstrated using a hypothesis testing approach; there was a significant positive association between women’s ratings of the quality of prenatal care and their satisfaction with care (r?=?0.81). Convergent validity was demonstrated by a significant positive correlation (r?=?0.63) between the “Support and Respect” subscale of the QPCQ and the “Respectfulness/Emotional Support” subscale of the Prenatal Interpersonal Processes of Care instrument. The overall QPCQ had acceptable internal consistency reliability (Cronbach’s alpha?=?0.96), as did each of the subscales. The test-retest reliability result (Intra-class correlation coefficient?=?0.88) indicated stability of the instrument on repeat administration approximately one week later. Temporal stability testing confirmed that women’s ratings of their quality of prenatal care did not change as a result of giving birth or between the early postpartum period and 4 to 6 weeks postpartum. Conclusion The QPCQ is a valid and reliable instrument that will be useful in future research as an outcome measure to compare quality of care across geographic regions, populations, and service delivery models, and to assess the relationship between quality of care and maternal and infant health outcomes.
The IFFANIAM study (Impact of frailty and functional status in elderly patients with ST segment elevation myocardial infarction undergoing primary angioplasty) is an observational multicenter registry to assess the impact of frailty and functional status on outcomes of elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty. STEMI patients age 75 years or older undergoing primary angioplasty will be extensively studied during admission in 4 tertiary care Hospitals in Spain, assessing their baseline functional status (Barthel index, Lawton-Brody index), frailty (Fried criteria, FRAIL scale [fatigue, resistance, ambulation, illnesses, and loss of weight]), comorbidities (Charlson index), nutritional status (Mini Nutritional Assessment-Short Form), and quality of life (Seattle Angina Questionnaire). Participants will be managed according current recommendations. The primary outcome will be the description of 1-year mortality, its causes, and associated factors. Secondaryoutcomes will be functional capacity and quality of life. Results will help to better understand the impact of frailty and functional ability on outcomes in elderly STEMI patients undergoing primary angioplasty, thus potentially contributing to improving their clinical management. Higher life expectancy has resulted in a large segment of elderly population and an increase in myocardial infarction in these patients. This calls attention to healthcare systems to focus on promoting methods to improve the clinical management of this population. PMID:24114768
Background Satisfactory psychometric properties in offline questionnaires do not guarantee the same outcome in Web-based versions. Any construct that is measured online should be compared to a paper-based assessment so that the appropriateness of online questionnaire data can be tested. Little research has been done in this area regarding Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. Objective The objective was to simultaneously collect paper-based and Web-based ADHD questionnaire data in adults not diagnosed with ADHD in order to compare the two data sources regarding their equivalence in raw scores, in measures of reliability, and in factorial structures. Methods Data from the German versions of the Connors Adult ADHD Rating Scales (CAARS-S), the Wender Utah Rating Scale (WURS-k), and the ADHD Self Rating Scale (ADHS-SB) were collected via online and paper questionnaires in a cross-sectional study with convenience sampling. We performed confirmatory factor analyses to examine the postulated factor structures in both groups separately and multiple group confirmatory factor analyses to test whether the postulated factor structures of the questionnaires were equivalent across groups. With Cronbach alpha, we investigated the internal consistency of the postulated factors in the different questionnaires. Mann-Whitney U tests with the effect size “Probability of Superiority (PS)” were used to compare absolute values in the questionnaires between the two groups. Results In the paper-based sample, there were 311 subjects (73.3% female); in the online sample, we reached 255 subjects (69% female). The paper-based sample had a mean age of 39.2 years (SD 18.6); the Web-based sample had a mean age of 30.4 years (SD 10.5) and had a higher educational background. The original four factor structure of the CAARS-S could be replicated in both samples, but factor loadings were different. The Web-based sample had significantly higher total scores on three scales. The five-factor structure of the German short form of the WURS-k could be replicated only in the Web-based sample. The Web-based sample had substantially higher total scores, and nearly 40% of the Web-based sample scored above the clinically relevant cut-off value. The three-factor structure of the ADHS-SB could be replicated in both samples, but factor loadings were different. Women in the Web-based sample had substantially higher total scores, and 30% of the Web-based sample scored above the clinically relevant cut-off value. Internal consistencies in all questionnaires were acceptable to high in both groups. Conclusions Data from the Web-based administration of ADHD questionnaires for adults should not be used for the extraction of population norms. Separate norms should be established for ADHD online questionnaires. General psychometric properties of ADHD questionnaires (factor structure, internal consistency) were largely unaffected by sampling bias. Extended validity studies of existing ADHD questionnaires should be performed by including subjects with a diagnosis of ADHD and by randomizing them to Web- or paper-based administration.
Hauschild, Franziska; Schmidt, Martin H; Baum, Erika; Christiansen, Hanna
Purpose Available patient-reported outcome (PRO) measures for chronic obstructive pulmonary disease (COPD) focus primarily on impairment\\u000a (symptoms) and activities (functioning). The purpose of the study was to develop a patient-based PRO measure for COPD that\\u000a captures the overall everyday impact of living with COPD from the patient’s perspective.\\u000a \\u000a \\u000a \\u000a \\u000a Methods LCOPD items (Living with COPD Questionnaire) were generated from qualitative interviews in the
Stephen P. McKennaDavid; David M. Meads; Lynda C. Doward; James Twiss; Robin Pokrzywinski; Dennis Revicki; Cameron J. Hunter; G. Alastair Glendenning
Background Health outcomes researchers are increasingly applying Item Response Theory (IRT) methods to questionnaire development, evaluation,\\u000a and refinement efforts.\\u000a \\u000a \\u000a \\u000a Objective To provide a brief overview of IRT, to review some of the critical issues associated with IRT applications, and to demonstrate\\u000a the basic features of IRT with an example.\\u000a \\u000a \\u000a \\u000a Methods Example data come from 6,504 adolescent respondents in the National Longitudinal Study of
Background Patient-reported outcomes are measured in many epidemiologic studies using self- or interviewer-administered questionnaires. While in some studies differences between these administration formats were observed, other studies did not show statistically significant differences important to patients. Since the evidence about the effect of administration format is inconsistent and mainly available from cross-sectional studies our aim was to assess the effects of different administration formats on repeated measurements of patient-reported outcomes in participants with AIDS enrolled in the Longitudinal Study of Ocular Complications of AIDS. Methods We included participants enrolled in the Longitudinal Study of Ocular Complications in AIDS (LSOCA) who completed the Medical Outcome Study [MOS] -HIV questionnaire, the EuroQol, the Feeling Thermometer and the Visual Function Questionnaire (VFQ) 25 every six months thereafter using self- or interviewer-administration. A large print questionnaire was available for participants with visual impairment. Considering all measurements over time and adjusting for patient and study site characteristics we used linear models to compare HRQL scores (all scores from 0-100) between administration formats. We defined adjusted differences of ?0.2 standard deviations [SD]) to be quantitatively meaningful. Results We included 2,261 participants (80.6% males) with a median of 43.1 years of age at enrolment who provided data on 23,420 study visits. The self-administered MOS-HIV, Feeling Thermometer and EuroQol were used in 70% of all visits and the VFQ-25 in 80%. For eight domains of the MOS-HIV differences between the interviewer- and self- administered format were < 0.1 SD. Differences in scores were highest for the social and role function domains but the adjusted differences were still < 0.2 SD. There was no quantitatively meaningful difference between administration formats for EuroQol, Feeling Thermometer and VFQ-25 domain scores. For ocular pain (VFQ-25), we found a statistically significant difference of 3.5 (95% CI 0.2, 6.8), which did, however, not exceed 0.2 SD. For all instruments scores were similar for the large and standard print formats with all adjusted differences < 0.2 SD. Conclusions Our large study provides evidence that administration formats do not have a meaningful effect on repeated measurements of patient-reported outcomes. As a consequence, longitudinal studies may not need to consider the effect of different administration formats in their analyses.
Objectives We set out to evaluate the impact of Foundation Year (FY) training on the doctors who had been through this training system. Design Doctors in training were surveyed using a structured web-based questionnaire. Setting Postgraduate training in the UK has been the subject of much upheaval in recent years. Participants A total of 1065 doctors in training were surveyed in late 2011 and early 2012, of which 638 were current FY doctors. Main outcome measures The survey was both quantitative and qualitative, focusing on selection, working hours, training quality, training assessments and the regulation of training. Results A majority of current FY trainees worked extra weekly hours with the breakdown being: 5–10 hrs (54%), 10–15 hrs (17%), >15 hrs (9%) and no extra weekly hours (20%). All current FY trainees wanted to work for more than 40 h a week with the following breakdown of desired hours: per week 40–48 (22%), 48–60 (50%) and 60–70 h (19%). The average hours per week spent clerking emergency admissions by current FY trainees were as follows: zero hours (11%), 0–5 h (37%), 5–10 h (30%), 10–15 h (11%) and greater (11%). A large majority (90%) felt that it was possible for incompetent trainees to obtain satisfactory results from assessments and that the FY training program was poor at identifying failing trainees. There were high levels of dissatisfaction with the selection process. Conclusions FY training appears to be failing in several key areas with the lack of emergency exposure a particular area of concern. It is essential that any future reforms of training address these problem areas.
Objective. To further evaluate the adequacy of the items in our questionnaire aimed at unraveling the possible correlations between psychological features and internal disorders. This paper is dedicated to the items exploring the individual’s interaction with other people. Method. The items are divided into several subdomains. For each subdomain, we have calculated the correlations between the items of the respective subdomain (inner associations) and with the items in other subdomains (outer associations) by means of chi square test or Fisher exact test as dictated by statistical reasons. We examined the answers from our first 10192 respondents. Results and conclusions. Many inter-item correlations are the consequence of higher or lesser degrees of synonymy. Those within a given subdomain confirm the adequate allocation of items. Those bridging different subdomains may point either to incorrect assignments, or to semantic inclusion relations. Other results are not explicable by semantic similarity, and probably reveal psychological subtleties, such as: most individuals have a sense of undeservedness when badly treated by other people; those easily hurt by insults and humiliations have a propensity to timidity and/or emotivity; the subjects who shun conflicts are more prone to persistent thoughts, brooding people are more sensitive and more prone to conflicts, injustice-indignant people frequently get into conflict although they declare to be bothered by dissent etc. But at the heart of all the PFs in the Interaction-with-other-people domain there seems to be the sense of being undervalued, which should probably be the key issue to be addressed by any therapeutic interventions for diseases psychoemotionally determined by disturbed interpersonal relationships. Abbreviations: PF = psychological feature; Chisq = chi-square; OdRa = odds ratio; OdRaCL = odds ratio confidence limits; ErrProb = probability of error
The purpose of this large cohort study was to analyze the effects of prior and postoperative radiotherapy (RT) on surgical outcomes and patient-reported outcome measures (PROMs) in implant-based immediate breast reconstruction (IBR). All breast cancer patients (n = 725, of whom 29 had bilateral IBR) operated with implant-based IBR at four Stockholm hospitals from 2007 to 2011 were included. The median follow-up was 43 months. Three groups were compared: no RT (n = 386), prior RT (n = 64), and postoperative RT (n = 304). Outcomes were IBR failure (implant loss with or without secondary autologous reconstruction), unplanned reoperations, and PROMs, as measured by the BreastQ(®) questionnaire. IBR failure occurred in 22/386 (6 %) of non-irradiated cases, 16/64 (25 %) after prior and 45/304 (15 %) after postoperative RT (p < 0.001). Failure risk was higher after prior than postoperative RT (HR 9.28 vs. 3.08). Further risk factors were high BMI, less surgeon reconstructive experience, and postoperative infection, while the use of permanent implants lowered the risk of IBR failure. The estimated 5 years IBR failure rate was 10.4 % for non-irradiated, 28.2 % for previously and 25.2 % for postoperatively irradiated patients (p < 0.001). At least one unplanned reoperation occurred in 169/384 of non-irradiated (44 %), 42/64 (66 %) of previously, and 180/303 (59 %) of postoperatively irradiated breasts (p < 0.001). Further contributing factors were the use of one-stage expander and permanent implants, less surgeon reconstructive experience, and smoking. RT significantly impaired scores on all scales of the BreastQ(®). However, a clear majority of women in all groups would choose IBR again. Implant-based IBR remains a feasible option for women undergoing mastectomy as patient satisfaction levels are high. After prior RT, however, autologous alternatives should be considered. PMID:24258257
Eriksson, Max; Anveden, Lotta; Celebioglu, Fuat; Dahlberg, Kristina; Meldahl, Ingrid; Lagergren, Jakob; Eriksen, Catharina; de Boniface, Jana
NCI developed a new instrument called the NHANES Food Frequency Questionnaire (formerly called Food Propensity Questionnaire) and supported its application in the National Health and Nutrition Examination Survey (NHANES). This instrument collects much of the same information as a food frequency questionnaire (FFQ), but without asking about portion size. The resulting data can be employed in the NCI usual dietary intakes model as covariates. By not asking about portion size, the NHANES FFQ requires less respondent burden than other FFQs.
ObjectivesThe Nurses Work Functioning Questionnaire (NWFQ) is a 50-item self-report questionnaire specifically developed for nurses and allied health professionals. Its seven subscales measure impairments in the work functioning due to common mental disorders. Aim of this study is to evaluate the psychometric properties of the NWFQ, by assessing reproducibility and construct validity.MethodsThe questionnaire was administered to 314 nurses and allied
Fania R. Gärtner; Karen Nieuwenhuijsen; Frank J. H. van Dijk; Judith K. Sluiter
Purpose: To assess the test-retest reliability of the 1999 Youth Risk Behavior Survey (YRBS) questionnaire.Methods: A sample of 4619 male and female high school students from white, black, Hispanic, and other racial\\/ethnic groups completed the YRBS questionnaire on two occasions approximately two weeks apart. The questionnaire assesses a broad range of health risk behaviors. This study used a protocol that
Nancy D Brener; Laura Kann; Tim McManus; Steven A Kinchen; Elizabeth C Sundberg; James G Ross
Questionnaire sorting is a concept for sorting mentioned by Coxon [(1999) SORTING DATA. Collection and Analysis. Thousand Oaks: Sage] and Harloff and Coxon [(2005), How to Sort. A Short Guide on Sorting Investigations. www.methodofsorting.com]. The use of questionnaire sorting is detailed herein. A paper questionnaire variant and a HTML\\u000a form variant are introduced. Their equivalence among each other and with
Knee dislocation is a complex and rare injury often presenting in the context of high velocity trauma. The aim of this study is to establish the subjective outcomes of surgically treated knee dislocations. A total of 20 knees dislocations treated by open repair were reviewed. Their progress and outcomes were assessed by using a modified Lysholm score questionnaire. Data was obtained on patient demographics, details of injury, investigation, treatment, rehabilitation, 24 months objective outcome and subjective outcomes. Six patients had a vascular deficit and six had neurological deficits. The median range of motion was 0°-100°. Patients with an initially lower pre-injury level of function were able to return an activity level comparable to their pre-injury status. 22% of competitive athletes retuned to competitive sports. 38% of patients undertaking heavy activity returned to comparable pre-injury level of activity and 67% of patients undertaking moderate level of activity before injury returned to a comparable level after repair. 68% regularly had problems running, 70% problem squatting, 40% swelling and 42% problem with stairs. Most patients however did not have locking of the knee or problems with knees giving way. Patients pain scores decreased over time to an acceptable level. Despite the severity of the injury, majority of patients achieved a satisfactory outcome, although none of the patients reached the same level of function as before the injury. 80% of the patients were satisfied with their outcome. All dissatisfied patients suffered postoperative complications.
This presentation will inform the EDL community of the capability of ADEPT for delivery of small (sub 1 m diameter) secondary payloads as well as provide status of on-going technology development activities.
Objective To develop and psychometrically evaluate an audio digitised tool for assessment of comprehension of informed consent among low-literacy Gambian research participants. Setting We conducted this study in the Gambia where a high illiteracy rate and absence of standardised writing formats of local languages pose major challenges for research participants to comprehend consent information. We developed a 34-item questionnaire to assess participants’ comprehension of key elements of informed consent. The questionnaire was face validated and content validated by experienced researchers. To bypass the challenge of a lack of standardised writing formats, we audiorecorded the questionnaire in three major Gambian languages: Mandinka, Wolof and Fula. The questionnaire was further developed into an audio computer-assisted interview format. Participants The digitised questionnaire was administered to 250 participants enrolled in two clinical trials in the urban and rural areas of the Gambia. One week after first administration, the questionnaire was readministered to half of the participants who were randomly selected. Participants were eligible if enrolled in the parent trials and could speak any of the three major Gambian languages. Outcome measure The primary outcome measure was reliability and validity of the questionnaire. Results Item reduction by factor analysis showed that 21 of the question items have strong factor loadings. These were retained along with five other items which were fundamental components of informed consent. The 26-item questionnaire has high internal consistency with a Cronbach's ? of 0.73–0.79 and an intraclass correlation coefficient of 0.94 (95% CI 0.923 to 0.954). Hypotheses testing also showed that the questionnaire has a positive correlation with a similar questionnaire and discriminates between participants with and without education. Conclusions We have developed a reliable and valid measure of comprehension of informed consent information for the Gambian context, which might be easily adapted to similar settings. This is a major step towards engendering comprehension of informed consent information among low-literacy participants.
Afolabi, Muhammed O; Bojang, Kalifa; D'Alessandro, Umberto; Ota, Martin O C; Imoukhuede, Egeruan B; Ravinetto, Raffaella; Larson, Heidi J; McGrath, Nuala; Chandramohan, Daniel
Relation between self report energy expenditure from the Zutphen Physical Activity Questionnaire score, and 7-day objective physical activity (PA) measurements from accelerometers and pedometers (Pearson correlation).
The VARK Questionnaire "How Do I Learn Best?" is a very useful free learning styles survey tool. This questionnaire can help students better understand how they learn and how to best study depending upon their preferred learning style: visual, aural, kinesthetic, read-write or multimodal. After taking the questionnaire, the participant will receive a personal learning profile with learning and study hints specifically geared to their learning style. It also can help instructors find out how their students learn and the best ways to teach them. There is also a version of the questionnaire available for athletes or for younger people.
Background Questionnaires are commonly used to collect patient, or user, experiences with health care encounters; however, their adaption to specific target groups limits comparison between groups. We present the construction of a generic questionnaire (maximum of ten questions) for user evaluation across a range of health care services. Methods Based on previous testing of six group-specific questionnaires, we first constructed a generic questionnaire with 23 items related to user experiences. All questions included a "not applicable" response option, as well as a follow-up question about the item's importance. Nine user groups from one health trust were surveyed. Seven groups received questionnaires by mail and two by personal distribution. Selection of core questions was based on three criteria: applicability (proportion "not applicable"), importance (mean scores on follow-up questions), and comprehensiveness (content coverage, maximum two items per dimension). Results 1324 questionnaires were returned providing subsample sizes ranging from 52 to 323. Ten questions were excluded because the proportion of "not applicable" responses exceeded 20% in at least one user group. The number of remaining items was reduced to ten by applying the two other criteria. The final short questionnaire included items on outcome (2), clinician services (2), user involvement (2), incorrect treatment (1), information (1), organisation (1), and accessibility (1). Conclusion The Generic Short Patient Experiences Questionnaire (GS-PEQ) is a short, generic set of questions on user experiences with specialist health care that covers important topics for a range of groups. It can be used alone or with other instruments in quality assessment or in research. The psychometric properties and the relevance of the GS-PEQ in other health care settings and countries need further evaluation.
Psychotic disorders due to a known medical illness or substance use are collectively termed secondary psychoses. In this paper, we first review the historic evolution of the concept of secondary versus primary psychosis and how this distinction supplanted the earlier misleading classification of psychoses into organic and functional. We then outline the clinical features and approach to the diagnosis of secondary psychotic disorders. Features such as atypical presentation, temporal relation to detectable medical cause, evidence of direct physiological causal relationship to the etiological agent, and the absence of evidence of a primary psychotic illness that may better explain the presentation suggest consideration of a secondary psychosis. Finally, we discuss how careful studies of secondary psychotic disorders can help elucidate the pathophysiology of primary, or idiopathic, psychotic disorders such as schizophrenia. We illustrate this issue through a discussion of three secondary psychotic disorders — psychoses associated with temporal lobe epilepsy, velocardiofacial syndrome, and N-methyl D-aspartate (NMDA) receptor encephalitis — that can, respectively, provide neuroanatomical, genetic, and neurochemical models of schizophrenia pathogenesis.
Objective: To determine secondary preventive treatment and habits among patients with coronary heart disease in general practice. Design: Process of care data on a random sample of patients were collected from medical records. Health and lifestyle data were collected by postal questionnaire (response rate 71%). Setting: Stratified, random sample of general practices in Grampian. Subjects: 1921 patients aged under 80 years with coronary heart disease identified from pre-existing registers of coronary heart disease and nitrate prescriptions. Main outcome measures: Treatment with aspirin, ? blockers, and angiotensin converting enzyme inhibitors. Management of lipid concentrations and hypertension according to local guidelines. Dietary habits (dietary instrument for nutritional evaluation score), physical activity (health practice indices), smoking, and body mass index. Results: 825/1319 (63%) patients took aspirin. Of 414 patients with recent myocardial infarction, 131 (32%) took ? blockers, and of 257 with heart failure, 102 (40%) took angiotensin converting enzyme inhibitors. Blood pressure was managed according to current guidelines for 1566 (82%) patients but lipid concentrations for only 133 (17%). 673 of 1327 patients (51%) took little or no exercise, 245 of 1333 (18%) were current smokers, 808 of 1264 (64%) were overweight, and 627 of 1213 (52%) ate more fat than recommended. Conclusion: In terms of secondary prevention, half of patients had at least two aspects of their medical management that were suboptimal and nearly two thirds had at least two aspects of their health behaviour that would benefit from change. There seems to be considerable potential to increase secondary prevention of coronary heart disease in general practice. Key messages Patients with coronary heart disease can benefit from both medical and lifestyle secondary prevention measures This study found that half of patients with coronary heart disease in general practice had at least two missed opportunities for effective medical interventions Nearly two thirds of patients with coronary heart disease in general practice had two or more high risk lifestyle factors that would benefit from change There seems to be plenty of opportunity for improving secondary prevention of coronary heart disease in general practice
Campbell, Neil C; Thain, Joan; Deans, H George; Ritchie, Lewis D; Rawles, John M
A study examined features of camps and camp staff that might affect the personal and social benefits of organized camping for children. Questionnaires were completed by 29 camp directors and 270 campers aged 8-14 from 33 residential camps across the United States. Results indicate that higher personal and social outcomes were associated with…