Application of summative content analysis to a postal questionnaire.

PubMed

Griffiths, Thomas Howard

2016-01-01

Content analysis of replies to closed questions in questionnaires can be undertaken to understand remarks that may explain the responses, provide illustrative examples of issues raised in the questionnaire, define new issues or issues of importance that were not covered in the questionnaire and inform the design of new questions in future surveys. To discuss the usefulness of summative content analysis to free text in postal questionnaires. Content analysis provides useful comparative insights between two respondent groups in the case example provided. Five themes emerged: poor understanding of the concept of 'patient lateral transfer work technique' and the direct instrument nursing observation (DINO) instrument's key directions; outcomes of patient transfer; positive responses; manual handling risk; and poor translation into English of DINO. Respondents need an opportunity to clarify their responses to questionnaires using free text, to provide insight into their understanding of the question being asked, understanding of the concept or construct being discussed, and data triangulation through the confirmation of item responses and free-text comments. Responses to questions in a postal questionnaire and the opportunity for free-text commentary by respondents enable the identification of hidden meanings behind tickbox responses to questions.

Validity of two simple measures for estimating life-course socio-economic position in cross-sectional postal survey data in an older population: results from the North Staffordshire Osteoarthritis Project (NorStOP)

PubMed Central

2012-01-01

Background Since few cohorts encompass the whole life-course, many studies that measure socio-economic position (SEP) across the life-course rely on participant recall of SEP measures from cross-sectional postal or interview surveys. It is also particularly important that SEP measures should be appropriate for the age of the population studied, as the level of missing data has been shown to increase in older people. The aim of this study was to investigate the accuracy of recall of two SEP measures in older adults, age left school and longest job, by examining their validity in a general population postal survey in North Staffordshire, UK. Methods Sets of questions on education and longest job were included in a questionnaire at different stages of the study. All patients aged 50+ registered with three general practices were sent a baseline Health Questionnaire. 6 years later, 3410 responders were mailed a follow-up Health Questionnaire; a sub-sample of these participants took part in independent qualitative interviews. Validity was assessed by: percentage completion; internal percentage agreement within each set of questions; percentage agreement of qualitative and quantitative data for age left school and longest job; comparing recall of age left school with historical change in legal school leaving age; comparing frequency of pottery job titles with those in 1981 Census data for Stoke-on-Trent. Results The adjusted response to different stages of the study was 71–85%. Completion of questions was 83–98%. Internal agreement was 84–97% (education) and 95–100% (longest job). Comparison of survey and interview data showed 86% agreement (± 1 year) for age left school and 91% agreement for longest job. The change in age left school data concurred with the historical shift in legal school leaving age. 11% of job titles were pottery in NorStOP data and 15% in Stoke-on-Trent Census data. Conclusions The results from this study provide evidence for the accuracy of recall of two simple measures of SEP (age left school and longest job) in a postal survey of older adults. Consistency with evidence from external datasets indicated the potential validity of these measures for studying life-course SEP in population surveys. PMID:22738317

Social surveys in HIV/AIDS: telling or writing? A comparison of interview and postal methods.

PubMed

McEwan, R T; Harrington, B E; Bhopal, R S; Madhok, R; McCallum, A

1992-06-01

We compare a probability sample postal questionnaire survey and a quota controlled interview survey, and review the literature on these subjects. In contrast to other studies, where quota samples were not representative because of biased selection of respondents by interviewers, our quota sample was representative. Response rates were similar in our postal and interview surveys (74 and 77%, respectively), although many previous similar postal surveys had poor response rates. As in other comparison studies, costs were higher in our interview survey, substantive responses and the quality of responses to closed-ended questions were similar, and responses to open-ended questions were better in the interview survey. 'Socially unacceptable' responses on sexual behaviour were less likely in interviews. Quota controlled surveys are appropriate in surveys on HIV/AIDS under certain circumstances, e.g. where the population parameters are well known, and where interviewers can gain access to the entire population. Postal questionnaires are better for obtaining information on sexual behaviour, if adequate steps are taken to improve response rates, and when in-depth answers are not needed. For most surveys in the HIV/AIDS field we recommend the postal method.

Effect of paper quality on the response rate to a postal survey: A randomised controlled trial. [ISRCTN32032031

PubMed Central

Clark, T Justin; Khan, Khalid S; Gupta, Janesh K

2001-01-01

Background Response rates to surveys are declining and this threatens the validity and generalisability of their findings. We wanted to determine whether paper quality influences the response rate to postal surveys Methods A postal questionnaire was sent to all members of the British Society of Gynaecological Endoscopy (BSGE). Recipients were randomised to receiving the questionnaire printed on standard quality paper or high quality paper. Results The response rate for the recipients of high quality paper was 43/195 (22%) and 57/194 (29%) for standard quality paper (relative rate of response 0.75, 95% CI 0.33–1.05, p = 0.1 Conclusion The use of high quality paper did not increase response rates to a questionnaire survey of gynaecologists affiliated to an endoscopic society. PMID:11782286

Rates, Delays, and Completeness of General Practitioners’ Responses to a Postal Versus Web-Based Survey: A Randomized Trial

PubMed Central

Maisonneuve, Hubert; Cerutti, Bernard; Fournier, Jean Pascal; Senn, Nicolas; Haller, Dagmar M

2017-01-01

Background Web-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians, and none to our knowledge among general practitioners (GPs). Objective Our aim is to compare two modes of survey delivery (postal and Web-based) in terms of participation rates, response times, and completeness of questionnaires in a study assessing GPs’ preventive practices. Methods This randomized study was conducted in Western Switzerland (Geneva and Vaud) and in France (Alsace and Pays de la Loire) in 2015. A random selection of community-based GPs (1000 GPs in Switzerland and 2400 GPs in France) were randomly allocated to receive a questionnaire about preventive care activities either by post (n=700 in Switzerland, n=400 in France) or by email (n=300 in Switzerland, n=2000 in France). Reminder messages were sent once in the postal group and twice in the Web-based group. Any GPs practicing only complementary and alternative medicine were excluded from the study. Results Among the 3400 contacted GPs, 764 (22.47%, 95% CI 21.07%-23.87%) returned the questionnaire. Compared to the postal group, the participation rate in the Web-based group was more than four times lower (246/2300, 10.70% vs 518/1100, 47.09%, P<.001), but median response time was much shorter (1 day vs 1-3 weeks, P<.001) and the number of GPs having fully completed the questionnaire was almost twice as high (157/246, 63.8% vs 179/518, 34.6%, P<.001). Conclusions Web-based surveys offer many advantages such as reduced response time, higher completeness of data, and large cost savings, but our findings suggest that postal surveys can be still considered for GP research. The use of mixed-mode approaches is probably a good strategy to increase GPs’ participation in surveys while reducing costs. PMID:28330830

Postal urine specimens: are they a feasible method for genital chlamydial infection screening?

PubMed Central

Macleod, J; Rowsell, R; Horner, P; Crowley, T; Caul, E O; Low, N; Smith, G D

1999-01-01

BACKGROUND: A United Kingdom (UK) screening programme for Chlamydia trachomatis has recently been announced. Pilot projects involving the opportunistic testing of women attending health facilities are due to commence in several sites. There is a danger that this approach will fail to obtain adequate population coverage. The alternative--true systematic population screening--is generally assumed to be unfeasible. Studies in Denmark using postal urine specimens have challenged this assumption. No such studies have been reported from the UK. AIM: To assess the potential of urine specimens sent by post as the basis for a UK population screening strategy for genital chlamydial infection. METHOD: Two hundred patients (100 men, 100 women) aged 18 to 45 years were randomly sampled from the list of one urban group practice. Subjects were mailed an explanatory letter, a urine sample container, a sexual lifestyle questionnaire, and a prepaid return envelope. Non-responders were contacted by telephone; persistent non-responders were visited at home. Samples were tested for Chlamydia by DNA amplification and enzyme immunoassay. RESULTS: Sixty-four (32%) subjects were no longer living at their GP registered address. Of the remaining 136, 126 (93%) responded to the survey and 113 (83%) accepted the request for a urine sample and completed a questionnaire. Acceptance rates were similar for men and women and across age groups. Four samples (3%) were Chlamydia positive. CONCLUSION: Home mailed urine specimen collection in conjunction with a self-completed postal questionnaire is feasible. This could provide a viable basis both for determining population Chlamydia prevalence and for a UK Chlamydia population screening strategy. Overall cost effectiveness of such a strategy will depend on the cost of the test used. Comparative performance characteristics of the different currently available tests in this setting have yet to be fully determined. PMID:10562745

75 FR 44138 - New Postal Products

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

... POSTAL REGULATORY COMMISSION 30 CFR Part 3020 [Docket Nos. MC2010-21; CP2010-36 and MC2010-20] New Postal Products AGENCY: Postal Regulatory Commission. ACTION: Final rule. SUMMARY: The Commission is updating postal product lists. This action reflects the disposition of recent dockets, as set out in two...

Accuracy of responses from postal surveys about continuing medical education and information behavior: experiences from a survey among German diabetologists

PubMed Central

Trelle, Sven

2002-01-01

Background Postal surveys are a popular instrument for studies about continuing medical education habits. But little is known about the accuracy of responses in such surveys. The objective of this study was to quantify the magnitude of inaccurate responses in a postal survey among physicians. Methods A sub-analysis of a questionnaire about continuing medical education habits and information management was performed. The five variables used for the quantitative analysis are based on a question about the knowledge of a fictitious technical term and on inconsistencies in contingency tables of answers to logically connected questions. Results Response rate was 52%. Non-response bias is possible but seems not very likely since an association between demographic variables and inconsistent responses could not be found. About 10% of responses were inaccurate according to the definition. Conclusion It was shown that a sub-analysis of a questionnaire makes a quantification of inaccurate responses in postal surveys possible. This sub-analysis revealed that a notable portion of responses in a postal survey about continuing medical education habits and information management was inaccurate. PMID:12153701

A parent‐completed respiratory questionnaire for 1‐year‐old children: repeatability

PubMed Central

Strippoli, Marie‐Pierre F; Silverman, Michael; Michel, Gisela; Kuehni, Claudia E

2007-01-01

Background and aims There are few standardised questionnaires for the assessment of respiratory symptoms in preschool children. We have developed and tested the short‐term repeatability of a postal questionnaire on respiratory symptoms for 1‐year‐old children. Methods A newly developed postal questionnaire for the assessment of wheeze and other respiratory symptoms was sent to parents of a population‐based random sample of 4300 children aged 12–24 months. After an interval of 3 months, a random sample of 800 respondents received the questionnaire a second time. The responses were compared using Cohen's kappa (κ) to assess agreement corrected for chance. Results The first questionnaire was returned by 3194 (74%) families, the second one by 460/800 (58%). Repeatability was excellent (κ 0.80–0.96) for questions on household characteristics, environmental exposures and family history, good (κ 0.61–0.80) for questions on prevalence, severity and treatment of wheeze, and moderate (κ 0.39–0.66) for chronic cough and upper respiratory symptoms. Conclusions This short postal questionnaire designed for use in population‐based studies has excellent repeatability for family and household characteristics and good repeatability for questions on wheeze. Short‐term changes in symptom status might be responsible for variable answers on recent chronic cough and upper respiratory symptoms. Overall, the questionnaire is a valuable instrument for community‐based research on respiratory symptoms in 1 to 2‐year‐old children. PMID:17502330

The development of two postnatal health instruments: one for mothers (M-PHI) and one for fathers (F-PHI) to measure health during the first year of parenting.

PubMed

Jones, G L; Morrell, C J; Cooke, J M; Speier, D; Anumba, D; Stewart-Brown, S

2011-09-01

To develop and psychometrically evaluate two questionnaires measuring both positive and negative postnatal health of mothers (M-PHI) and fathers (F-PHI) during the first year of parenting. The M-PHI and the F-PHI were developed in four stages. Stage 1: Postnatal women's focus group (M-PHI) and postnatal fathers' postal questionnaire (F-PHI); Stage 2: Qualitative interviews; Stage 3: Pilot postal survey and main postal survey; and Stage 4: Test-retest postal survey. The M-PHI consisted of a 29-item core questionnaire with six main scales and five conditional scales. The F-PHI consisted of a 27-item questionnaire with six main scales. All scales achieved good internal reliability (Cronbach's α 0.66-0.87 for M-PHI, 0.72-0.90 for F-PHI). Intraclass correlation coefficients demonstrated high test-retest reliability (0.60-0.88). Correlation coefficients supported the criterion validity of the M-PHI and the F-PHI when tested against the Short-Form-12 (SF-12), Edinburgh Postnatal Depression Scale (EPDS) and the Warwick and Edinburgh Mental Well-Being Scale (WEMWBS). The M-PHI and F-PHI are valid, reliable, parent-generated instruments. These unique instruments will be invaluable for practitioners wishing to promote family-centred care and for trialists and other researchers requiring a validated instrument to measure both positive and negative health during the first postnatal year, as to date no such measurement has existed.

Should breast reduction surgery be rationed? A comparison of the health status of patients before and after treatment: postal questionnaire survey.

PubMed Central

Klassen, A.; Fitzpatrick, R.; Jenkinson, C.; Goodacre, T.

1996-01-01

OBJECTIVES: To assess the health status of patients before and after breast reduction surgery and to make comparisons with the health status of women in the general population. DESIGN: Postal questionnaire survey sent to patients before and six months after surgery. SETTING: The three plastic surgery departments in the Oxford Regional Health Authority, during April to August 1993. SUBJECTS: 166 women (over the age of 16 years) referred for breast reduction; scores from the "short form 36" (SF-36) health questionnaire completed by women in the 1991-2 Oxford healthy life survey. MAIN OUTCOME MEASURES: Health status of breast reduction patients before and after surgery as assessed by the SF-36, the 28 item general health questionnaire, and Rosenberg's self esteem scale; comparisons between the health status of breast reduction patients and that of women in the general population; outcome of surgery as assessed retrospectively by patients. RESULTS: Differences between the health status of breast reduction patients and that of women in the general population were detected by the SF-36 both before and after surgery. Breast reduction surgery produced substantial change in patients' physical, social, and psychological function. The proportion of cases of possible psychiatric morbidity according to the general health questionnaire fell from 41% (22/54) before surgery to 11% (6/54) six months after treatment. Eighty six per cent (50/58) of patients expressed great satisfaction with the surgical result postoperatively. CONCLUSION: The study provides empirical evidence that supports the inclusion of breast reduction surgery in NHS purchasing contracts. PMID:8776311

39 CFR 267.4 - Information security standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Information security standards. 267.4 Section 267.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION PROTECTION OF INFORMATION § 267.4 Information security standards. (a) The Postal Service will operate under a uniform set of...

39 CFR 267.4 - Information security standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Information security standards. 267.4 Section 267.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION PROTECTION OF INFORMATION § 267.4 Information security standards. (a) The Postal Service will operate under a uniform set of...

39 CFR 267.4 - Information security standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Information security standards. 267.4 Section 267.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION PROTECTION OF INFORMATION § 267.4 Information security standards. (a) The Postal Service will operate under a uniform set of...

39 CFR 267.4 - Information security standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Information security standards. 267.4 Section 267.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION PROTECTION OF INFORMATION § 267.4 Information security standards. (a) The Postal Service will operate under a uniform set of...

39 CFR 267.4 - Information security standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Information security standards. 267.4 Section 267.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION PROTECTION OF INFORMATION § 267.4 Information security standards. (a) The Postal Service will operate under a uniform set of...

Rates, Delays, and Completeness of General Practitioners' Responses to a Postal Versus Web-Based Survey: A Randomized Trial.

PubMed

Sebo, Paul; Maisonneuve, Hubert; Cerutti, Bernard; Fournier, Jean Pascal; Senn, Nicolas; Haller, Dagmar M

2017-03-22

Web-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians, and none to our knowledge among general practitioners (GPs). Our aim is to compare two modes of survey delivery (postal and Web-based) in terms of participation rates, response times, and completeness of questionnaires in a study assessing GPs' preventive practices. This randomized study was conducted in Western Switzerland (Geneva and Vaud) and in France (Alsace and Pays de la Loire) in 2015. A random selection of community-based GPs (1000 GPs in Switzerland and 2400 GPs in France) were randomly allocated to receive a questionnaire about preventive care activities either by post (n=700 in Switzerland, n=400 in France) or by email (n=300 in Switzerland, n=2000 in France). Reminder messages were sent once in the postal group and twice in the Web-based group. Any GPs practicing only complementary and alternative medicine were excluded from the study. Among the 3400 contacted GPs, 764 (22.47%, 95% CI 21.07%-23.87%) returned the questionnaire. Compared to the postal group, the participation rate in the Web-based group was more than four times lower (246/2300, 10.70% vs 518/1100, 47.09%, P<.001), but median response time was much shorter (1 day vs 1-3 weeks, P<.001) and the number of GPs having fully completed the questionnaire was almost twice as high (157/246, 63.8% vs 179/518, 34.6%, P<.001). Web-based surveys offer many advantages such as reduced response time, higher completeness of data, and large cost savings, but our findings suggest that postal surveys can be still considered for GP research. The use of mixed-mode approaches is probably a good strategy to increase GPs' participation in surveys while reducing costs. ©Paul Sebo, Hubert Maisonneuve, Bernard Cerutti, Jean Pascal Fournier, Nicolas Senn, Dagmar M Haller. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.03.2017.

Identifying dyspepsia in the Greek population: translation and validation of a questionnaire.

PubMed

Anastasiou, Foteini; Antonakis, Nikos; Chaireti, Georgia; Theodorakis, Pavlos N; Lionis, Christos

2006-03-04

Studies on clinical issues, including diagnostic strategies, are considered to be the core content of general practice research. The use of standardised instruments is regarded as an important component for the development of Primary Health Care research capacity. Demand for epidemiological cross-cultural comparisons in the international setting and the use of common instruments and definitions valid to each culture is bigger than ever. Dyspepsia is a common complaint in primary practice but little is known with respect to its incidence in Greece. There are some references about the Helicobacter Pylori infection in patients with functional dyspepsia or gastric ulcer in Greece but there is no specific instrument for the identification of dyspepsia. This paper reports on the validation and translation into Greek, of an English questionnaire for the identification of dyspepsia in the general population and discusses several possibilities of its use in the Greek primary care. The selected English postal questionnaire for the identification of people with dyspepsia in the general population consists of 30 items and was developed in 1995. The translation and cultural adaptation of the questionnaire has been performed according to international standards. For the validation of the instrument the internal consistency of the items was established using the alpha coefficient of Chronbach, the reproducibility (test - retest reliability) was measured by kappa correlation coefficient and the criterion validity was calculated against the diagnosis of the patients' records using also kappa correlation coefficient. The final Greek version of the postal questionnaire for the identification of dyspepsia in the general population was reliably translated. The internal consistency of the questionnaire was good, Chronbach's alpha was found to be 0.88 (95% CI: 0.81-0.93), suggesting that all items were appropriate to measure. Kappa coefficient for reproducibility (test - retest reliability) was found 0.66 (95% CI: 0.62-0.71), whereas the kappa analysis for criterion validity was 0.63 (95% CI: 0.36-0.89). This study indicates that the Greek translation is comparable with the English-language version in terms of validity and reliability, and is suitable for epidemiological research within the Greek primary health care setting.

The effect of postal questionnaire burden on response rate and answer patterns following admission to intensive care: a randomised controlled trial.

PubMed

Hatch, Robert; Young, Duncan; Barber, Vicki; Harrison, David A; Watkinson, Peter

2017-03-27

The effects of postal questionnaire burden on return rates and answers given are unclear following treatment on an intensive care unit (ICU). We aimed to establish the effects of different postal questionnaire burdens on return rates and answers given. Design: A parallel group randomised controlled trial. We assigned patients by computer-based randomisation to one of two questionnaire packs (Group A and Group B). Patients from 26 ICUs in the United Kingdom. Patients who had received at least 24 h of level 3 care and were 16 years of age or older. Patients did not know that there were different questionnaire burdens. The study included 18,490 patients. 12,170 were eligible to be sent a questionnaire pack at 3 months. We sent 12,105 questionnaires (6112 to group A and 5993 to group B). The Group A pack contained demographic and EuroQol group 5 Dimensions 3 level (EQ-5D-3 L) questionnaires, making four questionnaire pages. The Group B pack also contained the Hospital Anxiety and Depression Score (HADS) and the Post-Traumatic Stress Disorder Check List-Civilian (PCL-C) questionnaires, making eight questionnaire pages in total. Questionnaire return rate 3 months after ICU discharge by group. In group A, 2466/6112 (40.3%) participants responded at 3 months. In group B 2315/ 5993 (38.6%) participants responded (difference 1.7% CI for difference 0-3.5% p = 0.053). Group A reported better functionality than group B in the EQ-5D-3 L mobility (41% versus 37% reporting no problems p = 0.003) and anxiety/depression (59% versus 55% reporting no problems p = 0.017) domains. In survivors of intensive care, questionnaire burden had no effect on return rates. However, questionnaire burden affected answers to the same questionnaire (EQ-5D-3 L). ISRCTN69112866 (assigned 02/05/2006).

HIV and measures to control infection in general practice.

PubMed Central

Foy, C; Gallagher, M; Rhodes, T; Setters, J; Philips, P; Donaldson, C; Bond, J; Moore, M; Naji, S

1990-01-01

OBJECTIVE--To assess the impact of HIV on procedures to control infection in general practices. DESIGN--A postal questionnaire survey. SETTING--General practices throughout Britain. SUBJECTS--5359 General practitioners, 3429 (63.9%) of whom returned the questionnaire. MAIN OUTCOME MEASURE--Response to questionnaire on knowledge about HIV and policies for controlling infection. RESULTS--Most doctors (2018) had started to wear gloves when taking blood. Almost half (1510) had not resheathed needles previously but a further 776 had adopted this policy because of HIV. Over half of the doctors did not know or were unsure about the risk of infection from needlestick injuries, and 1759 had no practice policy for controlling infection. CONCLUSIONS--Many doctors are uncertain about measures to control infection in general practice. More information and advice are needed to help doctors develop policies to protect patients and staff. PMID:2344517

Organizational commitment among general practitioners: a cross-sectional study of the role of psychosocial factors.

PubMed

Kuusio, Hannamaria; Heponiemi, Tarja; Sinervo, Timo; Elovainio, Marko

2010-06-01

To examine whether general practitioners (GP) working in primary health care have lower organizational commitment compared with physicians working in other health sectors. The authors also tested whether psychosocial factors (job demands, job control, and colleague consultation) explain these differences in commitment between GPs and other physicians. Cross-sectional postal questionnaire. Setting and participants. A postal questionnaire was sent to a random sample of physicians (n = 5000) drawn from the Finnish Association database in 2006. A total of 2841 physicians (response rate 57%) returned the questionnaire, of which 2657 (545 GPs and 2090 other physicians) fulfilled all the participant criteria. Organizational commitment was measured with two different indicators: intention to change jobs and low affective commitment. GPs were less committed to their organizations than other physicians. Work-related psychosocial factors (high job demands, low job control, and poor colleague consultation) were all significant risk factors for low organizational commitment. The evidence collected suggests that policies that reduce psychological demands, such as job demands and low control, may contribute to better organizational commitment and, thus, alleviate the shortages of physicians in primary care. Furthermore, giving GPs a stronger say in decisions concerning their work and providing them with more variety in work tasks may even improve the quality of primary care. The strategies for workplace development should focus on redesigning jobs and identifying GPs at higher risk, such as those with especially high job strain.

Survey of dental radiographic services in private dental clinics in Damascus, Syria.

PubMed

Salti, L; Whaites, E J

2002-03-01

To perform a radiographic survey of private dental clinics in Damascus, Syria using a postal questionnaire to produce recommendations for improving the quality of dental radiographic services and education in Syria. Three hundred private dental clinics in Damascus were surveyed using a postal questionnaire (in English and Arabic) containing 27 questions on demographic information, equipment, techniques, selection criteria, frequency of examinations, and undergraduate/ postgraduate education. Two hundred and two (67%) dentists responded of which 95% graduated in Syria. The results showed a general lack of knowledge and understanding of dental radiography. Sixty four per cent did not know the kVp setting of their equipment, 73% used D-speed film, 57% did not use film holders and beam aiming devices, 25% did not use a viewing box. In addition, 45% of known equipment operated at 50 kVp or less and 16% was over 20 years old. No meaningful selection criteria existed with a wide variation in type and frequency of radiographs used for different clinical conditions. Syrian undergraduate training in dental radiology was minimal and there was no postgraduate education in the speciality. Several areas of the radiographic service in Damascus fall short of current recommendations on good practice. Recommendations are made to improve the service, the quality of undergraduate education and to establish postgraduate education.

Medicine or ecstasy? The importance of the logo.

PubMed

Daveluy, Amélie; Miremont-Salamé, Ghada; Rahis, Anne-Cécile; Delile, Jean-Michel; Bégaud, Bernard; Gachie, Jean-Pierre; Haramburu, Françoise

2010-04-01

Some pharmaceutical tablets have an appearance that resembles that of ecstasy (a logo and often a name referring to it, a given shape and/or a colour). These are sometimes sold in the street as 'ecstasy'. In order to assess the knowledge of this phenomenon, surveys were conducted among designer drug users (DDUsers), pharmacists and pharmaceutical firms. Three surveys were conducted: the first one was conducted among DDUsers by means of an anonymous questionnaire; the second one consisted of a 1-month postal survey within a network of 155 community pharmacies in the Aquitaine region, Southwestern France and the third one consisted of a postal questionnaire sent to 71 pharmaceutical firms. Nineteen users, 77 pharmacists and 25 pharmaceutical firms participated in the surveys. All DDUsers knew the existence of what they call ecstasy 'swindles', but less than one quarter of the pharmacists and one third of pharmaceutical firms were aware of the potential recreational and involuntary misuse of medicines. The phenomenon of 'swindle' in the illicit market is not new. However, the sale of medicines because of their appearance or logo seems to be quite rare. In order to limit this diversion, prevention should be reinforced. In addition, recommendations on the appearance of medicine tablets should be set up by regulatory agencies in charge of medicine approval.

A review of how to conduct a surgical survey using a questionnaire.

PubMed

Hing, C B; Smith, T O; Hooper, L; Song, F; Donell, S T

2011-08-01

Health surveys using questionnaires facilitate the acquisition of information on the knowledge, behaviour, attitudes, perceptions and clinical history of a selected population. Their internal and external validities are threatened by poor design and low response rates. Numerous studies have investigated survey design and administration but care should be taken when generalising findings in different clinical and cultural settings. The current evidence-base suggests that no single mode of survey administration, such as postal, electronic or telephone, is superior to another. Whilst there is no evidence of an ideal response rate relationship to survey validity, response rates can be enhanced by including monetary incentives, providing a time cue, and repeat contact with non-responders. Unlike other modes of experimental data collection, few guidelines currently exist for survey and questionnaire design and response rate should not be considered a direct measure of a survey's quality. Copyright © 2010 Elsevier B.V. All rights reserved.

39 CFR 3001.18 - Nature of proceedings.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Nature of proceedings. 3001.18 Section 3001.18 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES OF PRACTICE AND PROCEDURE Rules of General Applicability § 3001.18 Nature of proceedings. (a) Proceedings to be set for hearing. Except as otherwise...

39 CFR 3001.18 - Nature of proceedings.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Nature of proceedings. 3001.18 Section 3001.18 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES OF PRACTICE AND PROCEDURE Rules of General Applicability § 3001.18 Nature of proceedings. (a) Proceedings to be set for hearing. Except as otherwise...

39 CFR 3001.18 - Nature of proceedings.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Nature of proceedings. 3001.18 Section 3001.18 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES OF PRACTICE AND PROCEDURE Rules of General Applicability § 3001.18 Nature of proceedings. (a) Proceedings to be set for hearing. Except as otherwise...

39 CFR 3001.18 - Nature of proceedings.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Nature of proceedings. 3001.18 Section 3001.18 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES OF PRACTICE AND PROCEDURE Rules of General Applicability § 3001.18 Nature of proceedings. (a) Proceedings to be set for hearing. Except as otherwise...

39 CFR 3001.18 - Nature of proceedings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Nature of proceedings. 3001.18 Section 3001.18 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES OF PRACTICE AND PROCEDURE Rules of General Applicability § 3001.18 Nature of proceedings. (a) Proceedings to be set for hearing. Except as otherwise...

Factors influencing the response to postal questionnaire surveys about respiratory symptoms.

PubMed

Hazell, Michelle L; Morris, Julie A; Linehan, Mary F; Frank, Peter I; Frank, Timothy L

2009-09-01

Response rates to postal questionnaires have been falling in recent years. To examine factors affecting the response to five postal respiratory questionnaire surveys. Cross sectional study. General practice. Five surveys were conducted in all adults registered with two UK general practices using an ECRHQ-based questionnaire, with two reminders at 4-week intervals. Response rates declined over time (1993 - 71.2%; 1995 - 70.5%; 1999 - 65.5%; 2001 - 65.3%; 2004 - 46.9%). Age and gender of non-responders were available for 2001 and 2004: responders were older (mean 48.8 years vs 37.6, p<0.001; 50.5 vs 38.8, p<0.001) and more likely to be female (54.9% vs 44.9%, p<0.001; 55.3% vs 48.5%, p<0.001). The response rate was increased by 18% (2004) and 23% (2001) by the use of two reminders. Early responders were older and more likely to be females, but were less likely to smoke than late responders after reminders. There was no important association between respiratory symptoms and associated feature prevalence and stage of response. Declining response rates may represent reduced motivation and reluctance to share personal information. Qualitative exploration of late/non-response could help reduce bias when planning and analysing such surveys. The use of two reminders is an important factor in improving response.

On the qi deficiency in traditional Chinese medicine.

PubMed

Chiang, Hui-Chu; Chang, Hen-Hong; Huang, Po-Yu; Hsu, Mutsu

2014-09-01

Qi deficiency (QD), one of the most common disorders in Traditional Chinese medicine (TCM), is relevant to many disorders in obstetrics and gynecology. This study aimed to identify the common processes and criteria for diagnosing QD among contemporary proficient TCM practitioners. Steps of decision tree analysis and modified Delphi method were merged together into four-round postal questionnaires to collect qualitative and quantitative data. Open-ended questions and content analysis were used to explore the proficient TCM practitioners' cognitive activities used for diagnosis. The statements obtained from the qualitative responses were used to develop the items for subsequent questionnaires. Based on the TCM practitioners' responses, the diagnostic processes and criteria for making diagnosis were generated. Twenty-eight out of the 30 participants completed all four questionnaires from June 2007 to January 2010. The 11 diagnostic procedures identified in the returned first round of questionnaires were used as the alternatives to select and rank for all the steps to diagnose QD. After three more rounds of postal surveys, an algorithm with a five-stage diagnostic process as well as sets of decision criteria were identified. Although the priorities of procedures and descriptions of reasoning were varied, the content revealed the major themes in the model. The criteria to differentiate signs and symptoms (S/S) included five principles for correlating S/S with QD, and 17 S/S should be differentiated carefully. The results demonstrate that the TCM practitioners precisely diagnosed QD using a number of specific procedures and criteria that could be used as a reference to understand women complaining of S/S that could be similar to QD. Copyright © 2014. Published by Elsevier B.V.

The effect of two lottery-style incentives on response rates to postal questionnaires in a prospective cohort study in preschool children at high risk of asthma: a randomized trial.

PubMed

van der Mark, Lonneke B; van Wonderen, Karina E; Mohrs, Jacob; Bindels, Patrick Je; Puhan, Milo A; Ter Riet, Gerben

2012-12-18

In research with long-term follow-up and repeated measurements, quick and complete response to questionnaires helps ensure a study's validity, precision and efficiency. Evidence on the effect of non-monetary incentives on response rates in observational longitudinal research is scarce. To study the impact of two strategies to enhance completeness and efficiency in observational cohort studies with follow-up durations of around 2 years. METHOD AND INTERVENTION: In a factorial design, 771 children between 2 and 5 years old and their parents participating in a prospective cohort study were randomized to three intervention groups and a control group. Three types of lotteries were run: (i) daytrip tickets for the whole family to a popular amusement park if they returned all postal questionnaires, (ii) €12.50-worth gift vouchers for sending back the questionnaire on time after each questionnaire round and (iii) a combination of (i) and (ii). Primary outcome was the proportion of participants who returned all questionnaires without any reminder. Secondary outcomes were '100% returned with or without reminder', 'probability of 100% non-response', 'probability of withdrawal', 'proportion of returned questionnaires' and 'overall number of reminders sent'. After testing for interaction between the two lottery interventions, the two trials were analysed separately. We calculated risk differences (RD) and numbers needed to "treat" and their 95% confidence intervals. Daytrip nor voucher intervention had an effect on the proportion of participants who returned all questionnaires (RD -0.01; 95% CI-0.07 - 0.06) and (RD 0.02; 95% CI-0.50 - 0.08), respectively. No effects were found on the secondary outcomes. Our findings do not support the idea that lottery-style incentives lead to more complete response to postal questionnaires in observational cohort studies with repeated data collection and follow-up durations of around 2 years.

Identifying dyspepsia in the Greek population: translation and validation of a questionnaire

PubMed Central

Anastasiou, Foteini; Antonakis, Nikos; Chaireti, Georgia; Theodorakis, Pavlos N; Lionis, Christos

2006-01-01

Background Studies on clinical issues, including diagnostic strategies, are considered to be the core content of general practice research. The use of standardised instruments is regarded as an important component for the development of Primary Health Care research capacity. Demand for epidemiological cross-cultural comparisons in the international setting and the use of common instruments and definitions valid to each culture is bigger than ever. Dyspepsia is a common complaint in primary practice but little is known with respect to its incidence in Greece. There are some references about the Helicobacter Pylori infection in patients with functional dyspepsia or gastric ulcer in Greece but there is no specific instrument for the identification of dyspepsia. This paper reports on the validation and translation into Greek, of an English questionnaire for the identification of dyspepsia in the general population and discusses several possibilities of its use in the Greek primary care. Methods The selected English postal questionnaire for the identification of people with dyspepsia in the general population consists of 30 items and was developed in 1995. The translation and cultural adaptation of the questionnaire has been performed according to international standards. For the validation of the instrument the internal consistency of the items was established using the alpha coefficient of Chronbach, the reproducibility (test – retest reliability) was measured by kappa correlation coefficient and the criterion validity was calculated against the diagnosis of the patients' records using also kappa correlation coefficient. Results The final Greek version of the postal questionnaire for the identification of dyspepsia in the general population was reliably translated. The internal consistency of the questionnaire was good, Chronbach's alpha was found to be 0.88 (95% CI: 0.81–0.93), suggesting that all items were appropriate to measure. Kappa coefficient for reproducibility (test – retest reliability) was found 0.66 (95% CI: 0.62–0.71), whereas the kappa analysis for criterion validity was 0.63 (95% CI: 0.36–0.89). Conclusion This study indicates that the Greek translation is comparable with the English-language version in terms of validity and reliability, and is suitable for epidemiological research within the Greek primary health care setting. PMID:16515708

Patient satisfaction with large-scale out-of-hours primary health care in The Netherlands: development of a postal questionnaire.

PubMed

Moll van Charante, Eric; Giesen, Paul; Mokkink, Henk; Oort, Frans; Grol, Richard; Klazinga, Niek; Bindels, Patrick

2006-08-01

Since the turn of the millennium, out-of-hours primary health care in The Netherlands has faced a substantial change from small locum groups towards large GP cooperatives. Improving the quality of care requires evaluation of patient satisfaction. To develop a reliable postal questionnaire for wide-scale use by patients contacting their out-of-hours GP cooperative and to present the results of a national survey. Literature review and interviews with both patients and health carers were carried out to identify issues of potential relevance, followed by two postal pilot studies and additional interviews to remove or rephrase items. Finally, postal questionnaires were sent to 14,400 people who contacted one of 24 GP cooperatives in The Netherlands. Overall response was 52.2% for all types of contact. Three scales were identified prior to the field phase and confirmed by principal components analysis: telephone nurse, doctor and organization. Reliability was high, with Cronbach's alphas and intraclass correlation coefficients exceeding 0.70 for all scales. Only items in the organization scale showed clear differences among the participating cooperatives. Respondents receiving telephone advice showed lower levels of satisfaction than respondents with other types of contact (P < 0.001); centre consultation scored lower than home visit (P < 0.030 or less for all differences). A reliable measure of patient satisfaction has been developed that can also be used for the comparison of GP cooperatives on an organizational level. Overall satisfaction was high, showing highest levels for home visit and lowest levels for telephone advice.

39 CFR 3030.10 - Complaint contents.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Complaint contents. 3030.10 Section 3030.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS Form and Manner Requirements of Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts and circumstances that give rise to the complaint; (2)...

39 CFR 3030.10 - Complaint contents.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Complaint contents. 3030.10 Section 3030.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS Form and Manner Requirements of Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts and circumstances that give rise to the complaint; (2)...

39 CFR 3030.10 - Complaint contents.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Complaint contents. 3030.10 Section 3030.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS Form and Manner Requirements of Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts and circumstances that give rise to the complaint; (2)...

39 CFR 3030.10 - Complaint contents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Complaint contents. 3030.10 Section 3030.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS Form and Manner Requirements of Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts and circumstances that give rise to the complaint; (2)...

39 CFR 3030.10 - Complaint contents.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Complaint contents. 3030.10 Section 3030.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS Form and Manner Requirements of Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts and circumstances that give rise to the complaint; (2)...

Effect of questionnaire length, personalisation and reminder type on response rate to a complex postal survey: randomised controlled trial

PubMed Central

2011-01-01

Background Minimising participant non-response in postal surveys helps to maximise the generalisability of the inferences made from the data collected. The aim of this study was to examine the effect of questionnaire length, personalisation and reminder type on postal survey response rate and quality and to compare the cost-effectiveness of the alternative survey strategies. Methods In a pilot study for a population study of travel behaviour, physical activity and the environment, 1000 participants sampled from the UK edited electoral register were randomly allocated using a 2 × 2 factorial design to receive one of four survey packs: a personally addressed long (24 page) questionnaire pack, a personally addressed short (15 page) questionnaire pack, a non-personally addressed long questionnaire pack or a non-personally addressed short questionnaire pack. Those who did not return a questionnaire were stratified by initial randomisation group and further randomised to receive either a full reminder pack or a reminder postcard. The effects of the survey design factors on response were examined using multivariate logistic regression. Results An overall response rate of 17% was achieved. Participants who received the short version of the questionnaire were more likely to respond (OR = 1.48, 95% CI 1.06 to 2.07). In those participants who received a reminder, personalisation of the survey pack and reminder also increased the odds of response (OR = 1.44, 95% CI 1.01 to 1.95). Item non-response was relatively low, but was significantly higher in the long questionnaire than the short (9.8% vs 5.8%; p = .04). The cost per additional usable questionnaire returned of issuing the reminder packs was £23.1 compared with £11.3 for the reminder postcards. Conclusions In contrast to some previous studies of shorter questionnaires, this trial found that shortening a relatively lengthy questionnaire significantly increased the response. Researchers should consider the trade off between the value of additional questions and a larger sample. If low response rates are expected, personalisation may be an important strategy to apply. Sending a full reminder pack to non-respondents appears a worthwhile, albeit more costly, strategy. PMID:21548947

Sun safety knowledge and practice in UK postal delivery workers.

PubMed

Houdmont, J; Davis, S; Griffiths, A

2016-06-01

Postal delivery workers spend a large proportion of their work time outdoors, placing them at increased risk of skin cancer. To date, no studies have examined occupational sun safety knowledge and practice within this group in the UK. To describe the occupational sun safety knowledge and practice of UK postal delivery workers and to investigate the association of demographic, personal and occupational factors with knowledge and practice in order to identify potential strategies for improving sun safety in this occupational group. Postal delivery workers completed a questionnaire that collected data on occupational sun safety knowledge and practice in addition to demographic, personal and workplace characteristics. One-way analysis of variances were applied to assess differences in knowledge and practice by these characteristics. A total of 1153 postal delivery workers completed the questionnaire, a 60% response rate. Thirty-three per cent reported receiving sun safety training within the previous 12 months. The majority of respondents reported correct knowledge on three of the six domains and good practice on four of the six behavioural domains. However, only one-fifth of respondents reported wearing sunglasses and ensuring a plentiful intake of water. Knowledge and practice differed significantly according to demographic, personal and workplace characteristics. There is a need to raise the profile of occupational skin cancer in this occupational group and to increase the priority given to occupational sun safety policies alongside targeted and tailored interventions, the effect of which can be evaluated. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine.

Response rate, response time, and economic costs of survey research: A randomized trial of practicing pharmacists.

PubMed

Hardigan, Patrick C; Popovici, Ioana; Carvajal, Manuel J

2016-01-01

There is a gap between increasing demands from pharmacy journals, publishers, and reviewers for high survey response rates and the actual responses often obtained in the field by survey researchers. Presumably demands have been set high because response rates, times, and costs affect the validity and reliability of survey results. Explore the extent to which survey response rates, average response times, and economic costs are affected by conditions under which pharmacist workforce surveys are administered. A random sample of 7200 U.S. practicing pharmacists was selected. The sample was stratified by delivery method, questionnaire length, item placement, and gender of respondent for a total of 300 observations within each subgroup. A job satisfaction survey was administered during March-April 2012. Delivery method was the only classification showing significant differences in response rates and average response times. The postal mail procedure accounted for the highest response rates of completed surveys, but the email method exhibited the quickest turnaround. A hybrid approach, consisting of a combination of postal and electronic means, showed the least favorable results. Postal mail was 2.9 times more cost effective than the email approach and 4.6 times more cost effective than the hybrid approach. Researchers seeking to increase practicing pharmacists' survey participation and reduce response time and related costs can benefit from the analytical procedures tested here. Copyright © 2016 Elsevier Inc. All rights reserved.

Typing Postal Cards. Student's Manual and Instructor's Manual.

ERIC Educational Resources Information Center

Snapp, Jane

Supporting performance objective 85 of the V-TECS (Vocational-Technical Education Consortium of States) Secretarial Catalog, both a set of student materials and an instructor's manual on typing postal cards are included in this packet. (The packet is the seventh in a set of fifteen on typewriting--CE 016 920-934.) The student materials include a…

39 CFR 501.12 - Administrative sanctions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... collected by the Postal Service from the customers) with interest. The demand shall set forth the facts and... receiving written notice, appeal that determination to the Chief Marketing Officer of the Postal Service who...

Utilizing the Total Design Method in medicine: maximizing response rates in long, non-incentivized, personal questionnaire postal surveys.

PubMed

Kazzazi, Fawz; Haggie, Rebecca; Forouhi, Parto; Kazzazi, Nazar; Malata, Charles M

2018-01-01

Maximizing response rates in questionnaires can improve their validity and quality by reducing non-response bias. A comprehensive analysis is essential for producing reasonable conclusions in patient-reported outcome research particularly for topics of a sensitive nature. This often makes long (≥7 pages) questionnaires necessary but these have been shown to reduce response rates in mail surveys. Our work adapted the "Total Design Method," initially produced for commercial markets, to raise response rates in a long (total: 11 pages, 116 questions), non-incentivized, very personal postal survey sent to almost 350 women. A total of 346 women who had undergone mastectomy and immediate breast reconstruction from 2008-2014 (inclusive) at Addenbrooke's University Hospital were sent our study pack (Breast-Q satisfaction questionnaire and support documents) using our modified "Total Design Method." Participants were sent packs and reminders according to our designed schedule. Of the 346 participants, we received 258 responses, an overall response rate of 74.5% with a useable response rate of 72.3%. One hundred and six responses were received before the week 1 reminder (30.6%), 120 before week 3 (34.6%), 225 before the week 7 reminder (64.6%) and the remainder within 3 weeks of the final pack being sent. The median age of patients that the survey was sent to, and the median age of the respondents, was 54 years. In this study, we have demonstrated the successful implementation of a novel approach to postal surveys. Despite the length of the questionnaire (nine pages, 116 questions) and limitations of expenses to mail a survey to ~350 women, we were able to attain a response rate of 74.6%.

Prevalence of gastrointestinal symptoms six months after bacterial gastroenteritis and risk factors for development of the irritable bowel syndrome: postal survey of patients.

PubMed Central

Neal, K. R.; Hebden, J.; Spiller, R.

1997-01-01

OBJECTIVE: To measure the prevalence of gastrointestinal symptoms six months after bacterial gastroenteritis and determine risk factors and associations with postdysenteric symptoms. DESIGN: Postal questionnaire. SETTING: Nottingham Health Authority. SUBJECTS: 544 people with microbiologically confirmed bacterial gastroenteritis between July 1994 and December 1994. MAIN OUTCOME MEASURES: Prevalence of gastrointestinal symptoms and relative risks for development of the irritable bowel syndrome and self reported altered bowel habit. RESULTS: A quarter of subjects reported persistence of altered bowel habit six months after an episode of infective gastroenteritis. Increasing duration of diarrhoea, younger age, and female sex increased this risk, whereas vomiting as part of the illness reduced the risk. One in 14 developed the irritable bowel syndrome with an increased risk seen in women (relative risk 3.4: 95% confidence interval 1.2 to 9.8) and with duration of diarrhoea (6.5; 1.3 to 34 for 15-21 days). CONCLUSIONS: Persistence of bowel symptoms commonly occurs after bacterial gastroenteritis and is responsible for considerable morbidity and health care costs. PMID:9080994

Strategies to improve retention in randomised trials

PubMed Central

Brueton, Valerie C; Tierney, Jayne; Stenning, Sally; Harding, Seeromanie; Meredith, Sarah; Nazareth, Irwin; Rait, Greta

2013-01-01

Background Loss to follow-up from randomised trials can introduce bias and reduce study power, affecting the generalisability, validity and reliability of results. Many strategies are used to reduce loss to follow-up and improve retention but few have been formally evaluated. Objectives To quantify the effect of strategies to improve retention on the proportion of participants retained in randomised trials and to investigate if the effect varied by trial strategy and trial setting. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PreMEDLINE, EMBASE, PsycINFO, DARE, CINAHL, Campbell Collaboration's Social, Psychological, Educational and Criminological Trials Register, and ERIC. We handsearched conference proceedings and publication reference lists for eligible retention trials. We also surveyed all UK Clinical Trials Units to identify further studies. Selection criteria We included eligible retention trials of randomised or quasi-randomised evaluations of strategies to increase retention that were embedded in 'host' randomised trials from all disease areas and healthcare settings. We excluded studies aiming to increase treatment compliance. Data collection and analysis We contacted authors to supplement or confirm data that we had extracted. For retention trials, we recorded data on the method of randomisation, type of strategy evaluated, comparator, primary outcome, planned sample size, numbers randomised and numbers retained. We used risk ratios (RR) to evaluate the effectiveness of the addition of strategies to improve retention. We assessed heterogeneity between trials using the Chi2 and I2 statistics. For main trials that hosted retention trials, we extracted data on disease area, intervention, population, healthcare setting, sequence generation and allocation concealment. Main results We identified 38 eligible retention trials. Included trials evaluated six broad types of strategies to improve retention. These were incentives, communication strategies, new questionnaire format, participant case management, behavioural and methodological interventions. For 34 of the included trials, retention was response to postal and electronic questionnaires with or without medical test kits. For four trials, retention was the number of participants remaining in the trial. Included trials were conducted across a spectrum of disease areas, countries, healthcare and community settings. Strategies that improved trial retention were addition of monetary incentives compared with no incentive for return of trial-related postal questionnaires (RR 1.18; 95% CI 1.09 to 1.28, P value < 0.0001), addition of an offer of monetary incentive compared with no offer for return of electronic questionnaires (RR 1.25; 95% CI 1.14 to 1.38, P value < 0.00001) and an offer of a GBP20 voucher compared with GBP10 for return of postal questionnaires and biomedical test kits (RR 1.12; 95% CI 1.04 to 1.22, P value < 0.005). The evidence that shorter questionnaires are better than longer questionnaires was unclear (RR 1.04; 95% CI 1.00 to 1.08, P value = 0.07) and the evidence for questionnaires relevant to the disease/condition was also unclear (RR 1.07; 95% CI 1.01 to 1.14). Although each was based on the results of a single trial, recorded delivery of questionnaires seemed to be more effective than telephone reminders (RR 2.08; 95% CI 1.11 to 3.87, P value = 0.02) and a 'package' of postal communication strategies with reminder letters appeared to be better than standard procedures (RR 1.43; 95% CI 1.22 to 1.67, P value < 0.0001). An open trial design also appeared more effective than a blind trial design for return of questionnaires in one fracture prevention trial (RR 1.37; 95% CI 1.16 to 1.63, P value = 0.0003). There was no good evidence that the addition of a non-monetary incentive, an offer of a non-monetary incentive, 'enhanced' letters, letters delivered by priority post, additional reminders, or questionnaire question order either increased or decreased trial questionnaire response/retention. There was also no evidence that a telephone survey was either more or less effective than a monetary incentive and a questionnaire. As our analyses are based on single trials, the effect on questionnaire response of using offers of charity donations, sending reminders to trial sites and when a questionnaire is sent, may need further evaluation. Case management and behavioural strategies used for trial retention may also warrant further evaluation. Authors' conclusions Most of the retention trials that we identified evaluated questionnaire response. There were few evaluations of ways to improve participants returning to trial sites for trial follow-up. Monetary incentives and offers of monetary incentives increased postal and electronic questionnaire response. Some other strategies evaluated in single trials looked promising but need further evaluation. Application of the findings of this review would depend on trial setting, population, disease area, data collection and follow-up procedures. PLAIN LANGUAGE SUMMARY Methods that might help to keep people in randomised trials Background Most trials follow people up to collect data through personal contact after they have been recruited. Some trials get data from other sources, such as routine collected data or disease registers. There are many ways to collect data from people in trials, and these include using letters, the internet, telephone calls, text messaging, face-to-face meetings or the return of medical test kits. Most trials have missing data, for example, because people are too busy to reply, are unable to attend a clinic, have moved or no longer want to participate. Sometimes data has not been recorded at study sites, or are not sent to the trial co-ordinating centre. Researchers call this 'loss to follow-up', 'drop out' or 'attrition' and it can affect the trial's results. For example, if the people with the most or least severe symptoms do not return questionnaires or attend a follow-up visit, this will bias the findings of the trial. Many methods are used by researchers to keep people in trials. These encourage people to send back data by questionnaire, return to a clinic or hospital for trial-related tests, or be seen by a health or community care worker. Study characteristics This review identified methods that encouraged people to stay in trials. We searched scientific databases for randomised studies (where people are allocated to one of two or more possible treatments in a random manner) or quasi-randomised studies (where allocation is not really random, e.g. based on date of birth, order in which they attended clinic) that compared methods of increasing retention in trials. We included trials of participants from any age, gender, ethnic, cultural, language and geographic groups. Key results The methods that appeared to work were offering or giving a small amount of money for return of a completed questionnaire and enclosing a small amount of money with a questionnaire with the promise of a further small amount of money for return of a filled in questionnaire. The effect of other ways to keep people in trials is still not clear and more research is needed to see if these really do work. Such methods are shorter questionnaires, sending questionnaires by recorded delivery, using a trial design where people know which treatment they will receive, sending specially designed letters with a reply self addressed stamped envelope followed by a number of reminders, offering a donation to charity or entry into a prize draw, sending a reminder to the study site about participants to follow-up, sending questionnaires close to the time the patient was last followed-up, managing peoples' follow-up, conducting follow-up by telephone and changing the order of questionnaire questions. Quality of evidence The methods that we identified were tested in trials run in many different disease areas and settings and, in some cases, were tested in only one trial. Therefore, more studies are needed to help decide whether our findings could be used in other research fields. PMID:24297482

The relationship between patients' perception of the effects of neurofibromatosis type 2 and the domains of the Short Form-36.

PubMed

Neary, W J; Hillier, V F; Flute, T; Stephens, S D G; Ramsden, R T; Evans, D G R

2010-08-01

To investigate the relationship between those issues concerning quality of life in patients with neurofibromatosis type 2 (NF2) as identified by the closed set NF2 questionnaire and the eight norm-based measures and the physical component summary (PCS) and mental component summary (MCS) scores of the Short Form-36 (SF-36) Questionnaire. Postal questionnaire study. Questionnaires sent to subjects' home addresses. Eighty-seven adult subjects under the care of the Manchester Multidisciplinary NF2 Clinic were invited to participate. Sixty-two (71%) completed sets of closed set NF2 questionnaires and SF-36 questionnaires were returned. Subjects with NF2 scored less than the norm of 50 on both the physical component summary and mental component summary scores and the eight individual norm-based measures of the Short Form-36 questionnaire. Correlations (using Kendall's tau) were examined between patients' perceptions of their severity of difficulty with the following activities and the eight norm-based measures and the physical component summary and mental component summary scores of the Short Form-36 questionnaire: Communicating with spouse/significant other (N = 61). The correlation coefficients were significant at the 0.01 level for the mental component summary score, together with three of the norm-based scores [vitality (VT), social functioning and role emotional]. Social communication (N = 62). All 10 correlations were significant at the 0.01 or 0.001 level. Balance (N = 59). All 10 correlations were highly significant at the P < 0.001 level. Hearing difficulties (N = 61). All correlations were significant at either the 0.01 level or less apart from the mental component summary score and three of the norm-based scores (role physical, VT and mental health). Mood change (N = 61). All correlations were significant at the 0.01 level or less, apart from one norm-based score (role physical). The Short Form-36 questionnaire has allowed us to relate patients' perceptions of their difficulties, as identified by the closed set NF2 questionnaire, to the physical and mental domains measured by this validated and widely used scale, and has provided further insight into areas of functioning affected by NF2.

Systematic review of the cost-effectiveness of sample size maintenance programs in studies involving postal questionnaires reveals insufficient economic information.

PubMed

David, Michael C; Bensink, Mark; Higashi, Hideki; Boyd, Roslyn; Williams, Lesley; Ware, Robert S

2012-10-01

To identify and assess the existing cost-effectiveness evidence for sample size maintenance programs. Articles were identified by searching Cochrane Central Register of Controlled Trials Embase, CINAHL, PubMed, and Web of Science from 1966 to July 2011. Randomized controlled trials in which investigators evaluated program cost-effectiveness in postal questionnaires were eligible for inclusion. Fourteen studies from 13 articles, with 11,165 participants met the inclusion criteria. Thirty-one distinct programs were identified; each incorporated at least one strategy (reminders, incentives, modified questionnaires, or types of postage) aimed at minimizing attrition. Reminders, in the form of replacement questionnaires and cards, were the most commonly used strategies, with 15 and 11 studies reporting their usage, respectively. All strategies improved response, with financial incentives being the most costly. Heterogeneity between studies was too great to allow for meta-analysis of the results. The implementation of strategies such as no-obligation incentives, modified questionnaires, and personalized reply paid postage improved program cost-effectiveness. Analyses of attrition minimization programs need to consider both cost and effect in their evaluation. Copyright © 2012 Elsevier Inc. All rights reserved.

Social and Economic Costs of Food Allergies in Europe: Development of a Questionnaire to Measure Costs and Health Utility

PubMed Central

Fox, Margaret; Voordouw, Jantine; Mugford, Miranda; Cornelisse, Judith; Antonides, Gerrit; Frewer, Lynn

2009-01-01

Objectives To develop a questionnaire to measure the additional social costs of food allergies (FAs). Data Source and Study Setting People with FAs and sampled members of the general population (with and without FAs) in the Netherlands and the United Kingdom in 2006. Study Design (1) Literature review. (2) Focus group to identify key costs of FAs and seek views on the questionnaires. (3) Pilot survey to test the questionnaires in cases and controls. Data Collection Twenty-eight participants in the United Kingdom and the Netherlands with clinically or self-diagnosed FAs took part in one of five focus groups. A case–control postal survey was conducted in the United Kingdom and the Netherlands (with 125 FA cases and 62 controls). Principal Findings Methods exist to measure social costs in chronic illness, but not FAs. Focus groups found features of FAs likely to impact costs of living. Pilot results suggest higher costs of living and health care costs, and well-being in FAs. Conclusion The questionnaire is proposed for use in wider European and other comparative studies of FAs. PMID:19619251

Reliability and validity of the Attributional Style Questionnaire- Survey in people with multiple sclerosis

PubMed Central

Kneebone, Ian I.; Dewar, Sophie J.

2016-01-01

Background: The current study aimed to examine the psychometric properties of an attributional style measure that can be administered remotely, to people who have multiple sclerosis (MS). Methods: A total of 495 participants with MS were recruited. Participants completed the Attributional Style Questionnaire-Survey (ASQ-S) and two comparison measures of cognitive variables via postal survey on three occasions, each 12 months apart. Internal reliability, test-retest reliability and congruent validity were considered. Results: The internal reliability of the ASQ-S was good (α > 0.7). The test-retest correlations were significant, but failed to reach the 0.7 set. The congruent validity of the ASQ-S was established relative to the comparisons. Conclusions: The psychometric properties of the ASQ-S indicate that it shows promise as a tool for researchers investigating depression in people with MS and is likely sound to use clinically in this population. PMID:28450893

Health Professionals' Responses to Disclosure of Child Sexual Abuse History: Female Child Sexual Abuse Survivors' Experiences

ERIC Educational Resources Information Center

McGregor, Kim; Julich, Shirley; Glover, Marewa; Gautam, Jeny

2010-01-01

This study reports on a postal questionnaire, conducted in 2004, with female survivors of historic child sexual abuse. The questionnaire explored their experiences of health professionals' responsiveness to disclosure of child sexual abuse history. Of 61 participants, aged between 22 and 65, 69% had disclosed to health professionals. Those who had…

Comparison of Evidence-Based Practice between Physicians and Nurses: A National Survey of Regional Hospitals in Taiwan

ERIC Educational Resources Information Center

Chiu, Ya-Wen; Weng, Yi-Hao; Lo, Heng-Lien; Hsu, Chih-Cheng; Shih, Ya-Hui; Kuo, Ken N.

2010-01-01

Introduction: Although evidence-based practice (EBP) has been widely investigated, few studies compare physicians and nurses on performance. Methods: A structured questionnaire survey was used to investigate EBP among physicians and nurses in 61 regional hospitals of Taiwan. Valid postal questionnaires were collected from 605 physicians and 551…

Effects of Refresher Training on Job-Task Typewriting Performance

DTIC Science & Technology

1979-10-01

preceded by some blank space. How much space? The scanner requires not less than a sixth nor more than a half inch of space. The postal department stresses ...postal department stresses that the code be not less than two nor more than six spaces away from the state. INSERT NEW PAPER AND BEGIN TYPING WITH THE...Questionnaire Project 2 Home 1. Name Phone Work 2. Social Security Number i 3. NOS 4. Time in 0S Months 5. Location of AIT 6. Sex 7. Grade(circle one) El E2 E3 E4

77 FR 6676 - Office of Inspector General; Contractor Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... POSTAL SERVICE 39 CFR Part 230 Office of Inspector General; Contractor Requirements AGENCY: Postal... for contractors employed by the Office of Inspector General. The rule also emphasizes consistency in contractor selection, and clarifies the OIG's exclusive authority to set qualifications and standards for its...

Strategies to improve retention in randomised trials: a Cochrane systematic review and meta-analysis

PubMed Central

Brueton, V C; Tierney, J F; Stenning, S; Meredith, S; Harding, S; Nazareth, I; Rait, G

2014-01-01

Objective To quantify the effect of strategies to improve retention in randomised trials. Design Systematic review and meta-analysis. Data sources Sources searched: MEDLINE, EMBASE, PsycINFO, DARE, CENTRAL, CINAHL, C2-SPECTR, ERIC, PreMEDLINE, Cochrane Methodology Register, Current Controlled Trials metaRegister, WHO trials platform, Society for Clinical Trials (SCT) conference proceedings and a survey of all UK clinical trial research units. Review methods Included trials were randomised evaluations of strategies to improve retention embedded within host randomised trials. The primary outcome was retention of trial participants. Data from trials were pooled using the fixed-effect model. Subgroup analyses were used to explore the heterogeneity and to determine whether there were any differences in effect by the type of strategy. Results 38 retention trials were identified. Six broad types of strategies were evaluated. Strategies that increased postal questionnaire responses were: adding, that is, giving a monetary incentive (RR 1.18; 95% CI 1.09 to 1.28) and higher valued incentives (RR 1.12; 95% CI 1.04 to 1.22). Offering a monetary incentive, that is, an incentive given on receipt of a completed questionnaire, also increased electronic questionnaire response (RR 1.25; 95% CI 1.14 to 1.38). The evidence for shorter questionnaires (RR 1.04; 95% CI 1.00 to 1.08) and questionnaires relevant to the disease/condition (RR 1.07; 95% CI 1.01 to 1.14) is less clear. On the basis of the results of single trials, the following strategies appeared effective at increasing questionnaire response: recorded delivery of questionnaires (RR 2.08; 95% CI 1.11 to 3.87); a ‘package’ of postal communication strategies (RR 1.43; 95% CI 1.22 to 1.67) and an open trial design (RR 1.37; 95% CI 1.16 to 1.63). There is no good evidence that the following strategies impact on trial response/retention: adding a non-monetary incentive (RR=1.00; 95% CI 0.98 to 1.02); offering a non-monetary incentive (RR=0.99; 95% CI 0.95 to 1.03); ‘enhanced’ letters (RR=1.01; 95% CI 0.97 to 1.05); monetary incentives compared with offering prize draw entry (RR=1.04; 95% CI 0.91 to 1.19); priority postal delivery (RR=1.02; 95% CI 0.95 to 1.09); behavioural motivational strategies (RR=1.08; 95% CI 0.93 to 1.24); additional reminders to participants (RR=1.03; 95% CI 0.99 to 1.06) and questionnaire question order (RR=1.00, 0.97 to 1.02). Also based on single trials, these strategies do not appear effective: a telephone survey compared with a monetary incentive plus questionnaire (RR=1.08; 95% CI 0.94 to 1.24); offering a charity donation (RR=1.02, 95% CI 0.78 to 1.32); sending sites reminders (RR=0.96; 95% CI 0.83 to 1.11); sending questionnaires early (RR=1.10; 95% CI 0.96 to 1.26); longer and clearer questionnaires (RR=1.01, 0.95 to 1.07) and participant case management by trial assistants (RR=1.00; 95% CI 0.97 to 1.04). Conclusions Most of the trials evaluated questionnaire response rather than ways to improve participants return to site for follow-up. Monetary incentives and offers of monetary incentives increase postal and electronic questionnaire response. Some strategies need further evaluation. Application of these results would depend on trial context and follow-up procedures. PMID:24496696

Importance and Satisfaction of Preventive Health Strategies in Institutions for People with Intellectual Disabilities: A Perspective of Institutional Directors

ERIC Educational Resources Information Center

Lin, J. D.; Yen, C. F.; Wu, J. L.

2005-01-01

Aim: To explore the perceptions of institutional directors on the preventive health strategies for people with intellectual disabilities in institutions. Methods: A structured questionnaire was conducted by a cross-sectional postal survey in all registered institutions in Taiwan in 2002. A total of 157 questionnaires were mailed, of which 121…

39 CFR 952.14 - Hearings.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Hearings. 952.14 Section 952.14 Postal Service... AND LOTTERY ORDERS § 952.14 Hearings. Hearings are held at 2101 Wilson Boulevard, Suite 600, Arlington... the hearing shall be set by the presiding officer in his or her sole discretion. ...

39 CFR 952.14 - Hearings.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Hearings. 952.14 Section 952.14 Postal Service... AND LOTTERY ORDERS § 952.14 Hearings. Hearings are held at 2101 Wilson Boulevard, Suite 600, Arlington... the hearing shall be set by the presiding officer in his or her sole discretion. ...

75 FR 78915 - Conduct on Postal Property

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... revisions to the COPP regulations set forth in 39 CFR 232.1. 1. Paragraph (f) Gambling: The prohibition of...) are revised to read as follows: Sec. 232.1 Conduct on postal property. * * * * * (f) Gambling. Participating in games for money or other personal property, the operation of gambling devices, the conduct of a...

Assessing patient acceptance of virtual clinics for diabetic retinopathy: a large scale postal survey.

PubMed

Ahnood, Dana; Souriti, Ahmad; Williams, Gwyn Samuel

2018-06-01

To explore the views of patients with diabetic retinopathy and maculopathy on their acceptance of virtual clinic review in place of face-to-face clinic appointments. A postal survey was mailed to all 813 patients under the care of the diabetic eye clinic at Singleton Hospital with 7 questions, explanatory information, and a stamped, addressed envelope available for returning completed questionnaires. Four hundred and ninety-eight questionnaires were returned indicating that 86.1% were supportive of the idea of virtual clinics, although only 56.9% were prepared for every visit to be virtual. Of respondents, 6.6% not happy to attend any virtual clinic. This is by far the largest survey of patients' attitudes regarding attending virtual clinics and confirms that the vast majority are supportive of this mode of health care delivery. Copyright © 2018 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Effect of Web-Based Versus Paper-Based Questionnaires and Follow-Up Strategies on Participation Rates of Dutch Childhood Cancer Survivors: A Randomized Controlled Trial

PubMed Central

van Dulmen-den Broeder, Eline; van der Pal, Helena J; Hollema, Nynke; Kremer, Leontien C; van den Heuvel-Eibrink, Marry M; van Leeuwen, Flora E

2015-01-01

Background Questionnaires are widely used in survey research, especially in cohort studies. However, participation in questionnaire studies has been declining over the past decades. Because high participation rates are needed to limit the risk of selection bias and produce valid results, it is important to investigate invitation strategies which may improve participation. Objectives The purpose of this study is to investigate the effect of Web-based versus paper-based questionnaires on participation rates in a questionnaire survey on late effects among childhood cancer survivors (CCSs). Methods A total of 750 CCSs were randomized across 3 study arms. The initial invitation in study arms 1 and 2 consisted of a Web-based questionnaire only, whereas in study arm 3 this invitation was complemented with a paper-based version of the questionnaire. The first postal reminder, sent to the nonresponding CCSs in all 3 study arms, consisted of either a reminder letter only (study arms 1 and 3) or a reminder letter complemented with a paper-based questionnaire (study arm 2). The second postal reminder was restricted to CCSs in study arms 1 and 2, with only those in study arm 1 also receiving a paper-based questionnaire. CCSs in study arm 3 received a second reminder by telephone instead of by mail. In contrast to CCSs in study arm 3, CCSs in study arms 1 and 2 received a third reminder, this time by telephone. Results: Overall, 58.1% (436/750) of the CCSs participated in the survey. Participation rates were equal in all 3 study arms with 57.4% (143/249) in arm 1, 60.6% (152/251) in arm 2, and 56.4% (141/250) in arm 3 (P=.09). Participation rates of CCSs who received an initial invitation for the Web-based questionnaire only and CCSs who received an invitation to complete either a paper-based or Web-based questionnaire did not differ (P=.55). After the first postal reminder, participation rates of CCSs invited for the Web-based questionnaire only also did not differ compared with CCSs invited for both the Web-based and paper-based questionnaires (P=.48). In general, CCSs preferred the paper-based over the Web-based questionnaire, and those completing the paper-based questionnaire were more often unemployed (P=.004) and lower educated (P<.001). Conclusion Invitation strategies offering a Web-based questionnaire without a paper-based alternative at first invitation can be used without compromising participation rates of CCS. Offering the choice between paper- and Web-based questionnaires seems to result in the highest accrual participation rate. Future research should look into the quality of the data delivered by both questionnaires filled in by respondents themselves. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 84711754; http://www.controlled-trials.com/ISRCTN84711754 (Archived by WebCite at http://www.webcitation.org/6c9ZB8paX) PMID:28410161

Associations between Beliefs about Medicines and Medicines Education: A Survey among Finnish Comprehensive School Teachers

ERIC Educational Resources Information Center

Siitonen, Piia; Vainio, Kirsti; Keinonen, Tuula; Kiviniemi, Vesa; Hämeen-Anttila, Katri

2015-01-01

Objective: To describe the association between teachers' beliefs about medicines and teaching about illnesses and medicines-related topics by Finnish comprehensive school teachers. Design: A nationwide postal survey. Setting: Finnish primary and lower secondary school teachers. Method: Data were collected using a nationwide postal survey from a…

Is it time to abandon paper? The use of emails and the Internet for health services research--a cost-effectiveness and qualitative study.

PubMed

Hunter, Jennifer; Corcoran, Katherine; Leeder, Stephen; Phelps, Kerryn

2013-10-01

A multidisciplinary primary care clinic in Sydney, Australia, was planning to use electronic questionnaires to measure patient-reported outcomes. Semi-structured interviews with 20 patients were undertaken to explore, among other things, practical issues regarding different questionnaire formats. The response rates and costs of email versus postal invitations were also evaluated. Compared with postal invitations, email invitations offered a cost-effective and practical alternative, with a greater proportion of patients volunteering for an interview. Assuming the interface is well-designed and user-friendly, many patients were happy to use the Internet to answer questionnaires. Most patients thought alternate formats should also be offered. Patients discussed advantages and disadvantages of the Internet format. Although more younger patients and females had given the clinic an email address; both sexes, and young and old patients, expressed strong preferences for either wanting or not wanting to use the Internet. Researchers should consider using email invitations as a cost-effective first-line strategy to recruit patients to participate in health services research. Internet questionnaires are potentially cheaper than paper questionnaires, and the format is acceptable to many patients. However, for the time being, concurrent alternate formats need to be offered to ensure wider acceptability and to maximize response rates. © 2012 John Wiley & Sons Ltd.

Guide to the design and application of online questionnaire surveys.

PubMed

Regmi, Pramod R; Waithaka, Elizabeth; Paudyal, Anjana; Simkhada, Padam; van Teijlingen, Edwin

2016-12-01

Collecting research data through traditional approaches (face-to-face, postal or telephone survey) can be costly and time consuming. The emerging data collection approach based on internet/e-based technologies (e.g. online platforms and email), is a relatively cost effective survey alternative. These novel data collection strategies can collect large amounts of data from participants in a short time frame. Similarly, they also seem to be feasible and effective in collecting data on sensitive issues or with samples they are generally hard to reach, for example, men who have sex with men (MSM) or migrants. As a significant proportion of the population currently in the world are digitally connected, the shift from postal (paper-pencil) or telephone towards online survey use in research is in the interests of researchers in academia as well as in the commercial world. However, compared to designing and executing paper version of the questionnaire, there is limited literature to help a starting researcher with the design and a use of online questionnaires. This short paper highlights issues around: a) methodological aspect of online questionnaire survey; b) online survey planning and management; and c) ethical concerns that may arise while using this option. We believe that this paper will be useful for researchers who want to gain knowledge or apply this approach in their research.

Lottery ticket was more effective than a prize draw in increasing questionnaire response among cancer survivors.

PubMed

Drummond, Frances J; O'Leary, Eamonn; Sharp, Linda

2015-07-01

Compare the effect of financial incentives on response to a cancer survivors' postal questionnaire. Prostate cancer survivors in Ireland, 1.5-18 years after diagnosis, were randomized to the (1) "lottery" arm [a € 1 lottery scratch card sent with the questionnaire (n = 2,413)] or (2) "prize" arm [entry into a draw on return of a completed questionnaire (n = 2,407)]. Impact of interventions on response overall and by survival period ("short term": < 5 years after diagnosis; "long term": ≥ 5 years after diagnosis) was compared as was cost-effectiveness. Adjusted response rate was 54.4%. Response was higher among younger men (P < 0.001) and those with earlier stage disease (P = 0.002). A modest 2.6% higher response rate was observed in the lottery compared with the prize arm [multivariate relative risk (RR) = 1.06; 95% confidence interval (CI): 1.00, 1.11]. When stratified by survival period, higher response in the lottery arm was only observed among long-term survivors (multivariate RR = 1.10; 95% CI: 1.02, 1.19; short-term survivors: RR = 1.01; 95% CI: 0.94, 1.09). Costs per completed questionnaire were € 4.54 and € 3.57 for the lottery and prize arms, respectively. Compared with the prize arm, cost per additional questionnaire returned in the lottery arm was € 25.65. Although more expensive, to optimize response to postal questionnaires among cancer survivors, researchers might consider inclusion of a lottery scratch card. Copyright © 2015 Elsevier Inc. All rights reserved.

Best practice guidance for the use of strategies to improve retention in randomized trials developed from two consensus workshops

PubMed Central

Brueton, Valerie; Stenning, Sally P.; Stevenson, Fiona; Tierney, Jayne; Rait, Greta

2017-01-01

Objectives To develop best practice guidance for the use of retention strategies in randomized clinical trials (RCTs). Study Design and Setting Consensus development workshops conducted at two UK Clinical Trials Units. Sixty-six statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs participated. The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions. Workshops commenced with a presentation of the evidence for incentives, communication, questionnaire format, behavioral, case management, and methodological retention strategies identified by a Cochrane review and associated qualitative study. Three simultaneous group discussions followed focused on (1) how convinced the workshop participants were by the evidence for retention strategies, (2) barriers to the use of effective retention strategies, (3) types of RCT follow-up that retention strategies could be used for, and (4) strategies for future research. Summaries of each group discussion were fed back to the workshop. Coded content for both workshops was compared for agreement and disagreement. Agreed consensus on best practice guidance for retention was identified. Results Workshop participants agreed best practice guidance for the use of small financial incentives to improve response to postal questionnaires in RCTs. Use of second-class post was thought to be adequate for postal communication with RCT participants. The most relevant validated questionnaire was considered best practice for collecting RCT data. Barriers identified for the use of effective retention strategies were: the small improvements seen in questionnaire response for the addition of monetary incentives, and perceptions among trialists that some communication strategies are outdated. Furthermore, there was resistance to change existing retention practices thought to be effective. Face-to-face and electronic follow-up technologies were identified as retention strategies for further research. Conclusions We developed best practice guidance for the use of retention strategies in RCTs and identified potential barriers to the use of effective strategies. The extent of agreement on best practice is limited by the variability in the currently available evidence. This guidance will need updating as new retention strategies are developed and evaluated. PMID:28546093

Effects of a Financial Incentive on Health Researchers’ Response to an Online Survey: a Randomized Controlled Trial

PubMed Central

Petticrew, Mark; Calnan, Mike; Nazareth, Irwin

2010-01-01

Background Nonresponse to questionnaires can affect the validity of surveys and introduce bias. Offering financial incentives can increase response rates to postal questionnaires, but the effect of financial incentives on response rates to online surveys is less clear. Objective As part of a survey, we aimed to test whether knowledge of a financial incentive would increase the response rate to an online questionnaire. Methods A randomized controlled trial of 485 UK-based principal investigators of publicly funded health services and population health research. Participants were contacted by email and invited to complete an online questionnaire via an embedded URL. Participants were randomly allocated to groups with either “knowledge of” or “no knowledge of” a financial incentive (£10 Amazon gift voucher) to be provided on completion of the survey. At the end of the study, gift vouchers were given to all participants who completed the questionnaire regardless of initial randomization status. Four reminder emails (sent from the same email address as the initial invitation) were sent out to nonrespondents at one, two, three, and four weeks; a fifth postal reminder was also undertaken. The primary outcome measure for the trial was the response rate one week after the second reminder. Response rate was also measured at the end of weeks one, two, three, four, and five, and after a postal reminder was sent. Results In total, 243 (50%) questionnaires were returned (232 completed, 11 in which participation was declined). One week after the second reminder, the response rate in the “knowledge” group was 27% (66/244) versus 20% (49/241) in the “no knowledge” group (χ21 = 3.0, P = .08). The odds ratio for responding among those with knowledge of an incentive was 1.45 (95% confidence interval [CI] 0.95 - 2.21). At the third reminder, participants in the “no knowledge” group were informed about the incentive, ending the randomized element of the study. However we continued to follow up all participants, and from reminder three onwards, no significant differences were observed in the response rates of the two groups. Conclusions Knowledge of a financial incentive did not significantly increase the response rate to an online questionnaire. Future surveys should consider including a randomized element to further test the utility of offering incentives of other types and amounts to participate in online questionnaires. Trial Registration ISRCTN59912797; http://www.controlled-trials.com/ISRCTN59912797 (Archived by WebCite at http://www.webcitation.org/5iPPLbT7s) PMID:20457556

Motivation as a determinant of physical activity in patients with rheumatoid arthritis.

PubMed

Hurkmans, E J; Maes, S; de Gucht, V; Knittle, K; Peeters, A J; Ronday, H K; Vlieland, T P M Vliet

2010-03-01

A sufficient level of physical activity is important in reducing the impact of disease in rheumatoid arthritis (RA) patients. According to self-determination theory, the achievement and maintenance of physical activity is related to goal setting and ownership, which can be supported by health professionals. Our objective was to examine the association between physical activity and the extent to which RA patients 1) believe that physical activity is a goal set by themselves (autonomous regulation) or by others (coerced regulation) and 2) feel supported by rheumatologists (autonomy supportiveness). A random selection of 643 RA patients from the outpatient clinics of 3 hospitals were sent a postal survey to assess current physical activity level (Short Questionnaire to Assess Health-Enhancing Physical Activity), regulation style (Treatment Self-Regulation Questionnaire), and the autonomy supportiveness of their rheumatologists (modified Health Care Climate Questionnaire). Of the 271 patients (42%) who returned the questionnaire, 178 (66%) were female, their mean +/- SD age was 62 +/- 14 years, and their mean +/- SD disease duration was 10 +/- 8 years. Younger age, female sex, higher education level, shorter disease duration, lower disease activity, and a more autonomous regulation were univariately associated with more physical activity. Hierarchical multiple regression analyses demonstrated that younger age and a more autonomous regulation were significantly associated with a higher physical activity level (P = 0.000 and 0.050, respectively). Regulation style was a significant determinant of physical activity in RA patients. This finding may contribute to further development of interventions to enhance physical activity in RA patients.

Reliability of Snellen charts for testing visual acuity for driving: prospective study and postal questionnaire

PubMed Central

Currie, Zanna; Bhan, Archana; Pepper, Irene

2000-01-01

Objectives To assess the ability of patients with binocular 6/9 or 6/12 vision on the Snellen chart (Snellen acuity) to read a number plate at 20.5 m (the required standard for driving) and to determine how health professionals advise such patients about driving. Design Prospective study of patients and postal questionnaire to healthcare professionals. Subjects 50 patients with 6/9 vision and 50 with 6/12 vision and 100 general practitioners, 100 optometrists or opticians, and 100 ophthalmologists. Setting Ophthalmology outpatient clinics in Sheffield. Main outcome measures Ability to read a number plate at 20.5 m and health professionals' advice about driving on the basis of visual acuity. Results 26% of patients with 6/9 vision failed the number plate test, and 34% with 6/12 vision passed it. Of the general practitioners advising patients with 6/9 vision, 76% said the patients could drive, 13% said they should not drive, and 11% were unsure. Of the general practitioners advising patients with 6/12 vision, 21% said the patients could drive, 54% said they should not drive, and 25% were unsure. The level of acuity at which optometrists, opticians, and ophthalmologists would advise drivers against driving ranged from 6/9−2 (ability to read all except two letters on the 6/9 line of the Snellen chart) to less than 6/18. Conclusions Snellen acuity is a poor predictor of an individual's ability to meet the required visual standard for driving. Patients with 6/9 vision or less should be warned that they may fail to meet this standard, but those with 6/12 vision should not be assumed to be below the standard. PMID:11039964

Dispensing doctor practices and community pharmacies: exploring the quality of pharmaceutical services.

PubMed

Weiss, Marjorie C; Grey, Elisabeth; Harris, Michael; Rodham, Karen

2016-01-01

This research sought (a) to investigate the similarities and differences in how pharmaceutical services are provided by community pharmacies (CPs) and dispensing doctor practices (DPs) and (b) to identify the issues relevant to determining the quality of pharmaceutical services in these settings. UK pharmaceutical services, including dispensing prescriptions and public health advice, can be provided from both (CP) and, in rural areas, (DP). While there is much similarity between CPs and DPs in the types of services provided, there is also the potential for variation in service quality across settings. A postal questionnaire of DPs and CPs in South West England was conducted to provide a descriptive overview of pharmaceutical services across the settings. A subsection of questionnaire respondent sites were selected to take part in case studies, which involved documentary analyses, observation and staff interviews. Survey response was 39% for CPs (52/134) and 48% (31/64) for DPs. There were three CP and four DP case study sites, with 17 staff interviews. More pharmacies than practices were open at the weekend and they had more staff trained above NVQ level 2. Both doctors and pharmacists saw themselves as medicines experts, as being accessible and having good relationships with patients. Workplace practices and organisational ethos varied both within and across settings, with good practice observed in both. Overall, CPs and DPs have much in common. Workplace culture and an evidence-based approach to checking prescriptions and error reporting need to be considered in future assessments of service quality.

Personally addressed hand-signed letters increase questionnaire response: a meta-analysis of randomised controlled trials

PubMed Central

Scott, Pippa; Edwards, Phil

2006-01-01

Background Postal questionnaires are commonly used to collect data for health studies, but non-response reduces study sample sizes and can introduce bias. Finding ways to increase the proportion of questionnaires returned would improve research quality. We sought to quantify the effect on response when researchers address participants personally by name on letters that accompany questionnaires. Methods All randomised controlled trials in a published systematic review that evaluated the effect on response of including participants' names on letters that accompany questionnaires were included. Odds ratios for response were pooled in a random effects meta-analysis and evidence for changes in effects over time was assessed using random effects meta-regression. Results Fourteen randomised controlled trials were included covering a wide range of topics. Most topics were unrelated to health or social care. The odds of response when including participants' names on letters were increased by one-fifth (pooled OR 1.18, 95% CI 1.03 to 1.34; p = 0.015). When participants' names and hand-written signatures were used in combination, the effect was a more substantial increase in response (OR 1.45, 95% CI 1.27 to 1.66; p < 0.001), corresponding to an absolute increase in the proportion of questionnaires returned of between 4% and 10%, depending on the baseline response rate. There was no evidence that the magnitude of these effects had declined over time. Conclusion This meta-analysis of the best available evidence indicates that researchers using postal questionnaires can increase response by addressing participants by name on cover letters. The effect appears to be enhanced by including hand-written signatures. PMID:16953871

Norfolk general practice: a comparison of rural and urban doctors

PubMed Central

Fearn, Richard M.G.

1988-01-01

A postal questionnaire was sent to all Norfolk practitioners, allowing a comparison to be made between rural general practice and urban practice in Norwich and Great Yarmouth. However, when Norfolk town and country doctors were compared, little difference was found in their personal or practice characteristics. In respect of their workload rural doctors, as expected, carried out more procedures overall but, somewhat surprisingly, did not make more home visits. Both sets of doctors had similar views on their present and future role in general practice. When Norfolk doctors collectively were compared with general practitioners nationally their service appeared to be of a high standard. The only uncertainty surrounded the effects of the greater clustering of Norfolk surgeries, together with the levels of home visiting and their attendant effects on patient accessibility. PMID:3255815

Promoting Sun Safety Among US Postal Service Letter Carriers: Impact of a 2-Year Intervention

PubMed Central

Mayer, Joni A.; Slymen, Donald J.; Clapp, Elizabeth J.; Pichon, Latrice C.; Eckhardt, Laura; Eichenfield, Lawrence F.; Elder, John P.; Sallis, James F.; Weinstock, Martin A.; Achter, April; Balderrama, Cynthia; Galindo, Gabriel R.; Oh, Sam S.

2007-01-01

Objectives. We examined whether US Postal Service letter carriers who received a sun safety intervention would wear wide-brim hats and sunscreen significantly more often than those who did not receive the intervention. Methods. We used a 2-group randomized design with 2662 evaluation cohort participants from 70 US postal stations. Evaluations were conducted at baseline, 3 months, 1 year, and 2 years. Questionnaire items assessed occupational use of sun-screen and wide-brim hats. The 2-year sun safety intervention included the provision of wide-brim hats, accessible sunscreen, reminders, and 6 educational sessions. Results. At the 3-month follow-up evaluations, the odds ratio (OR) for regular sun-screen use was 2.8 times higher among the intervention group than among the control group (95% confidence interval [CI]=2.2, 3.5); at the 2-year follow-up evaluations, the rate was still significantly higher (OR=2.0; 95% CI=1.6, 2.6). Intervention group participants also had significantly higher rates of hat use, with the differences remaining consistent across all follow-ups (OR=2.9; 95% CI=2.3, 3.6). Conclusions. The intervention should be disseminated to postal stations nationwide and possibly to other occupational groups that work outdoors. PMID:17267715

Electronic mail was not better than postal mail for surveying residents and faculty.

PubMed

Akl, Elie A; Maroun, Nancy; Klocke, Robert A; Montori, Victor; Schünemann, Holger J

2005-04-01

To compare response rate, time to response, and data quality of electronic and postal surveys in the setting of postgraduate medical education. A randomized controlled trial in a university-based internal medicine residency program. We randomized 119 residents and 83 faculty to an electronic versus a postal survey with up to two reminders and measured response rate, time to response, and data quality. For residents, the e-survey resulted in a lower response rate than the postal survey (63.3% versus 79.7%; difference -16.3%, 95% confidence interval (95% CI) -32.3% to -0.4%%; P=.049), but a shorter mean response time, by 3.8 days (95% CI 0.2-7.4; P=.042). For faculty, the e-survey did not result in a significantly lower response rate than the postal survey (85.4% vs. 81.0%; difference 4.4%, 95% CI -11.7 to 20.5%; P=.591), but resulted in a shorter average response time, by 8.4 days (95% CI 4.4 to 12.4; P < 0.001). There were no differences in the quality of data or responses to the survey between the two methods. E-surveys were not superior to postal surveys in terms of response rate, but resulted in shorter time to response and equivalent data quality.

Leadership Learning: A Development Initiative for Experienced New Zealand Principals

ERIC Educational Resources Information Center

Cardno, Carol; Fitzgerald, Tanya

2005-01-01

Purpose: During the 2000-2004 period, one New Zealand tertiary institution provided a management development programme for experienced secondary school principals. Aims to determine the extent to which the learning had been sustained beyond the formal programme. Design/methodology/approach: A postal questionnaire was administered to 80…

Internet-based treatment of stress urinary incontinence: 1- and 2-year results of a randomized controlled trial with a focus on pelvic floor muscle training.

PubMed

Sjöström, Malin; Umefjord, Göran; Stenlund, Hans; Carlbring, Per; Andersson, Gerhard; Samuelsson, Eva

2015-12-01

To evaluate the long-term effects of two non-face-to-face treatment programmes for stress urinary incontinence (SUI) based on pelvic floor muscle training (PFMT). The present study was a randomized controlled trial with online recruitment of 250 community-dwelling women aged 18-70 years with SUI ≥ one time/week. Diagnosis was based on validated self-assessed questionnaires, 2-day bladder diary and telephone interview with a urotherapist. Consecutive computer-generated block randomization was carried out with allocation by an independent administrator to 3 months of treatment with either an internet-based treatment programme (n = 124) or a programme sent by post (n = 126). Both interventions focused mainly on PFMT. The internet group received continuous e-mail support from a urotherapist, whereas the postal group trained on their own. Follow-up was performed after 1 and 2 years via self-assessed postal questionnaires. The primary outcomes were symptom severity (International Consultation on Incontinence Questionnaire Short Form [ICIQ-UI SF]) and condition-specific quality of life (ICIQ-Lower Urinary Tract Symptoms Quality of Life [ICIQ-LUTSqol]). Secondary outcomes were the Patient Global Impression of Improvement, health-specific quality of life (EQ-visual analogue scale [EQ-VAS]), use of incontinence aids, and satisfaction with treatment. There was no face-to-face contact with the participants at any time. Analysis was based on intention-to-treat. We lost 32.4% (81/250) of participants to follow-up after 1 year and 38.0% (95/250) after 2 years. With both interventions, we observed highly significant (P < 0.001) improvements with large effect sizes (>0.8) for symptoms and condition-specific quality of life (QoL) after 1 and 2 years, respectively. No significant differences were found between the groups. The mean (sd) changes in symptom score were 3.7 (3.3) for the internet group and 3.2 (3.4) for the postal group (P = 0.47) after 1 year, and 3.6 (3.5) for the internet group and 3.4 (3.3) for the postal group (P = 0.79) after 2 years. The mean changes (sd) in condition-specific QoL were 5.5 (6.5) for the internet group and 4.7 the for postal group (6.5) (P = 0.55) after 1 year, and 6.4 (6.0) for the internet group and 4.8 (7.6) for the postal group (P = 0.28) after 2 years. The proportions of participants perceiving they were much or very much improved were similar in both intervention groups after 1 year (internet, 31.9% [28/88]; postal, 33.8% [27/80], P = 0.82), but after 2 years significantly more participants in the internet group reported this degree of improvement (39.2% [29/74] vs 23.8% [19/80], P = 0.03). Health-specific QoL improved significantly in the internet group after 2 years (mean change in EQ-VAS, 3.8 [11.4], P = 0.005). We found no other significant improvements in this measure. At 1 year after treatment, 69.8% (60/86) of participants in the internet group and 60.5% (46/76) of participants in the postal group reported that they were still satisfied with the treatment result. After 2 years, the proportions were 64.9% (48/74) and 58.2% (46/79), respectively. Non-face-to-face treatment of SUI with PFMT provides significant and clinically relevant improvements in symptoms and condition-specific QoL at 1 and 2 years after treatment. © 2015 The Authors BJU International published by John Wiley & Sons Ltd on behalf of BJU International.

Statistical Study to Investigate Women’s Preference in the Phraseology of Lifetime and Age Specific Risk of Developing Breast Cancer

DTIC Science & Technology

2001-10-25

anxiety, hypochondriasis, low self - esteem and a hypervigilant style of information processing, referred to as monitoring [7], have been associated with...collected through self -completed, postal questionnaires and responses were received from 137 out of 175 distributed questionnaires. Respondents had a...referral guidelines for family histories of breast cancer are [2]: • 1st degree relative (i.e. mother, sister) younger than 40; • 2nd degree paternal

A linear programming model for preserving privacy when disclosing patient spatial information for secondary purposes.

PubMed

Jung, Ho-Won; El Emam, Khaled

2014-05-29

A linear programming (LP) model was proposed to create de-identified data sets that maximally include spatial detail (e.g., geocodes such as ZIP or postal codes, census blocks, and locations on maps) while complying with the HIPAA Privacy Rule's Expert Determination method, i.e., ensuring that the risk of re-identification is very small. The LP model determines the transition probability from an original location of a patient to a new randomized location. However, it has a limitation for the cases of areas with a small population (e.g., median of 10 people in a ZIP code). We extend the previous LP model to accommodate the cases of a smaller population in some locations, while creating de-identified patient spatial data sets which ensure the risk of re-identification is very small. Our LP model was applied to a data set of 11,740 postal codes in the City of Ottawa, Canada. On this data set we demonstrated the limitations of the previous LP model, in that it produces improbable results, and showed how our extensions to deal with small areas allows the de-identification of the whole data set. The LP model described in this study can be used to de-identify geospatial information for areas with small populations with minimal distortion to postal codes. Our LP model can be extended to include other information, such as age and gender.

What secondary school career advisors in New Zealand Know about pharmacy and how that knowledge affects student career choices.

PubMed

Aspden, Trudi; Cooper, Rachel; Liu, Yue; Marowa, Munyaradzi; Rubio, Christine; Waterhouse, Elisabeth-Jane; Sheridan, Janie

2015-02-17

To explore what career advisors at secondary schools (high schools) in New Zealand know about the pharmacy profession, how they obtain that knowledge, and what their potential influence is on students' decisions to study pharmacy. This study employed a cross sectional questionnaire design. A postal questionnaire was sent to 250 randomly selected secondary schools in New Zealand. The response rate was 112/248 (45%). Responding career advisors were familiar with many of the roles of pharmacists (mean knowledge score 11.5 out of 16). Over 90% of career advisors were familiar with the roles of pharmacists in the community setting; however, many had a poorer understanding of other pharmacist roles. One suggestion for improving the promotion of pharmacy within secondary schools was a greater involvement of pharmacists and pharmacy students in the promotion of pharmacy as a profession. Career advisors need a broader understanding of the potential roles of pharmacists. Increasing contact from practicing pharmacists and undergraduate pharmacy students are potential ways of increasing student interest in pharmacy.

Suicide by patients: questionnaire study of its effect on consultant psychiatrists

PubMed Central

Alexander, David A; Klein, Susan; Gray, Nicola M; Dewar, Ian G; Eagles, John M

2000-01-01

Objective To identify the effect of patients' suicide on consultant psychiatrists in Scotland. Design Confidential coded postal questionnaire survey. Participants Of 315 eligible consultant psychiatrists, 247 (78%) contributed. Setting Scotland. Main outcome measures Experience of patient suicide; the features and impact of “most distressing” suicide and what helped them to deal with it. Results 167 (68%) consultants had had a patient commit suicide under their care. Fifty four (33%) reported being affected personally in terms of low mood, poor sleep, or irritability. Changes in professional practice were described by 69 (42%) of the psychiatrists—for example, a more structured approach to the management of patients at risk and increased use of mental health legislation. Twenty four (15%) doctors considered taking early retirement because of a patient's suicide. Colleagues and family or friends were the best sources of help, and team and critical incident reviews were also useful. Conclusions Suicide by patients has a substantial emotional and professional effect on consultant psychiatrists. Support from colleagues is helpful, and professional reviews provide opportunities for learning and improved management of suicide and its aftermath. PMID:10845964

Should breast reduction surgery be rationed? A comparison of the health status of patients before and after treatment: postal questionnaire survey.

PubMed

Klassen, A; Fitzpatrick, R; Jenkinson, C; Goodacre, T

1996-08-24

To assess the health status of patients before and after breast reduction surgery and to make comparisons with the health status of women in the general population. Postal questionnaire survey sent to patients before and six months after surgery. The three plastic surgery departments in the Oxford Regional Health Authority, during April to August 1993. 166 women (over the age of 16 years) referred for breast reduction; scores from the "short form 36" (SF-36) health questionnaire completed by women in the 1991-2 Oxford healthy life survey. Health status of breast reduction patients before and after surgery as assessed by the SF-36, the 28 item general health questionnaire, and Rosenberg's self esteem scale; comparisons between the health status of breast reduction patients and that of women in the general population; outcome of surgery as assessed retrospectively by patients. Differences between the health status of breast reduction patients and that of women in the general population were detected by the SF-36 both before and after surgery. Breast reduction surgery produced substantial change in patients' physical, social, and psychological function. The proportion of cases of possible psychiatric morbidity according to the general health questionnaire fell from 41% (22/54) before surgery to 11% (6/54) six months after treatment. Eighty six per cent (50/58) of patients expressed great satisfaction with the surgical result postoperatively. The study provides empirical evidence that supports the inclusion of breast reduction surgery in NHS purchasing contracts.

The oral health of people with learning disabilities - a user-friendly questionnaire survey.

PubMed

Owens, J; Jones, K; Marshman, Z

2017-03-01

To conduct a user-friendly questionnaire survey of the oral health and service needs of adults with learning disabilities. Researchers collaborated with local self-advocacy services to develop a questionnaire adapted from one used in a regional postal survey. The questionnaire, which covered dental status, oral health and dental services use, was sent to a random sample of people from the learning disability case register. Of 2,000 questionnaires mailed, 117 were returned undelivered and 625 were completed (response rate 31.3%). The self-reported dental status of people with learning disabilities appeared similar to that of the 2008 postal survey of the general population in Sheffield. The major difference in dental status was 11.5% of people with learning disabilities wore upper dentures and 7.2% wore lower dentures, compared to 21.2% and 12.1% of the general population in Sheffield. Using the case register as a recruitment instrument may have excluded people with learning disabilities not registered. Time and finances only permitted one mailing. Analysis on the basis of deprivation could not be conducted. Contrary to current practice, it is possible to include people with learning disabilities in oral health surveys. A multidisciplinary team was essential for enabling the progression and implementation of inclusive research and for people with learning disabilities and their supporters to engage meaningfully. This level of collaboration appears necessary if we are committed to ensuring that people with learning disabilities and their supporters are made visible to policy and decision-makers. Copyright© 2017 Dennis Barber Ltd

National survey of physicians to determine the effect of unconditional incentives on response rates of physician postal surveys

PubMed Central

Abdulaziz, Kasim; Brehaut, Jamie; Taljaard, Monica; Émond, Marcel; Sirois, Marie-Josée; Lee, Jacques S; Wilding, Laura; Perry, Jeffrey J

2015-01-01

Objectives Physicians are a commonly targeted group in health research surveys, but their response rates are often relatively low. The goal of this paper was to evaluate the effect of unconditional incentives in the form of a coffee card on physician postal survey response rates. Design Following 13 key informant interviews and eight cognitive interviews a survey questionnaire was developed. Participants A random sample of 534 physicians, stratified by physician group (geriatricians, family physicians, emergency physicians) was selected from a national medical directory. Setting Using computer generated random numbers; half of the physicians in each stratum were allocated to receive a coffee card to a popular national coffee chain together with the first survey mailout. Interventions The intervention was a $10 Tim Hortons gift card given to half of the physicians who were randomly allocated to receive the incentive. Results 265 (57.0%) physicians completed the survey. The response rate was significantly higher in the group allocated to receive the incentive (62.7% vs 51.3% in the control group; p=0.01). Conclusions Our results indicate that an unconditional incentive in the form of a coffee gift card can substantially improve physician response rates. Future research can look at the effect of varying amounts of cash on the gift cards on response rates. PMID:25694460

Learning preferences and learning styles: a study of Wessex general practice registrars.

PubMed Central

Lesmes-Anel, J; Robinson, G; Moody, S

2001-01-01

BACKGROUND: Experienced trainers know that individual registrars react very differently to identical learning experiences generated during the year in practice. This divergence reflects differences in registrars' learning styles. Only one study of United Kingdom (UK) general practitioners' learning styles has been undertaken. Learning style theory predicts that matching learning preference with learning style will enhance learning. This paper researches for the first time the evidence in the setting of UK general practice. AIM: To determine, for the general practice registrars within the Wessex Region, the nature of their learning preferences and learning styles and correlations between them. DESIGN OF STUDY: A descriptive confidential postal questionnaire survey. SETTING: Fifty-seven registrars identified in the Wessex Region with a minimum experience of six months in general practice. METHOD: The questionnaire gathered demographic data (sex, age, experience in general practice, years post-registration, and postgraduate qualifications). Learning preferences were elicited using a six-point Likert scale for learning experiences. The Honey and Mumford Learning Style Questionnaire (LSQ) elicited the registrars' learning styles. A second questionnaire was sent to non-responders. RESULTS: The response rate was 74%. Registrars report that interactive learning with feedback is preferred, but more passive learning formats remain valued. A wide range of learning style scores was found. The Honey and Mumford LSQ mean scores fell within the reflector-theorist quadrant. Evidence for correlations between learning preferences and learning styles was also found, in particular for the multiple choice question and audit components of summative assessment. CONCLUSION: A wide range of registrar learning styles exists in Wessex, and initial correlations are described between learning preferences and learning styles as predicted by style theory. This work sets the stage for a shared understanding and use of learning style theory to enhance professional learning throughout a GP's career. More research is needed in this domain. PMID:11462316

The Utility of Electronic Mail Follow-Ups for Library Research.

ERIC Educational Resources Information Center

Roselle, Ann; Neufeld, Steven

1998-01-01

A survey of academic librarians determined that the use of e-mail in the follow-up stage of a library research project using mailed questionnaires was as effective as postal mail in speed and size of response. Discusses additional benefits (interpersonal communication, reduced time and costs) and drawbacks (time spent identifying messages…

ELECTRONIC TECHNICIAN PERSONNEL AND TRAINING NEEDS OF IOWA INDUSTRIES.

ERIC Educational Resources Information Center

WEEDE, GARY DEAN

THE PURPOSE OF THIS STUDY WAS TO PROVIDE DATA FOR USE IN DEVELOPING OR IMPROVING ELECTRONIC TECHNOLOGY PROGRAMS. A POSTAL CARD QUESTIONNAIRE WAS SENT TO 678 MANUFACTURING AND PROCESSING INDUSTRIES IN IOWA EMPLOYING MORE THAN 50 PERSONS AND ALL ELECTRICAL, ELECTRONIC, AND PRECISION INSTRUMENT MANUFACTURERS EMPLOYING FEWER THAN 50 PERSONS. DATA WERE…

The Economic Consequences of Autistic Spectrum Disorder among Children in a Swedish Municipality

ERIC Educational Resources Information Center

Jarbrink, Krister

2007-01-01

In this study, the societal economic consequences of autistic spectrum disorder were investigated using a sample of parents of children identified with the disorder and living in a Swedish municipality. Cost information was collected using a postal questionnaire that was developed through experiences gained from an earlier study. Using…

Management of bladder dysfunction and satisfaction of life after spinal cord injury in Norway

PubMed Central

Hagen, Ellen Merete; Rekand, Tiina

2014-01-01

Background There is limited knowledge about bladder dysfunction and bladder management in persons with spinal cord injury (SCI) after discharge from the hospital in Norway. The impact of bladder dysfunction on satisfaction of life has been rarely explored. Setting Community-based survey from Norway. Methods An anonymous cross-sectional postal survey. A questionnaire was sent to the registered members of the Norwegian Spinal Cord Injuries Association. A total of 400 participants, with traumatic or non-traumatic SCI, received the questionnaire. Results A total of 248 subjects (62%), 180 men and 68 women, answered the questionnaire. Mean age was 54 years and mean time since injury 13.4 years. A total of 164 participants (66.1%) used intermittent catheterization for bladder emptying (48.5% women versus 72.8% men); more paraplegics than tetraplegics (77.2% versus 55.7%). Recommendations given at the Spinal Cord Units were thoroughly followed by persons who had used catheters more than 5 years. Use of incontinence pads were associated with reduced satisfaction of life. Conclusions The most common method of management of bladder dysfunction is clean intermittent catheterization in Norway. Recommendations were followed more thoroughly by persons who have used intermittent catheterization for more than 5 years. Spinal Cord Units are important source for information and guidance. PMID:24621024

Satisfying the patient in primary care: a postal survey following a recent consultation.

PubMed

Long, Sarah; Jiwa, Moyez

2004-05-01

Factors over and above the skills of the health care professional appear to impact on how well patients can cope with an illness following a consultation in general practice. These other factors appear to relate to the organisation and fabric of the doctor's practice. This study reports a systematic analysis of responses to a questionnaire survey of patients following a telephone consultation in a general practice setting. This study aims to explore how views on specific aspects of a general practice service contrast among patients. A structured anonymised postal questionnaire was sent to 916 patients within 24 h of a telephone consultation with a doctor or nurse in five general practices in North Trent, UK. No reminders were sent. Included on the questionnaire were free-text questions that invited opinions on areas for improvement for the patients' registered practice. These were analysed qualitatively using content analysis by two independent researchers. The overall response rate was 52% although responses from young men were under-represented in the survey. One in three responders expressed a need for improvements in the appointments, more access and less delay before practice. Five themes and a number of sub-themes were identified. Patients wanted more appointments. Other themes included a desire for better communication, more patient friendly policies and facilities. Analysis suggests that it would be very difficult to satisfy the contrasting and divergent needs of all patients. Communication with patients in general practice is influenced by the fabric, policies and reception staff in the practice as much as by the skills and resources of the care provider. Seeking patients' opinions about the practice within the context of a recent telephone consultation unearthed conflicting desires that cannot be satisfied given existing resources in the National Health Service (NHS). Patients favour a speedy, convenient and above all, tailored service. This may be impossible to deliver universally. Attention to the non-doctor aspects of the service may enhance the ability of practitioners to enable patients to cope with illness. The data suggest that patients are not universally satisfied with the service provided and that it would be naive to attempt to please them all.

Prescribing injectable and oral methadone to opiate addicts: results from the 1995 national postal survey of community pharmacies in England and Wales.

PubMed Central

Strang, J.; Sheridan, J.; Barber, N.

1996-01-01

OBJECTIVE--To establish the extent of prescribing injectable and oral methadone to opiate addicts and the practice characteristics and dispensing arrangements attached to these prescriptions. DESIGN--National survey of 25% random sample of community (high street) pharmacies through postal questionnaire, with four mailings. SETTING--England and Wales. SUBJECTS--1 in 4 sample of all 10,616 community pharmacies, stratified by family health services authority. MAIN OUTCOME MEASURES--Data were collected on each prescription for controlled drugs currently being dispensed by pharmacies to misusers, describing the drug, form, dose, source (general practice or hospital; and NHS or private), and numbers of dispensing pick ups a week. RESULTS--Methadone was the opiate most commonly dispensed to misusers (96.0% of 3846 opiate prescriptions). 79.6% of methadone prescriptions were for the oral liquid form, 11.0% for tablet, and 9.3% for injectable ampoules. More than one third of all methadone prescriptions were for weekly or fortnightly pick up, with a further third being for daily pick up. Tablets and ampoules were even less likely to be dispensed on a daily basis. Private prescriptions were significantly more likely than NHS ones to be for tablets or ampoules, to be for substantially higher daily doses, and to be collected on a weekly or fortnightly basis. CONCLUSIONS--The distinctively British practice of prescribing injectable methadone was found to be widespread and, contrary to guidance, to be as prevalent in non-specialist as specialist settings. In view of the frequent crushing and injecting of methadone tablets, clearer more authoritative guidance is needed on the contexts in which injectable methadone (tablets as well as ampoules) should be prescribed and on the responsibilities for monitoring and supervision which should be attached. PMID:8704540

User-experience surveys with maternity services: a randomized comparison of two data collection models.

PubMed

Bjertnaes, Oyvind Andresen; Iversen, Hilde Hestad

2012-08-01

To compare two ways of combining postal and electronic data collection for a maternity services user-experience survey. Cross-sectional survey. Maternity services in Norway. All women who gave birth at a university hospital in Norway between 1 June and 27 July 2010. Patients were randomized into the following groups (n= 752): Group A, who were posted questionnaires with both electronic and paper response options for both the initial and reminder postal requests; and Group B, who were posted questionnaires with an electronic response option for the initial request, and both electronic and paper response options for the reminder postal request. Response rate, the amount of difference in background variables between respondents and non-respondents, main study results and estimated cost-effectiveness. The final response rate was significantly higher in Group A (51.9%) than Group B (41.1%). None of the background variables differed significantly between the respondents and non-respondents in Group A, while two variables differed significantly between the respondents and non-respondents in Group B. None of the 11 user-experience scales differed significantly between Groups A and B. The estimated costs per response for the forthcoming national survey was €11.7 for data collection Model A and €9.0 for Model B. The model with electronic-only response option in the first request had lowest response rate. However, this model performed equal to the other model on non-response bias and better on estimated cost-effectiveness, and is the better of the two models in large-scale user experiences surveys with maternity services.

Recruiting migrants for health research through social network sites: an online survey among chinese migrants in australia.

PubMed

Hu, Jie; Wong, Kam Cheong; Wang, Zhiqiang

2015-04-27

Traditionally, postal surveys or face to face interviews are the main approaches for health researchers to obtain essential research data. However, with the prevalence of information technology and Internet, Web-based surveys are gaining popularity in health research. This study aims to report the process and outcomes of recruiting Chinese migrants through social network sites in Australia and to examine the sample characteristics of online recruitment by comparing the sample which was recruited by an online survey to a sample of Australian Chinese migrants collected by a postal survey. Descriptive analyses were performed to describe and compare the process and outcomes of online recruitment with postal survey questionnaires. Chi square tests and t tests were performed to assess the differences between the two samples for categorical and continuous variables respectively. In total, 473 Chinese migrants completed the online health survey from July to October 2013. Out of 426 participants recruited through the three Chinese social network sites in Australia, over 86.6% (369/426) were recruited within six weeks. Participants of the Web-based survey were younger, with a higher education level or had resided in Australia for less time compared to those recruited via a postal survey. However, there was no significant difference in gender, marital status, and professional occupation. The recruitment of Chinese migrants through social network sites in our online survey was feasible. Compared to a postal survey of Chinese migrants, the online survey attracted different group of Chinese migrants who may have diverse health needs and concerns. Our findings provided insightful information for researchers who are considering employing a Web-based approach to recruit migrants and ethnic minority participants.

A Qualitatively Different Experience: Mainstreaming Pupils with a Visual Impairment in Northern Ireland

ERIC Educational Resources Information Center

Gray, Colette

2009-01-01

This paper reports the experiences of special education needs co-ordinators (SENCOs) on the inclusion of pupils with a visual impairment (VI) in mainstream schools in Northern Ireland. A mixed method approach (postal questionnaire survey (n=113) and interviews (n=6)) was utilised to triangulate the findings. The results indicate an inverse…

Supported Housing for People with Down's Syndrome

ERIC Educational Resources Information Center

Cumella, Stuart; Heslam, Sheila

2014-01-01

There has been limited research on the attitudes of family carers and the part they play in helping people with a learning disability choose accommodation. A postal questionnaire was sent to family carers of people with Down's Syndrome, to identify their attitudes to supported living, their experience of the application process, and the…

Impact of Death by Suicide of Patients on Thai Psychiatrists

ERIC Educational Resources Information Center

Thomyangkoon, Prakarn; Leenaars, Antoon

2008-01-01

The objective of this study was to identify the impact of a patient's suicide on psychiatrists in Thailand. A confidential coded postal questionnaire survey was sent to 320 eligible psychiatrists; with a response rate of 52.18%. The results showed that 94 (56.28%) of responding psychiatrists had a patient die by suicide, consistent with high rates…

Physical and Psychological Health of Family Carers Co-Residing with an Adult Relative with an Intellectual Disability

ERIC Educational Resources Information Center

Grey, Jillian M.; Totsika, Vasiliki; Hastings, Richard P.

2018-01-01

Background: Providing long-term care to an adult relative with intellectual disability can impact negatively on caregivers' health and well-being. Methods: Data were collected via online and postal questionnaires on 110 family carers' physical and psychological health, family stress and perceived positive gains from caring. Psychological…

Cataract surgery in the United Kingdom: a postal survey.

PubMed

Olali, Carpi A; Priya, Anita; Gupta, Mohit; Ahmed, Sohail

2010-01-01

A postal questionnaire study to evaluate the current practice of cataract surgery delivery in the United Kingdom including strategies for postoperative review was performed. A cataract questionnaire was sent to all hospital departments delivering ophthalmic services in the United Kingdom based on a list from the Royal College of Ophthalmologists. It included questions about the staffing level, number of cases operated on per list, and the different strategies employed postoperatively. The results were statistically analyzed. A total of 248 questionnaires were sent and 106 (43%) replies were received. The mean number of consultant teams was 11 (2-20). The average number of cases per list was 6-7 (range 4-9). In 65 hospitals, all patients are reviewed postoperatively in the hospital and some consultant teams review patients postoperatively in 18 hospitals. In 15 hospitals, patients were seen by the community optician. Most hospitals review their patients postoperatively within the first 3 weeks with more hospitals seeing them at 2-3 weeks. A wide variety of health professionals review the postoperative cases and they include doctors, nurses, and opticians (in house and community). There are varied practices for cataract surgery in the United Kingdom including the number of cases on the list and postoperative review protocols. There is room for better service organization in some hospitals in terms of patient flow and better use of medical staff time to improve output.

Computer skills and internet use in adults aged 50-74 years: influence of hearing difficulties.

PubMed

Henshaw, Helen; Clark, Daniel P A; Kang, Sujin; Ferguson, Melanie A

2012-08-24

The use of personal computers (PCs) and the Internet to provide health care information and interventions has increased substantially over the past decade. Yet the effectiveness of such an approach is highly dependent upon whether the target population has both access and the skill set required to use this technology. This is particularly relevant in the delivery of hearing health care because most people with hearing loss are over 50 years (average age for initial hearing aid fitting is 74 years). Although PC skill and Internet use by demographic factors have been examined previously, data do not currently exist that examine the effects of hearing difficulties on PC skill or Internet use in older adults. To explore the effect that hearing difficulty has on PC skill and Internet use in an opportunistic sample of adults aged 50-74 years. Postal questionnaires about hearing difficulty, PC skill, and Internet use (n=3629) were distributed to adults aged 50-74 years through three family physician practices in Nottingham, United Kingdom. A subsample of 84 respondents completed a second detailed questionnaire on confidence in using a keyboard, mouse, and track pad. Summed scores were termed the "PC confidence index." The PC confidence index was used to verify the PC skill categories in the postal questionnaire (ie, never used a computer, beginner, and competent). The postal questionnaire response rate was 36.78% (1298/3529) and 95.15% (1235/1298) of these contained complete information. There was a significant between-category difference for PC skill by PC confidence index (P<.001), thus verifying the three-category PC skill scale. PC and Internet use was greater in the younger respondents (50-62 years) than in the older respondents (63-74 years). The younger group's PC and Internet use was 81.0% and 60.9%, respectively; the older group's PC and Internet use was 54.0% and 29.8%, respectively. Those with slight hearing difficulties in the older group had significantly greater odds of PC use compared to those with no hearing difficulties (odds ratio [OR]=1.57, 95% confidence interval [CI] 1.06-2.30, P=.02). Those with moderate+ hearing difficulties had lower odds of PC use compared with those with no hearing difficulties, both overall (OR=0.58, 95% CI 0.39-0.87, P=.008) and in the younger group (OR=0.49, 95% CI 0.26-0.86, P=.008). Similar results were demonstrated for Internet use by age group (older: OR=1.57, 95% CI 0.99-2.47, P=.05; younger: OR=0.32, 95% CI 0.16-0.62, P=.001). Hearing health care is of particular relevance to older adults because of the prevalence of age-related hearing loss. Our data show that older adults experiencing slight hearing difficulty have increased odds of greater PC skill and Internet use than those reporting no difficulty. These findings suggest that PC and Internet delivery of hearing screening, information, and intervention is feasible for people between 50-74 years who have hearing loss, but who would not typically present to an audiologist.

Educational needs and employment status of Scottish dental hygienists.

PubMed

Ross, M K; Ibbetson, R J; Rennie, J S

2005-01-22

To investigate the educational needs and employment status of registered dental hygienists in Scotland. Three hundred and eighty one registered dental hygienists with postal addresses in Scotland. Structured questionnaire. A 76% response rate was achieved following two mailings. Of the respondents, 43% were in full-time employment albeit in more than one setting, mostly in the 'central belt' of Scotland. It was reported that 41% were employed in general dental practice with both NHS and private lists and 39% worked in a purely private setting. The introduction of extended clinical duties had been well received and 59% of subjects were interested in additional training in dental therapy, should this become available. Absence of funding for CPD was raised repeatedly, with only 41% reporting a degree of financial assistance. Greater accessibility to continuing education via distance learning, particularly in remote and rural settings, was requested by 73% of hygienists. This study identifies a number of issues in relation to this increasingly important group of healthcare professionals, which will inform the providers of oral healthcare. Although hygienists' involvement in CPD was commendable, results indicated that despite commitment to their profession, respondents did not always feel respected in terms of their employment status or support for continuing professional development.

The Contribution of Social Networks to the Health and Self-Management of Patients with Long-Term Conditions: A Longitudinal Study

PubMed Central

Reeves, David; Blickem, Christian; Vassilev, Ivaylo; Brooks, Helen; Kennedy, Anne; Richardson, Gerry; Rogers, Anne

2014-01-01

Evidence for the effectiveness of patient education programmes in changing individual self-management behaviour is equivocal. More distal elements of personal social relationships and the availability of social capital at the community level may be key to the mobilisation of resources needed for long-term condition self-management to be effective. Aim To determine how the social networks of people with long-term conditions (diabetes and heart disease) are associated with health-related outcomes and changes in outcomes over time. Methods Patients with chronic heart disease (CHD) or diabetes (n = 300) randomly selected from the disease registers of 19 GP practices in the North West of England. Data on personal social networks collected using a postal questionnaire, alongside face-to-face interviewing. Follow-up at 12 months via postal questionnaire using a self-report grid for network members identified at baseline. Analysis Multiple regression analysis of relationships between health status, self-management and health-economics outcomes, and characteristics of patients' social networks. Results Findings indicated that: (1) social involvement with a wider variety of people and groups supports personal self-management and physical and mental well-being; (2) support work undertaken by personal networks expands in accordance with health needs helping people to cope with their condition; (3) network support substitutes for formal care and can produce substantial saving in traditional health service utilisation costs. Health service costs were significantly (p<0.01) reduced for patients receiving greater levels of illness work through their networks. Conclusions Support for self-management which achieves desirable policy outcomes should be construed less as an individualised set of actions and behaviour and more as a social network phenomenon. This study shows the need for a greater focus on harnessing and sustaining the capacity of networks and the importance of social involvement with community groups and resources for producing a more desirable and cost-effective way of supporting long term illness management. PMID:24887107

Higher professional education for general practitioners: postal questionnaire survey.

PubMed

Smith, L F; Eve, R; Crabtree, R

2000-04-01

There is no consensus about whether higher professional education (HPE) is necessary for general practitioners (GPs) to complete their vocational training. To investigate beliefs about the need for HPE, its funding, duration, curriculum, and whether new principals (NPs) are eligible to undertake it. A confidential postal questionnaire was sent to senior partners, GP registrars, NPs, GP trainers, and GP tutors, principally in the old South West region of England, and nationally to other 'academic' GPs. Of 1199 GPs, 750 (62.6%) replied; 561 (79.2%) responders agreed with the principle of HPE for NPs, especially members of the Royal College of General Practitioners and academic GPs; senior partners (SPs) were less likely to agree (all P < 0.001). Of 700 GPs, 331 (50.3%) believed that HPE should last one or two years, 66.4% agreed that NPs should have a major input into the HPE curriculum, and 54.6% agreed that health authorities should be major sources of funding, together with the postgraduate deans (29.9%). GP tutors and trainers should have the main responsibility for teaching HPE. The principal barriers to setting up a HPE course are the financial cost, the time cost, difficulty in changing the status quo, and various practical problems. The facilitatory influences are: the enthusiasm of the NPs and of their clinical colleagues, an appropriate educational environment, a high quality clinical base, and recognition that NPs have specific needs. Of 668 GPs, 89.7% would release NPs if an HPE course were free and locums were paid, although SPs were less likely to agree (P < 0.001); if the HPE course cost the practice money, then only 30.6% would release NPs. If adequately externally funded, then there is widespread support for HPE with most GPs willing to release NPs. NPs and existing GP teachers should decide the curriculum. Its aim should be to provide educational support for NPs during the transition from GP registrar to fully-trained GP principal.

Inequalities in family practitioner use by sexual orientation: evidence from the English General Practice Patient Survey

PubMed Central

Urwin, Sean; Whittaker, William

2016-01-01

Objective To test for differences in primary care family practitioner usage by sexual orientation. Design Multivariate logistic analysis of pooled cross-sectional postal questionnaire responses to family practitioner usage. Setting Patient-reported use and experience of primary care in England, UK. Data from several waves of a postal questionnaire (General Practice Patient Survey) 2012–2014. Population 2 807 320 survey responses of adults aged 18 years and over, registered with a family practitioner. Main outcome measures Probability of a visit to a family practitioner within the past 3 months. Results Lesbian women were 0.803 times (95% CI 0.755 to 0.854) less likely to have seen a family practitioner in the past 3 months relative to heterosexual women (bisexual women OR=0.887, 95% CI 0.817 to 0.963). Gay men were 1.218 times (95% CI 1.163 to 1.276) more likely to have seen a family practitioner relative to heterosexual men (bisexual men OR=1.084, 95% CI 0.989 to 1.188). Our results are robust to the timing of the family practitioner visit (0–3, 0–6, 0–12 months). Gay men were more likely to have seen a family practitioner than heterosexual men where the proportion of women practitioners in the practice was higher (OR=1.238, 95% CI 1.041 to 1.472). Conclusions Inequalities in the use of primary care across sexual orientation in England exist having conditioned on several measures of health status, demographic and family practitioner characteristics. The findings suggest these differences may be reduced by policies targeting a reduction of differences in patient acceptability of primary care. In particular, further research is needed to understand whether lower use among heterosexual men represents unmet need or overutilisation among gay men, and the barriers to practitioner use seemingly occurring due to the gender distribution of practices. PMID:27173816

The contribution of social networks to the health and self-management of patients with long-term conditions: a longitudinal study.

PubMed

Reeves, David; Blickem, Christian; Vassilev, Ivaylo; Brooks, Helen; Kennedy, Anne; Richardson, Gerry; Rogers, Anne

2014-01-01

Evidence for the effectiveness of patient education programmes in changing individual self-management behaviour is equivocal. More distal elements of personal social relationships and the availability of social capital at the community level may be key to the mobilisation of resources needed for long-term condition self-management to be effective. To determine how the social networks of people with long-term conditions (diabetes and heart disease) are associated with health-related outcomes and changes in outcomes over time. Patients with chronic heart disease (CHD) or diabetes (n = 300) randomly selected from the disease registers of 19 GP practices in the North West of England. Data on personal social networks collected using a postal questionnaire, alongside face-to-face interviewing. Follow-up at 12 months via postal questionnaire using a self-report grid for network members identified at baseline. Multiple regression analysis of relationships between health status, self-management and health-economics outcomes, and characteristics of patients' social networks. Findings indicated that: (1) social involvement with a wider variety of people and groups supports personal self-management and physical and mental well-being; (2) support work undertaken by personal networks expands in accordance with health needs helping people to cope with their condition; (3) network support substitutes for formal care and can produce substantial saving in traditional health service utilisation costs. Health service costs were significantly (p<0.01) reduced for patients receiving greater levels of illness work through their networks. Support for self-management which achieves desirable policy outcomes should be construed less as an individualised set of actions and behaviour and more as a social network phenomenon. This study shows the need for a greater focus on harnessing and sustaining the capacity of networks and the importance of social involvement with community groups and resources for producing a more desirable and cost-effective way of supporting long term illness management.

Ages and Stages Questionnaires: feasibility of postal surveys for child follow-up.

PubMed

Troude, Pénélope; Squires, Jane; L'Hélias, Laurence Foix; Bouyer, Jean; de La Rochebrochard, Elise

2011-10-01

The Ages and Stages Questionnaire (ASQ), completed by parents and caregivers, has been shown to be an accurate tool for screening children who need further developmental assessment. To assess the feasibility of using the French Canadian translation of the ASQ in an epidemiological cohort of children from the French general population. Follow-up study by postal questionnaire at 12 and 36 months, using the ASQ. 339 French families recruited at the birth of their child in 2006 in two hospitals in the Paris suburbs. Response rates and French ASQ results at 12 and 36 months. The ASQ was scored as indicated in the manual. A high response rate of 79% was observed at the children's 1st and 3rd birthdays. Parents were enthusiastic about participating; half of them wrote comments on the questionnaires, most of them positive. Low scores at the 12-month assessment were associated with birth characteristics such as prematurity and transfer to the neonatology unit after birth, whereas at 36 months they tended to be associated with both birth and family socio-demographic characteristics. Use of the French ASQ in a research cohort appears feasible as response rates were high. Moreover, known links between child development measured by ASQ and birth and social characteristics were observed. However, further French studies are needed to understand differences observed in 12-month ASQ gross motor scores compared with US norms. For research purposes, further analysis of the ASQ in innovative, quantitative approaches, is needed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Safeguarding children in dentistry: 2. Do paediatric dentists neglect child dental neglect?

PubMed

Harris, J C; Elcock, C; Sidebotham, P D; Welbury, R R

2009-05-09

In this second part of a two-part report, further findings of a postal questionnaire sent in March 2005 to dentists with an interest in paediatric dentistry working in varied UK settings are presented and discussed in the context of current multi-agency good practice in safeguarding and promoting the welfare of children. Using insights gained from a survey of self-reported management of children with neglected dentitions, this paper explores whether paediatric dentists neglect child dental neglect. The authors conclude that current practice already includes much that contributes to promoting children's oral health and wellbeing. However, in a society where children continue to suffer as a result of abuse and neglect, they warn that improvements are needed in communication between dentists and other health and social care professionals if children's welfare is to be safeguarded and promoted effectively and future tragedies avoided.

Assessing obstetric patient experience: a SERVQUAL questionnaire.

PubMed

Garrard, Francesca; Narayan, Harini

2013-01-01

Across health services, there is a drive to respond to patient feedback and to incorporate their views into service improvement. The SERVQUAL method has been used in several clinical settings to quantify whether services meet patient expectations. However, work has been limited in the obstetric population. This paper seeks to address these issues. This study used an adapted SERVQUAL questionnaire to assess a reconfigured antenatal clinic service. The most important care aspects, as rated by patients, were used to construct the SERVQUAL questions. The questionnaire was administered to eligible women in two parts. The first was completed before their first hospital antenatal appointment and the second either at home (a postal-chasing exercise) or while waiting for their next appointment. Only fully completed questionnaires (both parts) were analysed. Service strengths included staff politeness, patient respect and privacy. Areas for improvement included hand cleanliness, women's involvement in decision making and communicating risk. However, the low variability in patient responses makes concrete conclusions difficult and methodological issues complicate evaluating hand cleanliness. The new antenatal clinic service received low negative weighted and un-weighted overall scores. The SERVQUAL measure was developed from patient feedback and used to further improve services. The SERVQUAL-based measure allowed an internal evaluation of patient experience and highlighted areas for improvement. However, without validation, the questionnaire cannot be used as an outcome measure and variation between published SERVQUAL questionnaires makes comparisons difficult. This highlights an important balance in patient evaluation measures--between locally responsive and externally comparable. The SERVQUAL approach allows healthcare teams to evaluate patient experience, while accounting for variation in their expectations and priorities. The study highlights several areas that are important to obstetric patients, where expectation scores are high. However, the similar means and small samples left little difference between excellence and room for improvement.

Policy, Service Pathways and Mortality: A 10-Year Longitudinal Study of People with Profound Intellectual and Multiple Disabilities

ERIC Educational Resources Information Center

Hogg, James; Juhlberg, K.; Lambe, L.

2007-01-01

Background: One hundred and forty-two children and adults with profound intellectual and multiple disabilities were identified in 1993 in a single Scottish region on whom detailed information was collected via a postal questionnaire survey. Methods: They were followed up in 2003. The time spanned represented a period of significant policy change…

Digital Game Playing Motives among Adolescents: Relations to Parent-Child Communication, School Performance, Sleeping Habits, and Perceived Health

ERIC Educational Resources Information Center

Wallenius, Marjut; Rimpela, Arja; Punamaki, Raija-Leena; Lintonen, Tomi

2008-01-01

The aims of this research were to describe Finnish adolescents' different motives for digital game playing, and to examine relations between digital game playing and parent-child communication, school performance, sleeping habits, and perceived health. A questionnaire was used to assess a nationwide postal sample of 12-18-year-old Finns (6761…

Cervical Screening for Women with Learning Disability: Current Practice and Attitudes within Primary Care in Edinburgh

ERIC Educational Resources Information Center

Wood, Rachael; Douglas, Margaret

2007-01-01

This study aimed to evaluate current practice in, and to explore primary care professionals' views about, providing cervical screening to women with learning disability, in two areas of Edinburgh. A postal questionnaire was sent to all 24 GP practices in the project area: 20 responded. Seven respondents were invited to participate in follow up…

Family Carers and the Prevention of Heroin Overdose Deaths: Unmet Training Need and Overlooked Intervention Opportunity of Resuscitation Training and Supply of Naloxone

ERIC Educational Resources Information Center

Strang, John; Manning, Victoria; Mayet, Soraya; Titherington, Emily; Offor, Liz; Semmler, Claudia; Williams, Anna

2008-01-01

Aim: To assess (a) carers' experiences of witnessing overdose; (b) their training needs; and (c) their interest in receiving training in overdose management. Design: Postal questionnaire distributed through consenting participating local carer group coordinators in England. Sample: 147 carers attending local support groups for friends and families…

The Identification of Attention Complaints in the General Population and Their Effect on Quality of Life

ERIC Educational Resources Information Center

Scholtissen-In de Braek, Dymphie M. J. M.; Hurks, Petra P. M.; van Boxtel, Martin P. J.; Dijkstra, Jeanette B.; Jolles, Jelle

2011-01-01

Objective: To provide more insight into subjective attention complaints in a healthy adult and elderly population and how these affect Quality of Life (QoL). Method: A group of 1,550 healthy Dutch participants complete a postal questionnaire including items from the Maastricht Attention and Memory Checklist (MAC). The impact of attention…

Rural and Urban Living in Persons with Spinal Cord Injury and Comparing Environmental Barriers, Their Health, and Quality-of-Life Outcomes.

PubMed

Glennie, R Andrew; Batke, Juliet; Fallah, Nader; Cheng, Christiana L; Rivers, Carly S; Noonan, Vanessa K; Dvorak, Marcel F; Fisher, Charles G; Kwon, Brian K; Street, John T

2017-10-15

There is worldwide geographic variation in the epidemiology of traumatic spinal cord injury (tSCI). The aim of this study was to determine whether environmental barriers, health status, and quality-of-life outcomes differ between patients with tSCI living in rural or urban settings, and whether patients move from rural to urban settings after tSCI. A cohort review of the Rick Hansen SCI Registry (RHSCIR) was undertaken from 2004 to 2012 for one province in Canada. Rural/urban setting was determined using postal codes. Outcomes data at 1 year in the community included the Short Form-36 Version 2 (SF36v2™), Life Satisfaction Questionnaire, Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), Functional Independent Measure ® Instrument, and SCI Health Questionnaire. Statistical methodologies used were t test, Mann-Whitney U test, and Fisher's exact or χ 2 test. In the analysis, 338 RHSCIR participants were included; 65 lived in a rural setting and 273 in an urban setting. Of the original patients residing in a rural area at discharge,10 moved to an urban area by 1 year. Those who moved from a rural to urban area reported a lower SF-36v2™ Mental Component Score (MCS; p = 0.04) and a higher incidence of depression at 1 year (p = 0.04). Urban patients also reported a higher incidence of depression (p = 0.02) and a lower CHIEF-SF total score (p = 0.01) indicating fewer environmental barriers. No significant differences were found in other outcomes. Results suggest that although the patient outcomes are similar, some patients move from rural to urban settings after tSCI. Future efforts should target screening mental health problems early, especially in urban settings.

Rural and Urban Living in Persons with Spinal Cord Injury and Comparing Environmental Barriers, Their Health, and Quality-of-Life Outcomes

PubMed Central

Batke, Juliet; Fallah, Nader; Cheng, Christiana L.; Rivers, Carly S.; Noonan, Vanessa K.; Dvorak, Marcel F.; Fisher, Charles G.; Kwon, Brian K.; Street, John T.

2017-01-01

Abstract There is worldwide geographic variation in the epidemiology of traumatic spinal cord injury (tSCI). The aim of this study was to determine whether environmental barriers, health status, and quality-of-life outcomes differ between patients with tSCI living in rural or urban settings, and whether patients move from rural to urban settings after tSCI. A cohort review of the Rick Hansen SCI Registry (RHSCIR) was undertaken from 2004 to 2012 for one province in Canada. Rural/urban setting was determined using postal codes. Outcomes data at 1 year in the community included the Short Form-36 Version 2 (SF36v2™), Life Satisfaction Questionnaire, Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), Functional Independent Measure® Instrument, and SCI Health Questionnaire. Statistical methodologies used were t test, Mann-Whitney U test, and Fisher's exact or χ2 test. In the analysis, 338 RHSCIR participants were included; 65 lived in a rural setting and 273 in an urban setting. Of the original patients residing in a rural area at discharge,10 moved to an urban area by 1 year. Those who moved from a rural to urban area reported a lower SF-36v2™ Mental Component Score (MCS; p = 0.04) and a higher incidence of depression at 1 year (p = 0.04). Urban patients also reported a higher incidence of depression (p = 0.02) and a lower CHIEF-SF total score (p = 0.01) indicating fewer environmental barriers. No significant differences were found in other outcomes. Results suggest that although the patient outcomes are similar, some patients move from rural to urban settings after tSCI. Future efforts should target screening mental health problems early, especially in urban settings. PMID:28462633

Life-course pathways to psychological distress: a cohort study

PubMed Central

von Stumm, Sophie; Deary, Ian J; Hagger-Johnson, Gareth

2013-01-01

Objectives Early life factors, like intelligence and socioeconomic status (SES), are associated with health outcomes in adulthood. Fitting comprehensive life-course models, we tested (1) the effect of childhood intelligence and SES, education and adulthood SES on psychological distress at midlife, and (2) compared alternative measurement specifications (reflective and formative) of SES. Design Prospective cohort study (the Aberdeen Children of the 1950s). Setting Aberdeen, Scotland. Participants 12 500 live-births (6282 boys) between 1950 and 1956, who were followed up in the years 2001–2003 at age 46–51 with a postal questionnaire achieving a response rate of 64% (7183). Outcome measures Psychological distress at age 46–51 (questionnaire). Results Childhood intelligence and SES and education had indirect effects on psychological distress at midlife, mediated by adult SES. Adult SES was the only variable to have a significant direct effect on psychological distress at midlife; the effect was stronger in men than in women. Alternative measurement specifications of SES (reflective and formative) resulted in greatly different model parameters and fits. Conclusions Even though formative operationalisations of SES are theoretically appropriate, SES is better specified as reflective than as a formative latent variable in the context of life-course modelling. PMID:23667162

A comparison of the efficacy of three intervention trial types: postal, group, and one-to-one facilitation, prior management and the impact of message framing and repeat messages on the flock prevalence of lameness in sheep.

PubMed

Grant, Claire; Kaler, Jasmeet; Ferguson, Eamonn; O'Kane, Holly; Green, Laura Elizabeth

2018-01-01

The aim of this study was to evaluate the effectiveness of three knowledge-transfer intervention trial types (postal, group, one-to-one) to promote best practice to treat sheep with footrot. Further aims were to investigate whether farmer behaviour (i.e. management of lameness) before the trial was associated with uptake of best practice and whether the benefits of best practice framed positively or negatively influenced change in behaviour. The intervention was a message developed from evidence and expert opinion. It was entitled "Six steps to sound sheep" and promoted (1) catch sheep within three days of becoming lame, (2) inspect feet without foot trimming, (3) correctly diagnose the cause, (4) treat sheep lame with footrot or interdigital dermatitis with antibiotic injection and spray without foot trimming, (5) record the identity of treated sheep, (6) cull repeatedly lame sheep. In 2013, 4000 randomly-selected English sheep farmers were sent a questionnaire, those who responded were recruited to the postal (1081 farmers) or one-to-one intervention (32 farmers) trials. A random sample of 400 farmers were invited to join the group trial; 78 farmers participated. A follow-up questionnaire was sent to all participants in summer 2014. There were 72%, 65% and 91% useable responses for the postal, group and one-to-one trials respectively. In both 2013 and 2014, the prevalence of lameness was lower in flocks managed by LC1 farmers than LC2 and LC3 farmers. Between 2013 and 2014, the reduction in geometric mean (95% CI) period prevalence of lameness, proportional between flock reduction in lameness and within flock reduction in lameness was greatest in the one-to-one (7.6% (7.1-8.2%) to 4.3% (3.6-5.0%), 35%, 72%) followed by the group (4.5% (3.9-5.0%) to 3.1% (2.4-3.7%), 27%, 55%) and then the postal trial (from 3.5% (3.3-3.7%) to 3.2% (3.1-3.4%), 21%, 43%). There was a marginally greater reduction in lameness in farmers using most of Six steps but slow to treat lame sheep pre-trial than those not using Six steps at all. There was no significant effect of message framing. The greatest behavioural change was a reduction in therapeutic and routine foot trimming and the greatest attitude change was an increase in negative attitudes towards foot trimming. We conclude that all three intervention trial approaches were effective to promote best practice to treat sheep with footrot with one-to-one facilitation more effective than group and postal intervention trials. Results suggest that farmers' behaviour change was greater among those practising aspects of the intervention message before the trial began than those not practising any aspect. Copyright © 2017 Elsevier B.V. All rights reserved.

Modified mercalli intensities for nine earthquakes in central and western Washington between 1989 and 1999

USGS Publications Warehouse

Brocher, Thomas M.; Dewey, James W.; Cassidy, John F.

2017-08-15

We determine Modified Mercalli (Seismic) Intensities (MMI) for nine onshore earthquakes of magnitude 4.5 and larger that occurred in central and western Washington between 1989 and 1999, on the basis of effects reported in postal questionnaires, the press, and professional collaborators. The earthquakes studied include four earthquakes of M5 and larger: the M5.0 Deming earthquake of April 13, 1990, the M5.0 Point Robinson earthquake of January 29, 1995, the M5.4 Duvall earthquake of May 3, 1996, and the M5.8 Satsop earthquake of July 3, 1999. The MMI are assigned using data and procedures that evolved at the U.S. Geological Survey (USGS) and its Department of Commerce predecessors and that were used to assign MMI to felt earthquakes occurring in the United States between 1931 and 1986. We refer to the MMI assigned in this report as traditional MMI, because they are based on responses to postal questionnaires and on newspaper reports, and to distinguish them from MMI calculated from data contributed by the public by way of the internet. Maximum traditional MMI documented for the M5 and larger earthquakes are VII for the 1990 Deming earthquake, V for the 1995 Point Robinson earthquake, VI for the 1996 Duvall earthquake, and VII for the 1999 Satsop earthquake; the five other earthquakes were variously assigned maximum intensities of IV, V, or VI. Starting in 1995, the Pacific Northwest Seismic Network (PNSN) published MMI maps for four of the studied earthquakes, based on macroseismic observations submitted by the public by way of the internet. With the availability now of the traditional USGS MMI interpreted for all the sites from which USGS postal questionnaires were returned, the four Washington earthquakes join a rather small group of earthquakes for which both traditional USGS MMI and some type of internet-based MMI have been assigned. The values and distributions of the traditional MMI are broadly similar to the internet-based PNSN intensities; we discuss some differences in detail that reflect differences in data-sampling procedure, differences in the procedure used to assign intensity numbers from macroseismic observations, and differences in how intensities are mapped.

An randomized controlled trial of Post-it® notes did not increase postal response rates in older depressed participants.

PubMed

Lewis, Helen; Keding, Ada; Bosanquet, Katharine; Gilbody, Simon; Torgerson, David

2017-02-01

Our aim was to evaluate the effectiveness of a Post-it® note to increase response rates and shorten response times to a 4-month postal follow-up questionnaire sent to participants taking part in the Collaborative Care in Screen-Positive Elders (CASPER) trials. Our trial was a two-arm randomized controlled trial comparing response rates to questionnaires with a printed Post-it® note (intervention) and without (control), nested in multi centred randomized controlled trials of older people with varying levels of depressive symptoms; the CASPER + and CASPER Self Help for those At Risk of Depression (SHARD) trials. A total of 611 participants were eligible and randomized. The primary outcome was response rates, secondary outcomes were time to response and need for a reminder. Of 297 participants, 266 (89.6%) returned their 4-month questionnaire in the post-it note arm, compared with 282 of 314 participants (89.8%) in the control arm (OR = 0.97, 95% CI: 0.57, 1.65, P = 0.913). There were no statistically significant differences in time to respond or the need to be sent a reminder. Patients with a major depressive episode were more likely to return questionnaires with post-it notes (P of interaction = .019). There was no significant difference in response rates, time to response, or the need for a reminder between the intervention and control at 4-month follow up for older people with depressive symptoms. However, there was a significant interaction between the Post-it® note group and level of depression. © 2016 John Wiley & Sons, Ltd.

The requirement for prior consent to participate on survey response rates: a population-based survey in Grampian

PubMed Central

Angus, Val C; Entwistle, Vikki A; Emslie, Margaret J; Walker, Kim A; Andrew, Jane E

2003-01-01

Background A survey was carried out in the Grampian region of Scotland with a random sample of 10,000 adults registered with a General Practitioner in Grampian. The study complied with new legislation requiring a two-stage approach to identify and recruit participants, and examined the implications of this for response rates, non-response bias and speed of response. Methods A two-stage survey was carried out consistent with new confidentiality guidelines. Individuals were contacted by post and asked by the Director of Public Health to consent to receive a postal or electronic questionnaire about communicating their views to the NHS. Those who consented were then sent questionnaires. Response rates at both stages were measured. Results 25% of people returned signed consent forms and were invited to complete questionnaires. Respondents at the consent stage were more likely to be female (odds ratio (OR) response rate of women compared to men = 1.5, 95% CI 1.4, 1.7), less likely to live in deprived postal areas (OR = 0.59, 95% CI 0.45, 0.78) and more likely to be older (OR for people born in 1930–39 compared to people born in 1970–79 = 2.82, 95% CI 2.36, 3.37). 80% of people who were invited to complete questionnaires returned them. Response rates were higher among older age groups. The overall response rate to the survey was 20%, relative to the original number approached for consent (1951/10000). Conclusion The requirement of a separate, prior consent stage may significantly reduce overall survey response rates and necessitate the use of substantially larger initial samples for population surveys. It may also exacerbate non-response bias with respect to demographic variables. PMID:14622444

39 CFR 1.1 - Establishment of the U.S. Postal Service.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Establishment of the U.S. Postal Service. 1.1 Section 1.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE POSTAL POLICY (ARTICLE I) § 1.1 Establishment of the U.S. Postal Service. The U.S. Postal Service is...

39 CFR 1.1 - Establishment of the U.S. Postal Service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Establishment of the U.S. Postal Service. 1.1 Section 1.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE POSTAL POLICY (ARTICLE I) § 1.1 Establishment of the U.S. Postal Service. The U.S. Postal Service is...

39 CFR 1.1 - Establishment of the U.S. Postal Service.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Establishment of the U.S. Postal Service. 1.1 Section 1.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE POSTAL POLICY (ARTICLE I) § 1.1 Establishment of the U.S. Postal Service. The U.S. Postal Service is...

39 CFR 1.1 - Establishment of the U.S. Postal Service.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Establishment of the U.S. Postal Service. 1.1 Section 1.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE POSTAL POLICY (ARTICLE I) § 1.1 Establishment of the U.S. Postal Service. The U.S. Postal Service is...

39 CFR 1.1 - Establishment of the U.S. Postal Service.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Establishment of the U.S. Postal Service. 1.1 Section 1.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE POSTAL POLICY (ARTICLE I) § 1.1 Establishment of the U.S. Postal Service. The U.S. Postal Service is...

Instrument development, data collection, and characteristics of practices, staff, and measures in the Improving Quality of Care in Diabetes (iQuaD) Study.

PubMed

Eccles, Martin P; Hrisos, Susan; Francis, Jill J; Stamp, Elaine; Johnston, Marie; Hawthorne, Gillian; Steen, Nick; Grimshaw, Jeremy M; Elovainio, Marko; Presseau, Justin; Hunter, Margaret

2011-06-09

Type 2 diabetes is an increasingly prevalent chronic illness and an important cause of avoidable mortality. Patients are managed by the integrated activities of clinical and non-clinical members of primary care teams. This study aimed to: investigate theoretically-based organisational, team, and individual factors determining the multiple behaviours needed to manage diabetes; and identify multilevel determinants of different diabetes management behaviours and potential interventions to improve them. This paper describes the instrument development, study recruitment, characteristics of the study participating practices and their constituent healthcare professionals and administrative staff and reports descriptive analyses of the data collected. The study was a predictive study over a 12-month period. Practices (N = 99) were recruited from within the UK Medical Research Council General Practice Research Framework. We identified six behaviours chosen to cover a range of clinical activities (prescribing, non-prescribing), reflect decisions that were not necessarily straightforward (controlling blood pressure that was above target despite other drug treatment), and reflect recommended best practice as described by national guidelines. Practice attributes and a wide range of individually reported measures were assessed at baseline; measures of clinical outcome were collected over the ensuing 12 months, and a number of proxy measures of behaviour were collected at baseline and at 12 months. Data were collected by telephone interview, postal questionnaire (organisational and clinical) to practice staff, postal questionnaire to patients, and by computer data extraction query. All 99 practices completed a telephone interview and responded to baseline questionnaires. The organisational questionnaire was completed by 931/1236 (75.3%) administrative staff, 423/529 (80.0%) primary care doctors, and 255/314 (81.2%) nurses. Clinical questionnaires were completed by 326/361 (90.3%) primary care doctors and 163/186 (87.6%) nurses. At a practice level, we achieved response rates of 100% from clinicians in 40 practices and > 80% from clinicians in 67 practices. All measures had satisfactory internal consistency (alpha coefficient range from 0.61 to 0.97; Pearson correlation coefficient (two item measures) 0.32 to 0.81); scores were generally consistent with good practice. Measures of behaviour showed relatively high rates of performance of the six behaviours, but with considerable variability within and across the behaviours and measures. We have assembled an unparalleled data set from clinicians reporting on their cognitions in relation to the performance of six clinical behaviours involved in the management of people with one chronic disease (diabetes mellitus), using a range of organisational and individual level measures as well as information on the structure of the practice teams and across a large number of UK primary care practices. We would welcome approaches from other researchers to collaborate on the analysis of this data.

Improving access for patients – a practice manager questionnaire

PubMed Central

Meade, James G; Brown, James S

2006-01-01

Background The administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown. This study researched the effect of implementing the access targets of the new GP contract on general practice appointment systems, and practice manager satisfaction in a UK primary health care setting. Methods A four-part postal questionnaire was administered. The questionnaire was modified from previously validated questionnaires and the findings compared with data obtained from the Western Health and Social Services Board (WHSSB) in N Ireland. Practice managers from the 59 general practices in the WHSSB responded to the questionnaire. Results There was a 94.9% response rate. Practice managers were generally satisfied with the introduction of access targets for patients. Some 57.1% of responding practices, most in deprived areas (Odds ratio 3.13 -95% CI 1.01 – 9.80, p = 0.0256) had modified their appointment systems. Less booking flexibility was reported among group practices (p = 0.006), urban practices (p < 0.001) and those with above average patient list sizes (p < 0.001). Receptionists had not received training in patient appointment management in a quarter of practices. Practices with smaller list sizes were more likely than larger ones to utilise nurses in seeing extra patients (p = 0.007) or to undertake triage procedures (p = 0.062). Conclusion The findings demonstrated the ability of general practices within the WHSSB to adjust to a demanding component of the new GP contract. Issues relating to the flexibility of patient appointment booking systems, receptionists' training and the development of the primary care nursing role were highlighted by the study. PMID:16784530

39 CFR 255.9 - Other postal regulations; authority of postal managers and employees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... managers and employees. 255.9 Section 255.9 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND... ELECTRONIC AND INFORMATION TECHNOLOGY § 255.9 Other postal regulations; authority of postal managers and... repeal, modify, or amend any other postal regulation, to authorize any postal manager or employee to...

[Out-of-hours primary care in Germany: general practitioners' views on the current situation].

PubMed

Frankenhauser-Mannuß, J; Goetz, K; Scheuer, M; Szescenyi, J; Leutgeb, R

2014-07-01

The aim of this study was to explore views, experiences und perspectives of German GPs related to current out-of-hours service provision covering both urban and rural settings. In the context of the international project EurOOHnet (European Research Network for Out-of-Hours Primary Health Care) the German members (of EurOOHnet) developed a questionnaire about organisational structures, infrastructure requirements and the procedures of information flow between regular care and out-of-hours care in 2011. This questionnaire was adopted in every participating country. A comprehensive postal questionnaire was sent to 410 feneral practice cooperatives in Germany. Qualitative content analysis and an inductive reasoning process, supported by the use of Atlas.ti, were used to identify key themes from responses to open-ended questions in the survey. Results were grouped into 3 overarching categories and each of these were grouped into 3 sub-categories. The questionnaire response rate was 44% (181/410). The analysis identified organisational issues (e. g., financing) and infrastructure barriers (e. g., lack of motivated GPs for out-of-hours care) as key themes. Significantly, different priorities between rural and urban GPs were identified. In particular, rural GPs highlighted shortages of GPs and distance between the GP practice and patients' residence as concerning factors impacting on out-of-hours care. Based on reported views from survey respondents, urban and rural primary care service needs vary significantly and, therefore, different solutions are needed to improve out-of-hours primary care and optimise service quality. © Georg Thieme Verlag KG Stuttgart · New York.

39 CFR 601.104 - Postal purchasing authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

... in writing local buying authority throughout the Postal Service. ... 39 Postal Service 1 2010-07-01 2010-07-01 false Postal purchasing authority. 601.104 Section 601.104 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE...

Computer Skills and Internet Use in Adults Aged 50-74 Years: Influence of Hearing Difficulties

PubMed Central

Clark, Daniel P A; Kang, Sujin; Ferguson, Melanie A

2012-01-01

Background The use of personal computers (PCs) and the Internet to provide health care information and interventions has increased substantially over the past decade. Yet the effectiveness of such an approach is highly dependent upon whether the target population has both access and the skill set required to use this technology. This is particularly relevant in the delivery of hearing health care because most people with hearing loss are over 50 years (average age for initial hearing aid fitting is 74 years). Although PC skill and Internet use by demographic factors have been examined previously, data do not currently exist that examine the effects of hearing difficulties on PC skill or Internet use in older adults. Objective To explore the effect that hearing difficulty has on PC skill and Internet use in an opportunistic sample of adults aged 50-74 years. Methods Postal questionnaires about hearing difficulty, PC skill, and Internet use (n=3629) were distributed to adults aged 50-74 years through three family physician practices in Nottingham, United Kingdom. A subsample of 84 respondents completed a second detailed questionnaire on confidence in using a keyboard, mouse, and track pad. Summed scores were termed the “PC confidence index.” The PC confidence index was used to verify the PC skill categories in the postal questionnaire (ie, never used a computer, beginner, and competent). Results The postal questionnaire response rate was 36.78% (1298/3529) and 95.15% (1235/1298) of these contained complete information. There was a significant between-category difference for PC skill by PC confidence index (P<.001), thus verifying the three-category PC skill scale. PC and Internet use was greater in the younger respondents (50-62 years) than in the older respondents (63-74 years). The younger group’s PC and Internet use was 81.0% and 60.9%, respectively; the older group’s PC and Internet use was 54.0% and 29.8%, respectively. Those with slight hearing difficulties in the older group had significantly greater odds of PC use compared to those with no hearing difficulties (odds ratio [OR]=1.57, 95% confidence interval [CI] 1.06-2.30, P=.02). Those with moderate+ hearing difficulties had lower odds of PC use compared with those with no hearing difficulties, both overall (OR=0.58, 95% CI 0.39-0.87, P=.008) and in the younger group (OR=0.49, 95% CI 0.26-0.86, P=.008). Similar results were demonstrated for Internet use by age group (older: OR=1.57, 95% CI 0.99-2.47, P=.05; younger: OR=0.32, 95% CI 0.16-0.62, P=.001). Conclusions Hearing health care is of particular relevance to older adults because of the prevalence of age-related hearing loss. Our data show that older adults experiencing slight hearing difficulty have increased odds of greater PC skill and Internet use than those reporting no difficulty. These findings suggest that PC and Internet delivery of hearing screening, information, and intervention is feasible for people between 50-74 years who have hearing loss, but who would not typically present to an audiologist. PMID:22954484

Reducing questionnaire length did not improve physician response rate: a randomized trial.

PubMed

Bolt, Eva E; van der Heide, Agnes; Onwuteaka-Philipsen, Bregje D

2014-04-01

To examine the effect of reducing questionnaire length on the response rate in a physician survey. A postal four double-page questionnaire on end-of-life decision making was sent to a random sample of 1,100 general practitioners, 400 elderly care physicians, and 500 medical specialists. Another random sample of 500 medical specialists received a shorter questionnaire of two double pages. After 3 months and one reminder, all nonresponding physicians received an even shorter questionnaire of one double page. Total response was 64% (1,456 of 2,269 eligible respondents). Response rate of medical specialists for the four double-page questionnaire was equal to that of the two double-page questionnaire (190 and 191 questionnaires were returned, respectively). The total response rate increased from 53% to 64% after sending a short one double-page questionnaire (1,203-1,456 respondents). The results of our study suggest that reducing the length of a long questionnaire in a physician survey does not necessarily improve response rate. To improve response rate and gather more information, researchers could decide to send a drastically shortened version of the questionnaire to nonresponders. Copyright © 2014 Elsevier Inc. All rights reserved.

76 FR 49511 - Postal Service Initiative on Retail Postal Locations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... POSTAL REGULATORY COMMISSION [Docket No. N2011-1; Order No. 778] Postal Service Initiative on Retail Postal Locations AGENCY: Postal Regulatory Commission. ACTION: Notice; correction. SUMMARY: The... Postal Service request for an advisory opinion on an initiative involving examination of the continuation...

76 FR 55619 - Performance Measurement for Special Postal Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-08

..., Corporate & Postal Business Law, United States Postal Service to Shoshana M. Grove, Secretary, Postal... & Postal Business Law, United States Postal Service. III. Background of Postal Service Proposals A...), Public Law 109-435, 120 Stat. 3198 (2006). The proposed rules described herein would establish reporting...

Referral for secondary restorative dental care in rural and urban areas of Scotland: findings from the Highlands Et Islands Teledentistry Project.

PubMed

Nuttall, N M; Steed, M S; Donachie, M A

2002-02-23

To compare the reported level of use of secondary care services for restorative dental care in rural and urban areas of Scotland. Postal questionnaire survey Postal questionnaire sent to all dentists in the Highland region, the island regions in Scotland and Dumfries Et Galloway (n = 150) and an equal number were sampled from the remainder of Scotland stratified by health board area. Non-respondents were sent 2 reminders after which 62% of the sample had responded. Most dentists (85%) who practised in what they considered were urban areas of Scotland said they felt that they had good access to a secondary referral service. Whereas most of those who practised in what they considered were rural areas either said they had no access to such a service (26%) or that access was difficult (53%), only 3% of those in urban areas said they had no access to a secondary restorative consultative service compared with 14% of dentists practising in rural areas of mainland Scotland and 54% of those practising on Scottish islands. The survey suggests the people of the Scottish islands and some of the remoter parts of the Scottish mainland would be among those who might benefit from improvement in access to a restorative dentistry consultant service.

39 CFR 762.28 - Release of original disbursement postal money orders.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Release of original disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Endorsements, Payment, Guaranties, Warranties and Processing of Disbursement Postal Money Orders § 762.28 Release of original disbursement postal...

39 CFR 762.28 - Release of original disbursement postal money orders.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Release of original disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Endorsements, Payment, Guaranties, Warranties and Processing of Disbursement Postal Money Orders § 762.28 Release of original disbursement postal...

39 CFR 762.28 - Release of original disbursement postal money orders.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Release of original disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Endorsements, Payment, Guaranties, Warranties and Processing of Disbursement Postal Money Orders § 762.28 Release of original disbursement postal...

39 CFR 762.28 - Release of original disbursement postal money orders.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Release of original disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Endorsements, Payment, Guaranties, Warranties and Processing of Disbursement Postal Money Orders § 762.28 Release of original disbursement postal...

75 FR 12123 - Restrictions on Private Carriage of Letters

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-15

... 320 Advertising; Computer technology. 0 For the reasons set forth above, the Postal Service amends 39... from the Inspection Service or the Manager, Mailing Standards, USPS Headquarters, unless an appeal is...

39 CFR 221.1 - The United States Postal Service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false The United States Postal Service. 221.1 Section 221.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION GENERAL ORGANIZATION § 221.1 The United States Postal Service. The United States Postal Service was established as an...

39 CFR 762.43 - Issuance of substitute disbursement postal money order.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Issuance of substitute disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Issuance of Substitutes for Lost, Destroyed, Mutilated, and Defaced Disbursement Postal Money Orders § 762.43 Issuance of substitute disbursement postal...

39 CFR 762.43 - Issuance of substitute disbursement postal money order.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Issuance of substitute disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Issuance of Substitutes for Lost, Destroyed, Mutilated, and Defaced Disbursement Postal Money Orders § 762.43 Issuance of substitute disbursement postal...

39 CFR 762.43 - Issuance of substitute disbursement postal money order.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Issuance of substitute disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Issuance of Substitutes for Lost, Destroyed, Mutilated, and Defaced Disbursement Postal Money Orders § 762.43 Issuance of substitute disbursement postal...

39 CFR 762.43 - Issuance of substitute disbursement postal money order.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Issuance of substitute disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Issuance of Substitutes for Lost, Destroyed, Mutilated, and Defaced Disbursement Postal Money Orders § 762.43 Issuance of substitute disbursement postal...

39 CFR 762.43 - Issuance of substitute disbursement postal money order.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Issuance of substitute disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Issuance of Substitutes for Lost, Destroyed, Mutilated, and Defaced Disbursement Postal Money Orders § 762.43 Issuance of substitute disbursement postal...

Mentorship in contemporary practice: the experiences of nursing students and practice mentors.

PubMed

Myall, Michelle; Levett-Jones, Tracy; Lathlean, Judith

2008-07-01

This paper explores the role of the mentor in contemporary nursing practice in the UK. It presents findings from a recent study which investigated the impact of a locality-based nursing education initiative on students, practice mentors and academic staff and draws on another study, conducted in the same setting and two Australian sites, to examine the perceptions of nursing students and mentors. Within nursing, mentorship is integral to students' clinical placement experiences and has attracted increasing interest among researchers. Despite a plethora of studies focussing on mentoring and its nature and application within the practice setting, limited attention has been paid to the extent to which guidelines provided by regulatory bodies for nursing inform and influence the practice of mentoring in contemporary health-care settings. The study used a two-phased design with data on mentorship being focussed on the second phase. Data were collected using an online survey questionnaire of pre-qualifying students and a postal questionnaire for practice mentors. The findings highlight the importance of mentorship for prequalifying students and emphasise the need to provide mentors with adequate preparation and support. They confirm previous research, but also highlight improvements in bridging the gap between rhetoric and reality for mentorship. Results are further strengthened when compared with those of the second study. Findings provide new evidence of a narrowing of the gap between the theory and practice of mentoring and for the continuing implementation of national standards to clarify the roles and responsibilities of the mentor. They also suggest the benefits of developing such standards in countries with similar systems of support for nursing students. Mentorship is pivotal to students' clinical experiences and is instrumental in preparing them for their role as confident and competent practitioners.

Psychiatric services in primary care settings: a survey of general practitioners in Thailand

PubMed Central

Lotrakul, Manote; Saipanish, Ratana

2006-01-01

Background General Practitioners (GPs) in Thailand play an important role in treating psychiatric disorders since there is a shortage of psychiatrists in the country. Our aim was to examine GP's perception of psychiatric problems, drug treatment and service problems encountered in primary care settings. Methods We distributed 1,193 postal questionnaires inquiring about psychiatric practices and service problems to doctors in primary care settings throughout Thailand. Results Four hundred and thirty-four questionnaires (36.4%) were returned. Sixty-seven of the respondents (15.4%) who had taken further special training in various fields were excluded from the analysis, giving a total of 367 GPs in this study. Fifty-six per cent of respondents were males and they had worked for 4.6 years on average (median = 3 years). 65.6% (SD = 19.3) of the total patients examined had physical problems, 10.7% (SD = 7.9) had psychiatric problems and 23.9% (SD = 16.0) had both problems. The most common psychiatric diagnoses were anxiety disorders (37.5%), alcohol and drugs abuse (28.1%), and depressive disorders (29.2%). Commonly prescribed psychotropic drugs were anxiolytics and antidepressants. The psychotropic drugs most frequently prescribed were diazepam among anti-anxiety drugs, amitriptyline among antidepressant drugs, and haloperidol among antipsychotic drugs. Conclusion Most drugs available through primary care were the same as what existed 3 decades ago. There should be adequate supply of new and appropriate psychotropic drugs in primary care. Case-finding instruments for common mental disorders might be helpful for GPs whose quality of practice was limited by large numbers of patients. However, the service delivery system should be modified in order to maintain successful care for a large number of psychiatric patients. PMID:16867187

39 CFR 761.8 - Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Servicing book-entry Postal Service securities... POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.8 Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

39 CFR 761.8 - Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Servicing book-entry Postal Service securities... POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.8 Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

39 CFR 761.8 - Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Servicing book-entry Postal Service securities... POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.8 Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

Views of senior UK doctors about working in medicine: questionnaire survey

PubMed Central

Lambert, Trevor W; Goldacre, Michael J

2014-01-01

Summary Objectives We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Design Questionnaire survey Participants 3479 contactable UK-trained medical graduates of 1993. Setting UK. Main outcome measures Comments made by doctors about their work, and their views about medical careers and training in the UK. Method Postal and email questionnaires. Results Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors’ training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Conclusions Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions. PMID:25408920

Assessing the validity and reliability of the Pool Activity Level (PAL) Checklist for use with older people with dementia.

PubMed

Wenborn, Jennifer; Challis, David; Pool, Jackie; Burgess, Jane; Elliott, Nicola; Orrell, Martin

2008-03-01

Activity is key to maintaining physical and mental health and well-being. However, as dementia affects the ability to engage in activity, care-givers can find it difficult to provide appropriate activities. The Pool Activity Level (PAL) Checklist guides the selection of appropriate, personally meaningful activities. The aim of this study was to assess the reliability and validity of the PAL Checklist when used with older people with dementia. A postal questionnaire sent to activity providers assessed content validity. Validity and reliability were measured in a sample of 60 older people with dementia. The questionnaire response rate was 83% (102/122). Most respondents felt no important items were missing. Seven of the nine activities were ranked as 'very important' or 'essential' by at least 77% of the sample, indicating very good content validity. Correlation with measures of cognition, severity of dementia and activity performance demonstrated strong concurrent validity. Inter-item correlation indicated strong construct validity. Cronbach's alpha coefficient measured internal consistency as excellent (0.95). All items achieved acceptable test-retest reliability, and the majority demonstrated acceptable inter-rater reliability. We conclude that the PAL Checklist demonstrates adequate validity and reliability when used with older people with dementia and appears a useful tool for a variety of care settings.

Symptoms and risk factors of ovarian cancer: a survey in primary care.

PubMed

Gajjar, Ketan; Ogden, Gemma; Mujahid, M I; Razvi, Khalil

2012-01-01

In spite of the increased awareness of ovarian cancer symptoms, the predictive value of symptoms remains very low. The aim of this paper is to obtain the views of general practitioners (GPs) in relation to symptom-based detection of ovarian cancer and to assess their knowledge for family history of breast and/or ovarian cancer as a predisposing factor for ovarian cancer. In this questionnaire survey, postal questionnaires were sent to 402 GPs in 132 primary care clinics, out of which we obtained 110 replies (27.4%). Approximately 26% of respondent GPs thought that the symptoms were more likely to be frequent, sudden, and persistent, and one-fifth were unsure of the importance of family history of breast cancer in relation to ovarian cancer. The participant GPs scored a set of symptoms for their relevance to ovarian cancer from 0 (not relevant) to 10 (most relevant). The highest scored symptoms were abdominal swelling (mean ± SD, 8.19 ± 2.33), abdominal bloating (7.01 ± 3.01), and pelvic pain (7.46 ± 2.26). There was a relative lack of awareness for repetitive symptoms as well as gastrointestinal symptoms as an important feature in a symptom-based detection of ovarian cancer.

Symptoms and Risk Factors of Ovarian Cancer: A Survey in Primary Care

PubMed Central

Gajjar, Ketan; Ogden, Gemma; Mujahid, M. I.; Razvi, Khalil

2012-01-01

In spite of the increased awareness of ovarian cancer symptoms, the predictive value of symptoms remains very low. The aim of this paper is to obtain the views of general practitioners (GPs) in relation to symptom-based detection of ovarian cancer and to assess their knowledge for family history of breast and/or ovarian cancer as a predisposing factor for ovarian cancer. In this questionnaire survey, postal questionnaires were sent to 402 GPs in 132 primary care clinics, out of which we obtained 110 replies (27.4%). Approximately 26% of respondent GPs thought that the symptoms were more likely to be frequent, sudden, and persistent, and one-fifth were unsure of the importance of family history of breast cancer in relation to ovarian cancer. The participant GPs scored a set of symptoms for their relevance to ovarian cancer from 0 (not relevant) to 10 (most relevant). The highest scored symptoms were abdominal swelling (mean ± SD, 8.19 ± 2.33), abdominal bloating (7.01 ± 3.01), and pelvic pain (7.46 ± 2.26). There was a relative lack of awareness for repetitive symptoms as well as gastrointestinal symptoms as an important feature in a symptom-based detection of ovarian cancer. PMID:22957264

Holiday travel and morbidity reported to general practitioners.

PubMed Central

Beale, N; Nethercott, S

1994-01-01

AIM. This study set out to explore the influence that holiday travel might have on the rate at which new episodes of illness are reported to general practitioners. METHOD. The study was carried out in a semi-rural practice of five doctors in Wiltshire in 1989. Details of patients' holiday travel were determined by postal questionnaire. Sociodemographic and clinical data were obtained from the patients' medical records. RESULTS. The response rate to the questionnaire was 85%. The study subjects were divided into those who had taken their holiday abroad (n = 643), those who had taken their holiday in the United Kingdom (n = 973), and those who had taken no holiday (n = 668) during the study year. Interim assessment of clinical results revealed no changes in morbidity indices in relation to holiday intervals in any of the groups except for an apparent rise in the number of new episodes of illness presented in the month before departure by those about to go abroad. Further analysis showed that this was due to a significant 112% increase in the number of episodes of illness presented by this study group in the week before they left home. CONCLUSION. This study suggests that the present focus on the supposed excess morbidity of patients returning from foreign holidays is misplaced. PMID:8204316

75 FR 67147 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-01

... POSTAL REGULATORY COMMISSION [Docket No. CP2011-1; Order No. 551] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal....'' Id. The Postal Service concludes that its filings demonstrate that the new GREP contract complies...

75 FR 8758 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-25

... POSTAL REGULATORY COMMISSION [Docket No. CP2010-24; Order No. 410] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal... incidental differences. Id. at 6. The Postal Service contends that its filings demonstrate that this new GEPS...

76 FR 49798 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-11

... POSTAL REGULATORY COMMISSION [Docket No. CP2011-67; Order No. 790] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal.... CP2010-36.'' Id. The Postal Service concludes that its filing demonstrates that the new GREP contract...

Insights and Concerns of Patients and GPs Regarding Introduction of Universal Health Insurance in Ireland.

PubMed

Breen, N; MacEoin, S; Loy, A; O'Shea, B; Darker, C

2015-10-01

The implementation of a universal health insurance (UHI) model is a key political policy in Ireland. The objective here was to determine the understanding of general practitioners (GPs) and patients regarding UHI, its implementation and impact on both sets of stakeholders. Postal questionnaire to GPs, and opportunistic survey sampling of patients in two different GP practices were carried out. Response rates were 92.5% (patients) and 78% (GPs). 79.4% of patients (n = 418) and 96.7% of GPs (n = 149) have a 'poor' understanding of how UHI will be implemented. 89% (n = 493) of patients and 98.7% (n = 153) of GPs feel government communication about UHI has been 'poor'. 98.1% of GPs (n = 152) and 77.3% of patients (n = 383) are not confident that 'UHI will be ready for implementation by 2015'. Neither stakeholder group is confident in the government's ability to deliver UHI within the given timeframe. There is a lack of knowledge and consultation on proposals for its implementation.

39 CFR 447.52 - Holding of State or local office by Postal Service employees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Holding of State or local office by Postal Service employees. 447.52 Section 447.52 Postal Service UNITED STATES POSTAL SERVICE PERSONNEL RULES OF CONDUCT FOR POSTAL EMPLOYEES Participation in Community Affairs § 447.52 Holding of State or local office by Postal Service employees. (a) An employee...

77 FR 12724 - International Postal Service-Global Expedited Package Services (GEPS) Contracts

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-02

... POSTAL SERVICE\\TM\\ 39 CFR Part 20 International Postal Service--Global Expedited Package Services (GEPS) Contracts AGENCY: Postal Service TM . ACTION: Final rule. SUMMARY: The Postal Service will revise Mailing Standards of the United States Postal Service, International Mail Manual (IMM[supreg]) to...

Increasing response rates to lifestyle surveys: a pragmatic evidence review.

PubMed

McCluskey, S; Topping, A E

2011-03-01

Lifestyle surveys are often a key component of a local Joint Strategic Needs Assessment (JSNA), undertaken to inform public health planning. They are usually administered to a large number of people in order to provide a comprehensive profile of population health. However, declining response rates coupled with the under-representation of certain population groups in lifestyle survey data has led to doubts concerning the reliability of findings. In order to inform the design of their own lifestyle survey, NHS Calderdale commissioned an evidence-based review of the methodological literature relating to the administration of lifestyle surveys, with the specific aim of identifying practical and resource-efficient strategies shown to be effective for maximizing whole-population response rates. A pragmatic review of the published literature was undertaken, specifically to explore the most practical and resource-efficient ways to maximize lifestyle survey response rates to the most commonly used methods (postal surveys, face-to-face interviews, telephone interviews and electronic surveys). Electronic databases including MEDLINE, CINAHL, DARE, EMBASE and PsychINFO were searched. Empirical evidence published in the last 10 years was identified and citation tracking performed on all retrieved articles. An internet search for 'grey literature' was also conducted. The postal questionnaire remains an important lifestyle survey tool, but reported response rates have decreased rapidly in recent years. Interviews and telephone surveys are recommended in order to supplement data from postal questionnaires and increase response rates in some population groups, but costs may be prohibitive. Electronic surveys are a cheaper alternative, but the empirical evidence on effectiveness is inconclusive. Careful planning and tailoring of survey design to the characteristics of target populations can increase response rates and representativeness of lifestyle survey data. The results of this pragmatic review could provide a valuable resource for those involved in the design and administration of lifestyle surveys.

Improving Population-Level Maternal Health: A Hard Nut to Crack? Long Term Findings and Reflections on a 16-Community Randomised Trial in Australia to Improve Maternal Emotional and Physical Health after Birth [ISRCTN03464021

PubMed Central

Small, Rhonda; Watson, Lyndsey; Gunn, Jane; Mitchell, Creina; Brown, Stephanie

2014-01-01

Background Community level interventions to improve maternal and child health have been supported and well evaluated in resource poor settings, but less so in developed countries. PRISM - Program of Resources, Information and Support for Mothers - was a primary care and community-based cluster-randomised trial in sixteen municipalities in Victoria, Australia, which aimed to reduce depression in mothers and improve their physical health. The aim of this paper is to report the longer term outcomes of PRISM and to reflect on lessons learned from this universal community intervention to improve maternal health. Methods Maternal health outcome data in PRISM were collected by postal questionnaire at six months and two years. At two years, the main outcome measures included the Edinburgh Postnatal Depression Scale (EPDS) and the SF-36. Secondary outcome measures included the Experience of Motherhood Scale (EOM) and the Parenting Stress Index (PSI). A primary intention to treat analysis was conducted, adjusting for the randomisation by cluster. Results 7,169/18,424 (39%) women responded to the postal questionnaire at two years −3,894 (40%) in the intervention arm and 3,275 (38%) in the comparison arm. Respondents were mostly representative on available population data comparisons. There were no differences in depression prevalence (EPDS≥13) between the intervention and comparison arms (13.4% vs 13.1%; ORadj = 1.06, 95%CI 0.91–1.24). Nor did women's mental health (MCS: 48.6 vs 49.1) or physical health scores (PCS: 49.1 vs 49.0) on the SF-36 differ between the trial arms. Conclusion Improvement in maternal mental and physical health outcomes at the population level in the early years after childbirth remains a largely unmet challenge. Despite the lack of effectiveness of PRISM intervention strategies, important lessons about systems change, sustained investment and contextual understanding of the workability of intervention strategies can be drawn from the experience of PRISM. Trial Registration. Controlled-Trials.com ISRCTN03464021 PMID:24586327

39 CFR 762.28 - Release of original disbursement postal money orders.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Release of original disbursement postal money... and Processing of Disbursement Postal Money Orders § 762.28 Release of original disbursement postal money orders. An original Disbursement Postal Money Order may be released to a responsible endorser only...

75 FR 28204 - Conduct on Postal Property; Penalties and Other Law

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-20

... POSTAL SERVICE 39 CFR Part 232 Conduct on Postal Property; Penalties and Other Law AGENCY: Postal... Postal Service property. DATES: Effective Date: May 20, 2010. FOR FURTHER INFORMATION CONTACT: Elizabeth... concerning the maximum penalty for a violation of the rules governing conduct on Postal Service property (75...

39 CFR 762.30 - Disbursement postal money orders issued to incompetent payees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... shall be forwarded to the Money Order Division, Postal Data Center, P.O. Box 14963, St. Louis, MO 63182... 39 Postal Service 1 2010-07-01 2010-07-01 false Disbursement postal money orders issued to... OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Endorsements, Payment...

39 CFR 762.31 - Disbursement postal money orders issued to deceased payees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... should be returned to the Money Order Division, Postal Data Center, P.O. Box 14963, St. Louis, MO 63182... 39 Postal Service 1 2010-07-01 2010-07-01 false Disbursement postal money orders issued to... OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Endorsements, Payment...

39 CFR 3055.91 - Consumer access to postal services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Consumer access to postal services. 3055.91 Section 3055.91 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL SERVICE PERFORMANCE AND CUSTOMER SATISFACTION REPORTING Reporting of Customer Satisfaction § 3055.91 Consumer access to postal services. (a) The...

The role of endotoxin in grain dust-induced lung disease.

PubMed

Schwartz, D A; Thorne, P S; Yagla, S J; Burmeister, L F; Olenchock, S A; Watt, J L; Quinn, T J

1995-08-01

To identify the role of endotoxin in grain dust-induced lung disease, we conducted a population-based, cross-sectional investigation among grain handlers and postal workers. The study subjects were selected by randomly sampling all grain facilities and post offices within 100 miles of Iowa City. Our study population consisted of 410 grain workers and 201 postal workers. Grain workers were found to be exposed to higher concentrations of airborne dust (p = 0.0001) and endotoxin (p = 0.0001) when compared with postal workers. Grain workers had a significantly higher prevalence of work-related (cough, phlegm, wheezing, chest tightness, and dyspnea) and chronic (usual cough or phlegm production) respiratory symptoms than postal workers. Moreover, after controlling for age, gender, and cigarette smoking status, work-related respiratory symptoms were strongly associated with the concentration of endotoxin in the bioaerosol in the work setting. The concentration of total dust in the bioaerosol was marginally related to these respiratory problems. After controlling for age, gender, and cigarette smoking status, grain workers were found to have reduced spirometric measures of airflow (FEV1, FEV1/FVC, and FEF25-75) and enhanced airway reactivity to inhaled histamine when compared with postal workers. Although the total dust concentration in the work environment appeared to have little effect on these measures of airflow obstruction, higher concentrations of endotoxin in the bioaerosol were associated with diminished measures of airflow and enhanced bronchial reactivity. Our results indicate that the concentration of endotoxin in the bioaerosol may be particularly important in the development of grain dust-induced lung disease.

Psychometric properties of the Norwegian version of the Safety Attitudes Questionnaire (SAQ), Generic version (Short Form 2006).

PubMed

Deilkås, Ellen T; Hofoss, Dag

2008-09-22

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 Norwegian and validated the translated version. The psychometric properties of the translated questionnaire are presented in this article. The questionnaire was translated with the back translation technique and tested in 47 clinical units in a Norwegian university hospital. SAQ's (the Generic version (Short Form 2006) the version with the two sets of questions on perceptions of management: on unit management and on hospital management) were distributed to 1911 frontline staff. 762 were distributed during unit meetings and 1149 through the postal system. Cronbach alphas, item-to-own correlations, and test-retest correlations were calculated, and response distribution analysis and confirmatory factor analysis were performed, as well as early validity tests. 1306 staff members completed and returned the questionnaire: a response rate of 68%. Questionnaire acceptability was good. The reliability measures were acceptable. The factor structure of the responses was tested by confirmatory factor analysis. 36 items were ascribed to seven underlying factors: Teamwork Climate, Safety Climate, Stress Recognition, Perceptions of Hospital Management, Perceptions of Unit Management, Working conditions, and Job satisfaction. Goodness-of-Fit Indices showed reasonable, but not indisputable, model fit. External validity indicators - recognizability of results, correlations with "trigger tool"-identified adverse events, with patient satisfaction with hospitalization, patient reports of possible maltreatment, and patient evaluation of organization of hospital work - provided preliminary validation. Based on the data from Akershus University Hospital, we conclude that the Norwegian translation of the SAQ showed satisfactory internal psychometric properties. With data from one hospital only, we cannot draw strong conclusions on its external validity. Further validation studies linking the SAQ-scores to patient outcome data should be performed.

39 CFR 255.3 - Nondiscrimination under any program or activity conducted by the Postal Service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Nondiscrimination under any program or activity conducted by the Postal Service. 255.3 Section 255.3 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION ACCESS OF PERSONS WITH DISABILITIES TO POSTAL SERVICE PROGRAMS, ACTIVITIES...

39 CFR 235.1 - Postal Service to the Armed Forces.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Postal Service to the Armed Forces. 235.1 Section... LIAISON § 235.1 Postal Service to the Armed Forces. (a) Publication 38, Postal Agreement with the... Armed Forces. (b) The Chief Inspector is responsible for military liaison. (c) Postal inspectors provide...

39 CFR 211.2 - Regulations of the Postal Service.

Code of Federal Regulations, 2011 CFR

2011-07-01

... regulations, all regulations of other agencies of the United States continued in effect as postal regulations... 39 Postal Service 1 2011-07-01 2011-07-01 false Regulations of the Postal Service. 211.2 Section... REGULATIONS § 211.2 Regulations of the Postal Service. (a) The regulations of the Postal Service consist of...

The development and psychometric evaluation of a safety climate measure for primary care.

PubMed

de Wet, C; Spence, W; Mash, R; Johnson, P; Bowie, P

2010-12-01

Building a safety culture is an important part of improving patient care. Measuring perceptions of safety climate among healthcare teams and organisations is a key element of this process. Existing measurement instruments are largely developed for secondary care settings in North America and many lack adequate psychometric testing. Our aim was to develop and test an instrument to measure perceptions of safety climate among primary care teams in National Health Service for Scotland. Questionnaire development was facilitated through a steering group, literature review, semistructured interviews with primary care team members, a modified Delphi and completion of a content validity index by experts. A cross-sectional postal survey utilising the questionnaire was undertaken in a random sample of west of Scotland general practices to facilitate psychometric evaluation. Statistical methods, including exploratory and confirmatory factor analysis, and Cronbach and Raykov reliability coefficients were conducted. Of the 667 primary care team members based in 49 general practices surveyed, 563 returned completed questionnaires (84.4%). Psychometric evaluation resulted in the development of a 30-item questionnaire with five safety climate factors: leadership, teamwork, communication, workload and safety systems. Retained items have strong factor loadings to only one factor. Reliability coefficients was satisfactory (α = 0.94 and ρ = 0.93). This study is the first stage in the development of an appropriately valid and reliable safety climate measure for primary care. Measuring safety climate perceptions has the potential to help primary care organisations and teams focus attention on safety-related issues and target improvement through educational interventions. Further research is required to explore acceptability and feasibility issues for primary care teams and the potential for organisational benchmarking.

Instrument development, data collection, and characteristics of practices, staff, and measures in the Improving Quality of Care in Diabetes (iQuaD) Study

PubMed Central

2011-01-01

Background Type 2 diabetes is an increasingly prevalent chronic illness and an important cause of avoidable mortality. Patients are managed by the integrated activities of clinical and non-clinical members of primary care teams. This study aimed to: investigate theoretically-based organisational, team, and individual factors determining the multiple behaviours needed to manage diabetes; and identify multilevel determinants of different diabetes management behaviours and potential interventions to improve them. This paper describes the instrument development, study recruitment, characteristics of the study participating practices and their constituent healthcare professionals and administrative staff and reports descriptive analyses of the data collected. Methods The study was a predictive study over a 12-month period. Practices (N = 99) were recruited from within the UK Medical Research Council General Practice Research Framework. We identified six behaviours chosen to cover a range of clinical activities (prescribing, non-prescribing), reflect decisions that were not necessarily straightforward (controlling blood pressure that was above target despite other drug treatment), and reflect recommended best practice as described by national guidelines. Practice attributes and a wide range of individually reported measures were assessed at baseline; measures of clinical outcome were collected over the ensuing 12 months, and a number of proxy measures of behaviour were collected at baseline and at 12 months. Data were collected by telephone interview, postal questionnaire (organisational and clinical) to practice staff, postal questionnaire to patients, and by computer data extraction query. Results All 99 practices completed a telephone interview and responded to baseline questionnaires. The organisational questionnaire was completed by 931/1236 (75.3%) administrative staff, 423/529 (80.0%) primary care doctors, and 255/314 (81.2%) nurses. Clinical questionnaires were completed by 326/361 (90.3%) primary care doctors and 163/186 (87.6%) nurses. At a practice level, we achieved response rates of 100% from clinicians in 40 practices and > 80% from clinicians in 67 practices. All measures had satisfactory internal consistency (alpha coefficient range from 0.61 to 0.97; Pearson correlation coefficient (two item measures) 0.32 to 0.81); scores were generally consistent with good practice. Measures of behaviour showed relatively high rates of performance of the six behaviours, but with considerable variability within and across the behaviours and measures. Discussion We have assembled an unparalleled data set from clinicians reporting on their cognitions in relation to the performance of six clinical behaviours involved in the management of people with one chronic disease (diabetes mellitus), using a range of organisational and individual level measures as well as information on the structure of the practice teams and across a large number of UK primary care practices. We would welcome approaches from other researchers to collaborate on the analysis of this data. PMID:21658211

"Do I really want to do this?" Longitudinal cohort study participants' perspectives on postal survey design: a qualitative study.

PubMed

Harcombe, Helen; Derrett, Sarah; Herbison, Peter; McBride, David

2011-01-27

Randomised controlled trials have investigated aspects of postal survey design yet cannot elaborate on reasons behind participants' decision making and survey behaviour. This paper reports participants' perspectives of the design of, and participation in, a longitudinal postal cohort survey. It describes strengths and weaknesses in study design from the perspectives of study participants and aims to contribute to the: 1) design of future cohort surveys and questionnaires generally and, 2) design of cohort surveys for people with musculoskeletal disorders (MSDs) specifically. In-depth interviews explored the design of postal surveys previously completed by participants. Interviews used open ended questioning with a topic guide for prompts if areas of interest were not covered spontaneously. Thematic data analysis was undertaken based on the framework method. A second researcher verified all coding. Data from fourteen interviews were analysed within three main themes; participation, survey design and survey content. One of the main findings was the importance of clear communication aimed at the correct audience both when inviting potential participants to take part and within the survey itself. Providing enough information about the study, having a topic of interest and an explanation of likely benefits of the study were important when inviting people to participate. The neutrality of the survey and origination from a reputable source were both important; as was an explanation about why information was being collected within the survey itself. Study findings included participants' impressions when invited to take part, why they participated, the acceptability of follow-up of non-responders and why participants completed the follow-up postal survey. Also discussed were participants' first impression of the survey, its length, presentation and participants' views about specific questions within the survey. Ideas generated in this study provide an insight into participants' decision making and survey behaviour and may enhance the acceptability of future surveys to potential participants. As well as clear communication, participants valued incentives and survey questions that were relevant to them. However, opinions varied as to the preferred format for responses with some advising more opportunity for open-ended feedback. We also found that some standard format questions can raise quandaries for individual participants.

[Nursing activities in family medicine groups for patients with chronic pain].

PubMed

Bergeron, Dave A; Bourgault, Patricia; Gallagher, Frances

2015-01-01

Thousands of people treated in primary care are currently experiencing chronic pain (CP), for which management is often inadequate. In Quebec, nurses in family medicine groups (FMGs) play a key role in the management of chronic health problems. The present study aimed to describe the activities performed by FMG nurses in relation to CP management and to describe barriers to those activities. A descriptive correlational cross-sectional postal survey was used. The accessible population includes FMG nurses on the Ordre des infirmières et infirmiers du Québec list. All nurses on the list who provided consent to be contacted at home for research purposes were contacted. A self-administered postal questionnaire (Pain Management Activities Questionnaire) was completed by 53 FMG nurses. Three activities most often performed by nurses were to establish a therapeutic relationship with the client; discuss the effectiveness of therapeutic measures with the physician; and conduct personalized teaching for the patient. The average number of individuals seen by interviewed nurses that they believe suffer from CP was 2.68 per week. The lack of knowledge of possible interventions in pain management (71.7%) and the nonavailability of information on pain management (52.8%) are the main barriers perceived by FMG nurses. FMG nurses are currently performing few activities in CP management. The nonrecognition of CP may explain this situation.

Can self-care health books affect amount of contact with the primary health care team? A randomized controlled trial in general practice.

PubMed

Platts, Amanda; Mitton, Rosly; Boniface, David; Friedli, Karin

2005-09-01

To investigate the effects of two differently styled self-care health books in general practice on the frequency and duration of patients' consultations and their views of the books. Random allocation of patients to either a descriptive or a decision-tree based self-care health book, or a no-book control condition. Three- and 12-months follow-up by postal questionnaire and monitoring of consultations. A large general practice in the South East of England. A total of 1967 volunteer, adult patients who attended the practice in 2001 participated. Demographics; health problems; use of health services; use and perceptions of the trial book; frequency and duration of consultations. Response rates to postal questionnaires at 3 and 12 months were 80% and 74%. In all, 48% consulted their allocated book, compared with 25% who consulted any healthcare book in the Control group. Those reporting health problems were more likely to have consulted their allocated book; 60% reported that the allocated book made them more likely to deal with a problem themselves and 40% reported themselves less likely to consult the practice. However, there were no differences in consultation rates or durations of consultations between the three groups. Handing out of self-care health books may provide qualitative benefits for patients but is unlikely to reduce attendance at the GP practice.

Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey.

PubMed

Schmidt, Carsten Oliver; Raspe, Heiner; Pfingsten, Michael; Hasenbring, Monika; Basler, Heinz Dieter; Eich, Wolfgang; Kohlmann, Thomas

2007-08-15

A population-based cross-sectional multiregion postal survey. To provide a descriptive epidemiology of the prevalence and severity of back pain in German adults and to analyze sociodemographic correlates for disabling back pain within and across regions. Back pain is a leading health problem in Germany. However, comprehensive population-based evidence on the severity of back pain is still fragmentary for this country. Despite earlier findings concerning large prevalence differences across regions, systematic explanations remain to be ascertained. Questionnaire data were collected for 9263 subjects in 5 German cities and regions (population-based random samples, postal questionnaire). Point, 1-year, and lifetime prevalence were assessed using direct questions, and graded back pain was determined using the Graded Chronic Pain Scale. Poststratification was applied to adjust for cross-regional sociodemographic differences. Point-prevalence was 37.1%, 1-year prevalence 76.0%, and lifetime prevalence 85.5%. A substantial minority had severe (Grade II, 8.0%) or disabling back pain (Grade III-IV, 11.2%). Subjects with a low educational level reported substantially more disabling back pain. This variable was an important predictor for large cross-regional differences in the burden of back pain. Back pain is a highly prevalent condition in Germany. Disabling back pain in this country may be regarded as part of a social disadvantage syndrome. Educational level should receive greater attention in future cross-regional comparisons of back pain.

76 FR 11532 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-02

... POSTAL REGULATORY COMMISSION [Docket No. CP2011-61; Order No. 680] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: This document addresses a recent Postal Service filing concerning an additional International Business Reply Service (IBRS) Competitive Contract 3. It...

78 FR 37246 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... POSTAL REGULATORY COMMISSION [Docket No. CP2013-67; Order No. 1749] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice SUMMARY: The Commission is noticing a recently filed Postal... the introductory (``Whereas'') paragraphs of the Agreement; revisions to existing articles; and new...

78 FR 43246 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-19

... POSTAL REGULATORY COMMISSION [Docket No. CP2013-15; Order No. 1779] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing concerning the amendment to Priority Mail Contract 48 negotiated service agreement. This notice...

76 FR 67496 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... POSTAL REGULATORY COMMISSION [Docket No. CP2012-1; Order No. 919] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request to enter into an additional Inbound Competitive Multi-Service Agreements with Foreign...

Psychiatric research: what ethical concerns do LRECs encounter? A postal survey. Local research ethics committees.

PubMed

Osborn, D P J; Fulford, K W M

2003-02-01

Psychiatric research can occasionally present particular ethical dilemmas, but it is not clear what kind of problems local research ethics committees (LRECs) actually experience in this field. We aimed to assess the type of problems that committees encounter with psychiatric research, using a postal survey of 211 LRECs. One hundred and seven (51%) of those written to replied within the time limit. Twenty eight (26%) experienced few problems with psychiatric applications. Twenty six (24%) emphasised the value of a psychiatric expert on the committee. The most common issues raised were informed consent (n=64, 60%) and confidentiality (n=17, 16%). The use of placebos (and washout periods) (n=18, 17%), the validity of psychiatric questionnaires (n=16, 15%) and overuse of psychiatric "jargon" (n=14, 13%) in psychiatric applications also raised concern. Our results suggest that LRECs have specific concerns regarding methodology, consent, and confidentiality in psychiatric research, and that they find psychiatric input invaluable.

Social cognitive correlates of physical activity among persons with multiple sclerosis: Influence of depressive symptoms.

PubMed

Ensari, Ipek; Kinnett-Hopkins, Dominique; Motl, Robert W

2017-10-01

Physical inactivity and elevated depressive symptoms are both highly prevalent and correlated among persons with multiple sclerosis (MS). Variables from Social Cognitive Theory (SCT) might be differentially correlated with physical activity in persons with MS who have elevated depressive symptoms. This study investigated the influence of elevated depressive symptoms on correlates of physical activity based on SCT in persons with MS. Participants (mean age = 50.3 years, 87% female, 69% Caucasian) completed questionnaires on physical activity, depressive symptoms, self-efficacy, social support, outcome expectations, functional limitations, and goal setting. The questionnaires were delivered and returned through the U.S. Postal Service. The sample (N = 551) was divided into 2 subgroups (i.e., elevated vs non-elevated levels of depressive symptoms) for statistical analyses. Bivariate correlations and stepwise multiple regressions were conducted using SPSS. Self-efficacy (r = 0.16), functional limitations (r = 0.22) and goal-setting (r = 0.42) were significantly (p < 0.05) associated with physical activity among the elevated depressive sample. The regression analysis indicated that self-efficacy predicted physical activity in Step 1 (β = 0.16, p < 0.05), but was no longer significant when goal-setting (β = 0.06, p > 0.05) entered the model. All social cognitive variables were significantly associated with physical activity levels (r = 0.16-0.40, p < 0.001) among the non-elevated depressive sample. Self-efficacy predicted physical activity in Step 1 (β = 0.24, p < 0.001), but it was no longer significant once goal-setting, functional limitations, and self-evaluative outcome expectations entered the model. Based on SCT, self-efficacy and goal-setting represent possible targets of behavior interventions for increasing physical activity among persons with MS who have elevated depressive symptoms. There is a larger set of targets among those with MS who do not have elevated symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.

The clinical assessment study of the foot (CASF): study protocol for a prospective observational study of foot pain and foot osteoarthritis in the general population

PubMed Central

2011-01-01

Background Symptomatic osteoarthritis (OA) affects approximately 10% of adults aged over 60 years. The foot joint complex is commonly affected by OA, yet there is relatively little research into OA of the foot, compared with other frequently affected sites such as the knee and hand. Existing epidemiological studies of foot OA have focussed predominantly on the first metatarsophalangeal joint at the expense of other joints. This three-year prospective population-based observational cohort study will describe the prevalence of symptomatic radiographic foot OA, relate its occurrence to symptoms, examination findings and life-style-factors, describe the natural history of foot OA, and examine how it presents to, and is diagnosed and managed in primary care. Methods All adults aged 50 years and over registered with four general practices in North Staffordshire, UK, will be invited to participate in a postal Health Survey questionnaire. Respondents to the questionnaire who indicate that they have experienced foot pain in the preceding twelve months will be invited to attend a research clinic for a detailed clinical assessment. This assessment will consist of: clinical interview; physical examination; digital photography of both feet and ankles; plain x-rays of both feet, ankles and hands; ultrasound examination of the plantar fascia; anthropometric measurement; and a further self-complete questionnaire. Follow-up will be undertaken in consenting participants by postal questionnaire at 18 months (clinic attenders only) and three years (clinic attenders and survey participants), and also by review of medical records. Discussion This three-year prospective epidemiological study will combine survey data, comprehensive clinical, x-ray and ultrasound assessment, and review of primary care records to identify radiographic phenotypes of foot OA in a population of community-dwelling older adults, and describe their impact on symptoms, function and clinical examination findings, and their presentation, diagnosis and management in primary care. PMID:21892960

A nationwide postal questionnaire survey: the presence of airway guidelines in anaesthesia department in Sweden.

PubMed

Knudsen, Kati; Pöder, Ulrika; Högman, Marieann; Larsson, Anders; Nilsson, Ulrica

2014-01-01

In Sweden, airway guidelines aimed toward improving patient safety have been recommended by the Swedish Society of Anaesthesia and Intensive Care Medicine. Adherence to evidence-based airway guidelines is known to be generally poor in Sweden. The aim of this study was to determine whether airway guidelines are present in Swedish anaesthesia departments. A nationwide postal questionnaire inquiring about the presence of airway guidelines was sent out to directors of Swedish anaesthesia departments (n = 74). The structured questionnaire was based on a review of the Swedish Society of Anaesthesia and Intensive Care voluntary recommendations of guidelines for airway management. Mean, standard deviation, minimum/maximum, percentage (%) and number of general anaesthesia performed per year as frequency (n), were used to describe, each hospital type (university, county, private). For comparison between hospitals type and available written airway guidelines were cross tabulation used and analysed using Pearson's Chi-Square tests. A p- value of less than 0 .05 was judged significant. In total 68 directors who were responsible for the anaesthesia departments returned the questionnaire, which give a response rate of 92% (n 68 of 74). The presence of guidelines showing an airway algorithm was reported by 68% of the departments; 52% reported having a written patient information card in case of a difficult airway and guidelines for difficult airways, respectively; 43% reported the presence of guidelines for preoperative assessment; 31% had guidelines for Rapid Sequence Intubation; 26% reported criteria for performing an awake intubation; and 21% reported guidelines for awake fibre-optic intubation. A prescription for the registered nurse anaesthetist for performing tracheal intubation was reported by 24%. The most frequently pre-printed preoperative elements in the anaesthesia record form were dental status and head and neck mobility. Despite recommendations from the national anaesthesia society, the presence of airway guidelines in Swedish anaesthesia departments is low. From the perspective of safety for both patients and the anaesthesia staff, airway management guidelines should be considered a higher priority.

78 FR 76334 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

... POSTAL REGULATORY COMMISSION [Docket No. CP2013-13; Order No. 1900] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing requesting an amendment to Parcel Select Contract 6. This notice informs the public of filings...

75 FR 57087 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

... POSTAL REGULATORY COMMISSION [Docket No. CP2010-104; Order No. 530] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal... Service concludes that its filing demonstrates that this new GEPS 3 contract complies with the...

75 FR 80859 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2011-11 and CP2011-47; Order No. 612] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a...). The Postal Service contemporaneously filed a contract related to the proposed new product pursuant to...

76 FR 9055 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-16

... POSTAL REGULATORY COMMISSION [Docket No. MC2011-20; Order No. 668] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal... original requirement. This effective date also is applicable to the new requirement. \\1\\ Notice of the...

78 FR 29784 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-21

... POSTAL REGULATORY COMMISSION [Docket No. CP2013-62; Order No. 1716] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice SUMMARY: The Commission is noticing a recent Postal Service filing concerning the addition of Global Expedited Package Services 3 Contract to the competitive product...

78 FR 76333 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

... POSTAL REGULATORY COMMISSION [Docket No. CP2011-4; Order No. 1901] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing requesting an amendment to Priority Mail Contract 29. This notice informs the public of the...

75 FR 80857 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2011-10 and CP2011-46; Order No. 611] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a...). The Postal Service contemporaneously filed a contract related to the proposed new product pursuant to...

75 FR 51505 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-20

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2010-31 and CP2010-76; Order No. 498] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... (Request). The Postal Service contemporaneously filed a contract related to the proposed new product...

76 FR 395 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2011-16 and CP2011-53; Order No. 627] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a.... 10-8). The Postal Service contemporaneously filed a contract related to the proposed new product...

77 FR 58185 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-19

... POSTAL REGULATORY COMMISSION [Docket No. CP2012-56; Order No. 1464] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request to add a Global Expedited Package Services contract to the competitive product list. This...

78 FR 77172 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... POSTAL REGULATORY COMMISSION [Docket No. CP2014-13; Order No. 1907] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing concerning a contract with Canada for the delivery of inbound Expedited Parcels USA and Express...

77 FR 50729 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-22

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2012-44; Order No. 1435] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request for two related changes to the product lists. The changes involve removing one product...

78 FR 42566 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... POSTAL REGULATORY COMMISSION [Docket No. CP2013-72; Order No. 1775] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service... Agreement; revisions to several existing articles; and new, deleted, and renumbered articles. Id. at 3-7...

77 FR 37077 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-20

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2012-25 and CP2012-33; Order No. 1369] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a...). The Postal Service contemporaneously filed a redacted contract related to the proposed new product. Id...

76 FR 7883 - Postal Service Rate Adjustment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

... POSTAL REGULATORY COMMISSION [Docket No. R2011-4; Order No. 663] Postal Service Rate Adjustment AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request concerning a Type 2 rate adjustment. This notice addresses procedural steps...

75 FR 27375 - Postal Rate Case Management

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... POSTAL REGULATORY COMMISSION [Docket No. PI2010-3; Order No. 456] Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is seeking comments relevant to management of an anticipated exigent postal rate case. It has scheduled a technical conference...

75 FR 23824 - New Postal Products

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-04

... POSTAL REGULATORY COMMISSION [Docket No. MC2009-19; Order No. 449] New Postal Products AGENCY... Service request to add postal products to the Mail Classification Schedule. This notice addresses... postal services to the Mail Classification Schedule (MCS) product lists.\\1\\ In approving these additions...

78 FR 70968 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-27

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2014-7 and CP2014-8; Order No. 1888] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing recent Postal Service filings requesting the addition of Priority Mail Contract 69 to the competitive product...

78 FR 70970 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-27

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2014-6 and CP2014-7; Order No. 1887] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing recent Postal Service filings requesting the addition of Priority Mail Contract 68 to the competitive product...

Interprofessional educator ambassadors: An empirical study of motivation and added value.

PubMed

Anderson, Elizabeth Susan; Thorpe, Lucy Nicola

2010-01-01

Interprofessional education (IPE) is being led by a driving force of teaches who advocate for the importance of this learning within health and social care professional curriculum. Many of these leaders have additional uni professional teaching responsibilities. This study aimed to explore the impact of leading an IPE curriculum on teachers, who were at the forefront of establishing a new IPE curriculum in the east midlands, UK. The prospective study used the principles of grounded theory to analyse the educator's experiences. The study included teachers who work from academic university posts and those who teach from within practice. These IPE leaders were identified through their involvement in the design and delivery of the local IPE initiatives. They were invited to share their experiences at either a mixed-discipline focus group, a one-to-one interview or by completing a postal/e questionnaire. During analysis the views from each data set were triangulated. A total of 58 educators shared their experiences. All benefitted from being part of the planning and teaching teams. They were driven by a strong belief that IPE had the potential to improve patient care and that future healthcare practice would remain team based. Engagement had brought additional benefits to their teaching and career development in particular through forming new relationships with colleagues from other caring professions. They were concerned about educators teaching interprofessional student groups with little prior experience of IPE. The data suggest educators who take on a leading developmental role in designing and delivering an interprofessional curriculum benefit personally and professionally through working relationships with colleagues in other professions and through teaching wider networks of students. These new insights strengthen personal practice and research and in turn have the potential to influence and improve the quality of faculty teaching.

Living wills and the Mental Capacity Act: a postal questionnaire survey of UK geriatricians.

PubMed

Schiff, Rebekah; Sacares, Peter; Snook, Jane; Rajkumar, Chakravarthi; Bulpitt, Christopher J

2006-03-01

To determine geriatricians' experience of and views on living wills, National Health Service Trusts' support of advance end-of-life health care planning and geriatricians' views on related legal changes in the Mental Capacity Act. Anonymous postal questionnaire survey of all 1,426 British Geriatrics Society members in England, Wales and Northern Ireland. A total of 842 (59%) questionnaires were returned. Of 811 geriatricians, 454 (56%) had cared for patients with living wills. Of the 280 who cared for patients when the living will had come into effect, 108 (39%) had changed treatment because of the living will and 84 (78%) of those felt that decisions had been easier to make. Living wills not already in effect made discussions with patients [171 of 178 (96%)] and families [135 of 178 (76%)] easier. Of 779 geriatricians, 713 (92%) saw advantages of older people using living wills; 467 of these also expressed concerns. Only 16 (2%) geriatricians who had concerns said that there were no advantages. A total of 214 (27%) were aware that their Trust had a form to help with discussions about cardiopulmonary resuscitation. Fewer [126 of 781 (16%)] were aware of a Trust policy on living wills. The proposal, in the Mental Capacity Bill, for advance refusals of treatment was supported by 59% (476 of 801), yet the proposal for a lasting power of attorney (LPA) covering health care was only supported by 47% (382 of 806). Many geriatricians have positive experiences of caring for patients with living wills. Despite recognising potential problems, most geriatricians support the use of living wills by older people. However, most believe that their Trust does not have a policy to support advance health care planning. Geriatricians have reservations about LPAs covering health care.

Senior house officers in medicine: postal survey of training and work experience.

PubMed Central

Baldwin, P. J.; Newton, R. W.; Buckley, G.; Roberts, M. A.; Dodd, M.

1997-01-01

OBJECTIVES: To describe working conditions for senior house officers in medicine in Scotland and to relate these to the quality of clinical training they receive. DESIGN: Postal questionnaire survey. SUBJECTS: All senior house officers in medicine and related specialties in post in Scotland in October 1995 (n = 437); 252 (58%) respondents. MAIN OUTCOME MEASURES: Questionnaires covered hours, working patterns, measures of workload, an attitudes to work scale, and experience of education and training. RESULTS: In the week before the questionnaire, doctors on rotas had worked a mean of 7.4 (95% confidence interval 5.8 to 9.0) hours in excess of their contracts, compared with 3.7 (2.0 to 5.5) hours for those on partial shifts. The most common reason for this was "the needs of the patients or the service." Those on partial shifts reported significantly less continuity of care with patients than those on rotas (Mann-Whitney U test, z = -4.2, P < 0.0001) or full shifts (z = -2.08, P = 0.03). Doctors in general medicine reported significantly higher measures of workload (number of acute admissions, number of times called out, and fewest hours' uninterrupted sleep) than those in subspecialties. Consultants' clinical teaching and style of conducting a ward round were significantly related to factors extracted from the attitudes to work scale. CONCLUSIONS: The quality of senior house officers' training is detrimentally affected by a variety of conditions, especially the need for closer support and supervision, the need for greater feedback, and the lack of time that consultants have to dedicate to clinical training. Efforts should be made to improve these conditions and to reinforce a close working relationship between trainee and supervising consultant. PMID:9116556

[Results of a randomised controlled trial on the acceptance and the outcomes of a counselling on medical inpatient rehabilitation in gainfully employed members of statutory health insurances with rheumatoid arthritis (clinicaltrials.gov identifier NCT00229541)].

PubMed

Schlademann, S; Hüppe, A; Raspe, H

2007-06-01

In a randomised controlled trial we examined the influence of a counselling (and implementation) of an inpatient rehabilitation programme on the somatic, mental and sociomedical course of rheumatoid arthritis (RA) in employees. Additionally, the recruitment of a study population via routine data of statutory health insurances was tested. Potential study participants were identified by health insurances via RA-specific data on work disability, hospital stays and medical prescriptions. These insurants entered a two-stage selection process (postal screening questionnaire, experts). Eligible participants completed a postal questionnaire on their subjective health status, the responders were randomised into intervention group (IG) and control group (CG), respectively. The IG was offered a counselling on medical rehabilitation, CG members received usual care. Pension funds and health insurances transferred data on sick leaves (cases, days), hospital treatment, disability pension and medical rehabilitation (primary outcomes). Twelve months after baseline, again a questionnaire on subjective health status was completed (secondary outcomes). Data were analysed on an intention to treat and as actual basis. Whilst the offered counselling was accepted very well (IG: 84.4%), the attendance in a medical inpatient rehabilitation was low (IG: 31.3%). Neither an intention to treat analysis (IG vs. CG) nor an as actual analysis (rehabilitation vs. no rehabilitation) perceived significant differences in the course of sick leave, hospital treatment or parameters of subjective health. The study showed the feasibility of a randomised controlled trial in rehabilitation-related Health Services Research. Recruitment via routine data of health insurances showed limitations. The low acceptance of a medical inpatient rehabilitation emphasises the need to establish alternative rehabilitative programs focussing on employed RA patients.

Provision of emergency contraception in general practice and confidentiality for the under 16's: results of a postal survey by general practitioners in Avon.

PubMed

Graham, A; Moore, L; Sharp, D

2001-10-01

To describe the provision of emergency contraception and confidentiality for the under 16's by general practitioners (GPs) in Avon, in order to inform the development of a health promotion intervention in schools in Avon. Confidential postal questionnaire survey. All principals in general practice in Avon Health Authority, South West England. Five hundred and eighty general practice principals were sent the questionnaire. Four hundred and eighty-six (84%) principals in general practice responded to the questionnaire. Only three (0.6%) GPs did not provide hormonal emergency contraception. Nearly half (232, 47.7%) would fit the intrauterine device (IUD) as emergency contraception. Fitting an IUD was associated with female gender of the GP (OR = 2.34, 95% CI 1.53-3.71), and whether the GP had a family planning qualification (OR = 4.55, 95% CI 2.41-8.60). Three hundred and fifty-two (72%) respondents would provide emergency contraception on a Sunday if requested to do so by a 14-year-old who reported having had unprotected sex the night before. Practice nurses in 26 (5%) of the respondent's practices were available to provide advice and tablets for patients requesting hormonal emergency contraception. However, 74 (21%) respondents employed a family planning trained practice nurse who was not involved in any way in the provision of emergency contraception. Practice nurses remain an under used resource in this area. Our findings suggest that most GPs provide hormonal emergency contraception. Only eight (1.6%) of respondents would need to ask for parental consent prior to providing hormonal emergency contraception to a 14-year old-girl. Young people need to be informed of GPs widespread adherence to current confidentiality guidelines.

77 FR 76095 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2013-24 and CP2013-32; Order No. 1586] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request to add First-Class Package Service Contract 34 to the competitive...

77 FR 42341 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-18

... POSTAL REGULATORY COMMISSION [Docket No. MC2012-31; Order No. 1399] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request to add Every Door Direct Mail-Retail (EDDM-R) to the market dominant product list. This...

75 FR 67146 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-01

... POSTAL REGULATORY COMMISSION [Docket Nos. CP2011-13 Through CP2011-18; Order No. 559] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... 4. The Postal Service concludes that its filings demonstrate that each of the new GEPS 3 contracts...

75 FR 26812 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-12

... POSTAL REGULATORY COMMISSION [Docket No. CP2010-47; Order No. 454] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request to add a Global Direct Contracts 1 (MC2010-17) negotiated service agreement to the...

75 FR 66677 - New Postal Products

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... POSTAL REGULATORY COMMISSION 39 CFR Part 3020 [Docket Nos. MC2010-34, et al.] New Postal Products AGENCY: Postal Regulatory Commission. ACTION: Final rule. SUMMARY: The Commission is updating the postal product lists. This action reflects the disposition of recent dockets, as reflected in Commission orders...

75 FR 53216 - New Postal Products

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... POSTAL REGULATORY COMMISSION 39 CFR Part 3020 [Docket Nos. MC2009-19, et al.] New Postal Products AGENCY: Postal Regulatory Commission. ACTION: Final rule. SUMMARY: The Commission is updating the postal product lists. This action reflects the disposition of recent dockets, as reflected in Commission orders...

76 FR 394 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... POSTAL REGULATORY COMMISSION [Docket No. CP2011-52; Order No. 624] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request to add a Global Direct Contracts 1 contract to the competitive product list. This notice...

77 FR 1089 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-09

... POSTAL REGULATORY COMMISSION [Docket No. CP2012-9; Order No. 1096] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request to add a Global Direct Contracts 1 contract to the competitive product list. This notice...

76 FR 396 - Product Change-Priority Mail-Non-Published Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... POSTAL SERVICE Product Change--Priority Mail--Non-Published Rates AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: Postal Service notice of filing of a request with the Postal Regulatory... States Postal Service Concerning Priority Mail--Non-Published Rates and Notice of Filing Materials Under...

75 FR 43581 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing... the competitive product list. The Postal Service has also filed related contracts. This notice... Paragraphs I. Introduction The Postal Service seeks to add a new product, Global Plus 1A, to the competitive...

78 FR 56248 - Product Change-Parcel Select Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-12

... POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal... States Postal Service to Add Parcel Select Contract 7 to Competitive Product List. Documents are...

39 CFR Appendix A to Part 3002 - Postal Regulatory Commission, Mission Statement of the Office of the Consumer Advocate

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Postal Regulatory Commission, Mission Statement of the Office of the Consumer Advocate A Appendix A to Part 3002 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL ORGANIZATION Pt. 3002, App. A Appendix A to Part 3002—Postal Regulatory Commission, Mission Statement of the Office of the Consumer...

75 FR 65531 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2011-3 and CP2011-4; Order No. 556] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently... Postal Service contemporaneously filed a contract related to the proposed new product pursuant to 39 U.S...

75 FR 65532 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2011-2 and CP2011-3; Order No. 555] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently... Postal Service contemporaneously filed a contract related to the proposed new product pursuant to 39 U.S...

75 FR 67148 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-01

... POSTAL REGULATORY COMMISSION [Docket Nos. CP2011-5 Through CP2011-12; Order No. 557] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a.... at 4. The Postal Service concludes that its filings demonstrate that each of the new GEPS 3 contracts...

78 FR 39783 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-02

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2013-54 and CP2013-70; Order No. 1764] New Postal... recently-filed Postal Service request to add a new product to the competitive product list. This document...-54. The Postal Service contemporaneously filed a redacted contract related to the proposed new...

76 FR 592 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... POSTAL REGULATORY COMMISSION [Docket Nos. CP2011-55; Order No. 633] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal... demonstrate that the new GREP contract complies with the requirements of 39 U.S.C. 3633 and is functionally...

78 FR 67951 - Price Cap Rules for Certain Postal Rate Adjustments; Corrections

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... POSTAL REGULATORY COMMISSION 39 CFR Part 3010 [Docket No. RM2013-2; Order No. 1786] Price Cap Rules for Certain Postal Rate Adjustments; Corrections AGENCY: Postal Regulatory Commission. ACTION: Correcting amendments. SUMMARY: The Postal Regulatory Commission published a document in the Federal Register...

76 FR 47275 - Postal Service Initiative on Retail Postal Locations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... POSTAL REGULATORY COMMISSION [Docket No. N2011-1; Order No. 778] Postal Service Initiative on... noticing a recently-filed Postal Service request for an advisory opinion on an initiative involving... centrally directed Retail Access Optimization (RAO) initiative for examining the continuation of service at...

39 CFR 762.11 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of Postal Service obligations. Disbursement Postal Money Orders are distinguishable on their face... of negotiability—“Pay to the order of”—printed on their face, while other postal money orders simply bear the words “Pay to” on their face; (b) Disbursement Postal Money Orders, unlike other postal money...

39 CFR 762.11 - General.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of Postal Service obligations. Disbursement Postal Money Orders are distinguishable on their face... of negotiability—“Pay to the order of”—printed on their face, while other postal money orders simply bear the words “Pay to” on their face; (b) Disbursement Postal Money Orders, unlike other postal money...

39 CFR 762.11 - General.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of Postal Service obligations. Disbursement Postal Money Orders are distinguishable on their face... of negotiability—“Pay to the order of”—printed on their face, while other postal money orders simply bear the words “Pay to” on their face; (b) Disbursement Postal Money Orders, unlike other postal money...

39 CFR 762.11 - General.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of Postal Service obligations. Disbursement Postal Money Orders are distinguishable on their face... of negotiability—“Pay to the order of”—printed on their face, while other postal money orders simply bear the words “Pay to” on their face; (b) Disbursement Postal Money Orders, unlike other postal money...

39 CFR 762.11 - General.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of Postal Service obligations. Disbursement Postal Money Orders are distinguishable on their face... of negotiability—“Pay to the order of”—printed on their face, while other postal money orders simply bear the words “Pay to” on their face; (b) Disbursement Postal Money Orders, unlike other postal money...

77 FR 66193 - Product Change-Parcel Select Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-02

... POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal... Postal Service To Add Parcel Select Contract 6 to Competitive Product List. Documents are available at...

77 FR 42780 - Product Change-Parcel Select Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal... Postal Service to Add Parcel Select Contract 3 to Competitive Product List. Documents are available at...

77 FR 42780 - Product Change-Parcel Select Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal... Postal Service to Add Parcel Select Contract 4 to Competitive Product List. Documents are available at...

77 FR 42780 - Product Change-Parcel Select Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal... Postal Service to Add Parcel Select Contract 5 to Competitive Product List. Documents are available at...

39 CFR 761.2 - Authority of Reserve Banks.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Authority of Reserve Banks. 761.2 Section 761.2 Postal Service UNITED STATES POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.2 Authority of Reserve Banks. Each Reserve Bank is hereby authorized...

39 CFR 761.2 - Authority of Reserve Banks.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Authority of Reserve Banks. 761.2 Section 761.2 Postal Service UNITED STATES POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.2 Authority of Reserve Banks. Each Reserve Bank is hereby authorized...

76 FR 29013 - Change in Postal Prices

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

... POSTAL REGULATORY COMMISSION [Docket No. CP2009-61; Order No. 729] Change in Postal Prices AGENCY... Postal Service filed notice that prices under Parcel Select & Parcel Return Service Contract 2 filed in... approved by the Commission. Id. \\1\\ Notice of United States Postal Service of Change in Prices Pursuant to...

76 FR 12141 - New Postal Product and New Price Category

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-04

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2011-23 and CP2011-62; Order No. 683] New Postal Product and New Price Category AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The... competitive product list. The Postal Service also states that it has established a new price category under...

75 FR 17175 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-05

... POSTAL REGULATORY COMMISSION [Docket Nos. CP2010-33, CP2010-34 and CP2010-35; Order No. 431] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing... differences. Id. at 6. The Postal Service contends that its filings demonstrate that each of the new GEPS 2...

39 CFR 281.2 - Action required by processing postal officials.

Code of Federal Regulations, 2010 CFR

2010-07-01

... center director of customer services at the office of mailing. The notification should include, but not... 39 Postal Service 1 2010-07-01 2010-07-01 false Action required by processing postal officials. 281.2 Section 281.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION FIRM...

39 CFR 602.1 - General principles.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false General principles. 602.1 Section 602.1 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY... is the policy of the Postal Service to secure full ownership rights for its intellectual properties...

39 CFR 602.1 - General principles.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false General principles. 602.1 Section 602.1 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY... is the policy of the Postal Service to secure full ownership rights for its intellectual properties...

39 CFR 602.1 - General principles.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false General principles. 602.1 Section 602.1 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY... is the policy of the Postal Service to secure full ownership rights for its intellectual properties...

39 CFR 3.3 - Matters reserved for decision by the Board.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Postal Service's independent, certified public accounting firm. (d) Authorization of the Postal Service... an advisory opinion on a proposed change in the nature of postal services which will generally affect... Postal Service whose positions are included in Level II of the Postal Career Executive Service. (k...

39 CFR 10.1 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Applicability. 10.1 Section 10.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE RULES OF CONDUCT FOR POSTAL SERVICE GOVERNORS (ARTICLE X) § 10.1 Applicability. This part contains rules of conduct for the...

How should hearing screening tests be offered?

PubMed

Koopman, Jan; Davey, Elizabeth; Thomas, Neil; Wittkop, Thomas; Verschuure, Hans

2008-05-01

This paper deals with the question of how the general public should be addressed when offering hearing screening. Postal-based questionnaires in the United Kingdom, Germany, and The Netherlands were sent to users of hearing devices, those that are in the process of obtaining one, or those that have indicated that they have special interest in hearing. Results of the survey indicated that respondents were enthusiastic about the idea of being able to carry out hearing self-screening tests via the internet, telephone, or questionnaires. A questionnaire as a method to screen on hearing was generally preferred above using the internet, which was preferred over using the telephone for the test. About 27% of the respondents indicated to use exclusively one method. Most respondents indicated that either method provided would be of interest (41%), 17% indicated not to be interested in conducting screening tests using the internet.

Current Status of Nursing Informatics Education in Korea.

PubMed

Jeon, Eunjoo; Kim, Jeongeun; Park, Hyeoun-Ae; Lee, Ji-Hyun; Kim, Jungha; Jin, Meiling; Ahn, Shinae; Jun, Jooyeon; Song, Healim; On, Jeongah; Jung, Hyesil; Hong, Yeong Joo; Yim, Suran

2016-04-01

This study presents the current status of nursing informatics education, the content covered in nursing informatics courses, the faculty efficacy, and the barriers to and additional supports for teaching nursing informatics in Korea. A set of questionnaires consisting of an 18-item questionnaire for nursing informatics education, a 6-item questionnaire for faculty efficacy, and 2 open-ended questions for barriers and additional supports were sent to 204 nursing schools via email and the postal service. Nursing schools offering nursing informatics were further asked to send their syllabuses. The subjects taught were analyzed using nursing informatics competency categories and other responses were tailed using descriptive statistics. A total of 72 schools (35.3%) responded to the survey, of which 38 reported that they offered nursing informatics courses in their undergraduate nursing programs. Nursing informatics courses at 11 schools were taught by a professor with a degree majoring in nursing informatics. Computer technology was the most frequently taught subject (27 schools), followed by information systems used for practice (25 schools). The faculty efficacy was 3.76 ± 0.86 (out of 5). The most frequently reported barrier to teaching nursing informatics (n = 9) was lack of awareness of the importance of nursing informatics. Training and educational opportunities was the most requested additional support. Nursing informatics education has increased during the last decade in Korea. However, the proportions of faculty with degrees in nursing informatics and number of schools offering nursing informatics courses have not increased much. Thus, a greater focus is needed on training faculty and developing the courses.

Measuring client experiences in long-term care in the Netherlands: a pilot study with the Consumer Quality Index Long-term Care.

PubMed

Triemstra, Mattanja; Winters, Sjenny; Kool, Rudolf B; Wiegers, Therese A

2010-04-12

This study aims to describe the development, testing and optimization of a new standard instrument, the Consumer Quality Index (CQ-index) Long-term Care, for measuring client experiences with long-term care in the Netherlands. Three versions of the CQ-index questionnaires and protocols for study sampling and data collection were developed, designed for interviews with residents of nursing or residential care homes and postal surveys among representatives of psychogeriatric residents and homecare clients. From July to November 2006 a pilot study was conducted among 2,697 clients of 68 nursing or residential care homes, 2,164 representatives of clients in 57 psychogeriatric care institutions, and 1,462 clients of 19 homecare organizations. We performed psychometric analyses and descriptive analyses, and evaluated the pilot study. The pilot study showed the feasibility and usability of the instruments, supported the multidimensionality of the questionnaires and showed first findings on client experiences and possibilities for quality improvement. Nine scales applied to all care settings: shared decision making, attitude and courtesy, information, body care, competence and safety of care, activities, autonomy, mental well-being, and availability of personnel. The pilot resulted in three optimized questionnaires and recommendations for nationwide implementation. The CQ-index Long-term Care provides a good basis to investigate the quality of nursing homes, residential care homes and homecare from the clients' perspective. This standardized instrument enables a nationwide comparison of the quality of long-term care for the purpose of transparency and quality assurance.

The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS?

PubMed Central

Garratt, A M; Ruta, D A; Abdalla, M I; Buckingham, J K; Russell, I T

1993-01-01

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. PMID:8518640

Levels of satisfaction of 'low-risk' mothers with their current health visiting service.

PubMed

Bowns, I R; Crofts, D J; Williams, T S; Rigby, A S; Hall, D M; Haining, R P

2000-04-01

To assess the expressed levels of satisfaction of 'low-risk' mothers with the current health visiting service. Setting Sheffield, England, Autumn 1997. Self-completion, postal questionnaire (initial postcard reminder followed by a second letter and questionnaire) to a sample of 403 mothers assessed as 'low priority' by their health visitor. Questions largely related to maternal opinion of the adequacy of the health visiting service delivered during the first 9-12 months. The local research ethics committee approved the study. A corrected response rate of 75% with little evidence of significant bias. A high proportion (86%) of women stated that they were either 'fairly' or 'very' satisfied with the service they had received from their health visitor with regard to their baby. A lower proportion (72%) was equally satisfied with the service they had received in respect of their own health. Despite an average number of approximately 10 contacts in relation to infant health with the health visitor during the first year of life, some 6% of women wanted more frequent contacts, particularly in the first few weeks. Study limitations The questionnaire was designed specifically for the study and validation was limited. The study population comprised a selected, 'low-risk' group. The number of reported contacts with the health visitor seemed to greatly exceed those indicated by a basic child health surveillance programme. The overall level of maternal satisfaction is high, though a minority of women would like more support. Dissatisfaction was expressed with the lack of an appointment system for clinics, poor punctuality in home visits, and inappropriate or inadequate advice.

Current Status of Nursing Informatics Education in Korea

PubMed Central

Jeon, Eunjoo; Kim, Jeongeun; Lee, Ji-Hyun; Kim, Jungha; Jin, Meiling; Ahn, Shinae; Jun, Jooyeon; Song, Healim; On, Jeongah; Jung, Hyesil; Hong, Yeong Joo; Yim, Suran

2016-01-01

Objectives This study presents the current status of nursing informatics education, the content covered in nursing informatics courses, the faculty efficacy, and the barriers to and additional supports for teaching nursing informatics in Korea. Methods A set of questionnaires consisting of an 18-item questionnaire for nursing informatics education, a 6-item questionnaire for faculty efficacy, and 2 open-ended questions for barriers and additional supports were sent to 204 nursing schools via email and the postal service. Nursing schools offering nursing informatics were further asked to send their syllabuses. The subjects taught were analyzed using nursing informatics competency categories and other responses were tailed using descriptive statistics. Results A total of 72 schools (35.3%) responded to the survey, of which 38 reported that they offered nursing informatics courses in their undergraduate nursing programs. Nursing informatics courses at 11 schools were taught by a professor with a degree majoring in nursing informatics. Computer technology was the most frequently taught subject (27 schools), followed by information systems used for practice (25 schools). The faculty efficacy was 3.76 ± 0.86 (out of 5). The most frequently reported barrier to teaching nursing informatics (n = 9) was lack of awareness of the importance of nursing informatics. Training and educational opportunities was the most requested additional support. Conclusions Nursing informatics education has increased during the last decade in Korea. However, the proportions of faculty with degrees in nursing informatics and number of schools offering nursing informatics courses have not increased much. Thus, a greater focus is needed on training faculty and developing the courses. PMID:27200224

A 6-year review of the outcome of endometrial ablation.

PubMed

Tsaltas, J; Taylor, N; Healey, M

1998-02-01

In June, 1995 a postal questionnaire was distributed to all 232 women who had an endometrial ablation at Monash Medical Centre between July, 1989 and December, 1994. Data was analyzed from the 149 who responded. Length of follow-up ranged from 6 months to 6 years 6 months. Of these 78% were satisfied with their ablation and 84% found their menses to be lighter or to have stopped. The repeat ablation rate was 13% and the hysterectomy rate was 17%.

75 FR 3383 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-21

...] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Final rule. SUMMARY: The Commission.... Introduction The Postal Service seeks to add a new product identified as Express Mail [[Page 3384

39 CFR 762.25 - Reclamation of amounts of paid disbursement postal money orders.

Code of Federal Regulations, 2010 CFR

2010-07-01

... paid disbursement postal money orders. The Postal Service shall have the right to demand refund from the presenting bank of the amount of a paid Disbursement Postal Money Order if after payment the... another for a deceased payee where the right to the proceeds of such Disbursement Postal Money Orders...

39 CFR 3001.72 - Filing of formal requests.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Requests for Changes in the Nature of Postal Services § 3001.72 Filing of formal requests. Whenever the... in the nature of postal services subject to this subpart, the Postal Service shall file with the... Postal Service proposes to make effective the change in the nature of postal services involved. Within 5...

39 CFR 10.4 - Financial disclosure reports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Financial disclosure reports. 10.4 Section 10.4 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE RULES OF CONDUCT FOR POSTAL SERVICE GOVERNORS (ARTICLE X) § 10.4 Financial disclosure reports. (a) Requirement of...

39 CFR 10.2 - Advisory service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Advisory service. 10.2 Section 10.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE RULES OF CONDUCT FOR POSTAL SERVICE GOVERNORS (ARTICLE X) § 10.2 Advisory service. (a) The General Counsel is the Ethical...

39 CFR 10.3 - Post-employment activities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Post-employment activities. 10.3 Section 10.3 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE RULES OF CONDUCT FOR POSTAL SERVICE GOVERNORS (ARTICLE X) § 10.3 Post-employment activities. Governors are subject...

Scanning for satisfaction or digging for dismay? Comparing findings from a postal survey with those from a focus group-study.

PubMed

Carlsen, Benedicte; Glenton, Claire

2012-09-03

Despite growing support for mixed methods approaches we still have little systematic knowledge about the consequences of combining surveys and focus groups. While the methodological aspects of questionnaire surveys have been researched extensively, the characteristics of focus group methodology are understudied. We suggest and discuss whether the focus group setting, as compared to questionnaire surveys, encourages participants to exaggerate views in a negative direction. Based on an example from our own research, where we conducted a survey as a follow up of a focus group study, and with reference to theoretical approaches and empirical evidence from the literature concerning survey respondent behaviour and small group dynamics, we discuss the possibility that a discrepancy in findings between the focus groups and the questionnaire reflects characteristics of the two different research methods. In contrast to the survey, the focus group study indicated that doctors were generally negative to clinical guidelines. We were not convinced that this difference in results was due to methodological flaws in either of the studies, and discuss instead how this difference may have been the result of a general methodological phenomenon. Based on studies of how survey questionnaires influence responses, it appears reasonable to claim that surveys are more likely to find exaggerated positive views. Conversely, there are some indications in the literature that focus groups may result in complaints and overly negative attitudes, but this is still an open question. We suggest that while problematic issues tend to be under-communicated in questionnaire surveys, they may be overstated in focus groups.We argue for the importance of increasing our understanding of focus group methodology, for example by reporting interesting discrepancies in mixed methods studies. In addition, more experimental research on focus groups should be conducted to advance the methodology and to test our hypothesis.

Scanning for satisfaction or digging for dismay? Comparing findings from a postal survey with those from a focus group-study

PubMed Central

2012-01-01

Background Despite growing support for mixed methods approaches we still have little systematic knowledge about the consequences of combining surveys and focus groups. While the methodological aspects of questionnaire surveys have been researched extensively, the characteristics of focus group methodology are understudied. We suggest and discuss whether the focus group setting, as compared to questionnaire surveys, encourages participants to exaggerate views in a negative direction. Discussion Based on an example from our own research, where we conducted a survey as a follow up of a focus group study, and with reference to theoretical approaches and empirical evidence from the literature concerning survey respondent behaviour and small group dynamics, we discuss the possibility that a discrepancy in findings between the focus groups and the questionnaire reflects characteristics of the two different research methods. In contrast to the survey, the focus group study indicated that doctors were generally negative to clinical guidelines. We were not convinced that this difference in results was due to methodological flaws in either of the studies, and discuss instead how this difference may have been the result of a general methodological phenomenon. Summary Based on studies of how survey questionnaires influence responses, it appears reasonable to claim that surveys are more likely to find exaggerated positive views. Conversely, there are some indications in the literature that focus groups may result in complaints and overly negative attitudes, but this is still an open question. We suggest that while problematic issues tend to be under-communicated in questionnaire surveys, they may be overstated in focus groups. We argue for the importance of increasing our understanding of focus group methodology, for example by reporting interesting discrepancies in mixed methods studies. In addition, more experimental research on focus groups should be conducted to advance the methodology and to test our hypothesis. PMID:22943658

Supporting staff in employment: the emotional wellbeing of staff in an NHS psychiatric hospital.

PubMed

Patterson, I D; Bell, J S

2000-09-01

The objective of this study was to assess the emotional wellbeing of a broad sample of NHS employees in a psychiatric setting; to seek their views on sources of distress; and to identify preferred ways of dealing with it. A cross-sectional postal survey, employing two questionnaires: GHQ-28, and a semi-structured questionnaire. These were sent to a nominal 50% sample (n = 599). The population was the staff of a large Scottish psychiatric service. A 47.9% response rate was achieved; 32.9% of respondents exceeded a cut-off score of four on the GHQ-28. Neither occupational, group nor gender effects were significant on this measure. The reporting of emotionally-distressing problems affecting their performance was found to be more common amongst doctors; males, overall, showed a non-significant trend towards having been affected more than females by such problems; and older staff (above 45) were affected significantly more often than younger staff. Almost a third of staff were unaware of the availability of an internal organisational resource (the Occupational Health service). NHS Trusts should ensure the culture at work is appropriate from a preventative point of view and be aware that factors outwith the workplace can affect employees emotional wellbeing and performance. Preventative and supportive measures to minimise psychological distress in the workforce should be considered; the Scottish Needs Assessment Programme: Mental Health in the Workplace offers useful guidance.

Medium-term and long-term outcomes of interventions for primary psoas tendinopathy.

PubMed

Garala, Kanai; Prasad, Vishnu; Jeyapalan, Kanagaratnam; Power, Richard A

2014-05-01

To assess medium- and long-term outcomes of psoas tendinopathy to psoas tenotomy and image-guided steroid injections. This is a 14-year retrospective case-control study to identify the efficacy of psoas tenotomy and image-guided steroid injections. This study was undertaken in a secondary care setting. Patients with confirmed psoas tendinopathy were followed up by postal questionnaire, which included a nonarthritic hip score (NAHS) and a study patient satisfaction questionnaire. Patients underwent image-guided steroid injections. Depending on the analgesic or symptomatic relief, some patients proceeded to psoas tenotomy. Response to steroid injection. Pain relief and symptomatic relief after the surgery. Twenty-three patients were reviewed with a 70% follow-up over a time of 49 months for surgery (range, 13-144 months) and 77 months for injection (range, 14-160 months). Eight patients had a lasting response to injection and required no further intervention, and 15 patients proceeded to psoas tenotomy using a medial Ludloff approach. The average NAHS scores after the surgery and injection were 66.15 and 76.08, respectively. Ten patients reported pain relief after their tenotomy, and 5 patients reported no change in pain. All 8 patients, who only underwent injection, reported lasting pain relief. Local steroid injections can provide long-term relief for patients presenting with psoas tendinopathy. For those patients with only temporary relief from injection, psoas tenotomy can provide good long-term pain relief.

39 CFR 2.2 - Agent for receipt of process.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Agent for receipt of process. 2.2 Section 2.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE GENERAL AND TECHNICAL PROVISIONS (ARTICLE II) § 2.2 Agent for receipt of process. The General Counsel of the Postal...

39 CFR 2.2 - Agent for receipt of process.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Agent for receipt of process. 2.2 Section 2.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE GENERAL AND TECHNICAL PROVISIONS (ARTICLE II) § 2.2 Agent for receipt of process. The General Counsel of the Postal...

39 CFR 2.2 - Agent for receipt of process.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Agent for receipt of process. 2.2 Section 2.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE GENERAL AND TECHNICAL PROVISIONS (ARTICLE II) § 2.2 Agent for receipt of process. The General Counsel of the Postal...

39 CFR 2.2 - Agent for receipt of process.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Agent for receipt of process. 2.2 Section 2.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE GENERAL AND TECHNICAL PROVISIONS (ARTICLE II) § 2.2 Agent for receipt of process. The General Counsel of the Postal...

39 CFR 2.2 - Agent for receipt of process.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Agent for receipt of process. 2.2 Section 2.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE GENERAL AND TECHNICAL PROVISIONS (ARTICLE II) § 2.2 Agent for receipt of process. The General Counsel of the Postal...

39 CFR 3050.20 - Compliance and other analyses in the Postal Service's section 3652 report.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PERSONNEL PERIODIC REPORTING § 3050.20 Compliance and other analyses in the Postal Service's section 3652 report. (a) The Postal Service's section 3652 report shall include an analysis of the information that it... 39 Postal Service 1 2014-07-01 2014-07-01 false Compliance and other analyses in the Postal...

39 CFR 3050.20 - Compliance and other analyses in the Postal Service's section 3652 report.

Code of Federal Regulations, 2012 CFR

2012-07-01

... PERSONNEL PERIODIC REPORTING § 3050.20 Compliance and other analyses in the Postal Service's section 3652 report. (a) The Postal Service's section 3652 report shall include an analysis of the information that it... 39 Postal Service 1 2012-07-01 2012-07-01 false Compliance and other analyses in the Postal...

Paediatric conscious sedation: views and experience of specialists in paediatric dentistry.

PubMed

Woolley, S M; Hingston, E J; Shah, J; Chadwick, B L

2009-09-26

The objectives were three-fold: to investigate the level of conscious sedation training received prior to and during specialist training in paediatric dentistry; to establish the use of conscious sedation during and following specialisation; and to determine the attitudes of specialists in paediatric dentistry to conscious sedation. A self-administered postal questionnaire was sent to all specialists in paediatric dentistry registered with the General Dental Council in January 2008. Non-responders were contacted again after a four-week period. A response rate of 60% was achieved. Of the 122 respondents, 67 (55%) had received sedation training as an undergraduate; 89 (75%) had been trained during specialisation. All respondents performed dental treatment under sedation as a trainee and the majority used nitrous oxide inhalation sedation (NOIS). Over 90% of respondents felt that NOIS should be available to all children, both in appropriate primary care settings and in hospitals. One hundred and twenty-one (99%) respondents thought that all trainees in paediatric dentistry should have sedation training. The most popular form of sedation amongst specialists in paediatric dentistry was NOIS. However, some of the respondents felt that children should have access to other forms of sedation in both the primary care and hospital settings. Additional research on other forms of sedation is required to evaluate their effectiveness and safety.

75 FR 70754 - Postal Classification Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-18

... POSTAL REGULATORY COMMISSION [Docket No. MC2011-5; Order No. 583] Postal Classification Changes...-filed Postal Service request announcing a classification change affecting bundle and container charges... Commission announcing a classification change [[Page 70755

Prevalence of Barriers and Facilitators to Enhancing Conservative Kidney Management for Older Adults in the Primary Care Setting

PubMed Central

Tam-Tham, Helen; King-Shier, Kathryn M.; Thomas, Chandra M.; Quinn, Robert R.; Fruetel, Karen; Davison, Sara N.

2016-01-01

Background and objectives Conservative management of adults with stage 5 CKD (eGFR<15 ml/min per 1.73 m2) is increasingly being provided in the primary care setting. We aimed to examine perceived barriers and facilitators for conservative management of older adults by primary care physicians. Design, setting, participants, & measurements In 2015, we conducted a cross–sectional, population–based survey of all primary care physicians in Alberta, Canada. Eligible participants had experience caring for adults ages ≥75 years old with stage 5 CKD not planning on initiating dialysis. Questionnaire items were on the basis of a qualitative descriptive study informed by the Behavior Change Wheel and tested for face and content validity. Physicians were contacted via postal mail and/or fax on the basis of a modified Dillman method. Results Four hundred nine eligible primary care physicians completed the questionnaire (9.6% response rate). The majority of respondents were men (61.6%), were ages 40–60 years old (62.6%), and practiced in a large/medium population center (68.0%). The most common barrier to providing conservative care in the primary care setting was the inability to access support to maintain patients in the home setting (39.1% of respondents; 95% confidence interval, 34.6% to 43.6%). The second most common barrier was working with nonphysician providers with limited kidney–specific clinical expertise (32.3%; 95% confidence interval, 28.0% to 36.7%). Primary care physicians indicated that the two most common strategies that would enhance their ability to provide conservative management would be the ability to use the telephone to contact a nephrologist or clinical staff from the conservative care clinic (86.9%; 95% confidence interval, 83.7% to 90.0% and 85.6%; 95% confidence interval, 82.4% to 88.9%, respectively). Conclusions We identified important areas to inform clinical programs to reduce barriers and enhance facilitators to improve primary care physicians’ provision of conservative kidney care. In particular, primary care physicians require additional resources for maintaining patients in their home and telephone access to nephrologists and conservative care specialists. PMID:27551007

39 CFR 3001.74 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-07-01

... witness. (f) Limitations on presentation of the evidence. The taking of evidence shall proceed with all... the policies established under the Act. Detailed data and information and statements of reasons or basis set forth in the Postal Service's prepared direct evidence may be relied upon for purposes of the...

Intelligent Classification in Huge Heterogeneous Data Sets

DTIC Science & Technology

2015-06-01

Competencies DoD Department of Defense GMTI Ground Moving Target Indicator ISR Intelligence, Surveillance and Reconnaissance NCD Noncoherent Change...Detection OCR Optical Character Recognition PCA Principal Component Analysis SAR Synthetic Aperture Radar SVD Singular Value Decomponsition USPS United States Postal Service 8 Approved for Public Release; Distribution Unlimited.

A cross-sectional evaluation of community pharmacists' perceptions of intermediate care and medicines management across the healthcare interface.

PubMed

Millar, Anna; Hughes, Carmel; Devlin, Maria; Ryan, Cristín

2016-12-01

Background Despite the importance placed on the concept of the multidisciplinary team in relation to intermediate care (IC), little is known about community pharmacists' (CPs) involvement. Objective To determine CPs' awareness of and involvement with IC services, perceptions of the transfer of patients' medication information between healthcare settings and views of the development of a CP-IC service. Setting Community pharmacies in Northern Ireland. Methods A postal questionnaire, informed by previous qualitative work was developed and piloted. Main outcome measure CPs' awareness of and involvement with IC. Results The response rate was 35.3 % (190/539). Under half (47.4 %) of CPs 'agreed/strongly agreed' that they understood the term 'intermediate care'. Three quarters of respondents were either not involved or unsure if they were involved with providing services to IC. A small minority (1.2 %) of CPs reported that they received communication regarding medication changes made in hospital or IC settings 'all of the time'. Only 9.5 and 0.5 % of respondents 'strongly agreed' that communication from hospital and IC, respectively, was sufficiently detailed. In total, 155 (81.6 %) CPs indicated that they would like to have greater involvement with IC services. 'Current workload' was ranked as the most important barrier to service development. Conclusion It was revealed that CPs had little awareness of, or involvement with, IC. Communication of information relating to patients' medicines between settings was perceived as insufficient, especially between IC and community pharmacy settings. CPs demonstrated willingness to be involved with IC and services aimed at bridging the communication gap between healthcare settings.

Falls risk among a very old home-dwelling population

PubMed Central

Iinattiniemi, Sari; Jokelainen, Jari; Luukinen, Heikki

2009-01-01

Objective The aim of this prospective study was to examine risk factors of falling in a very old home-dwelling population. Design A prospective study of home-dwelling elderly people. Methods Baseline data were collected by home-nursing staff through postal questionnaires and clinical tests. Data on falls were recorded in telephone interviews every other month during a follow-up of 11 months constituting 494 person years (PY). Negative binomial modeling was used to assess fall risk. Setting General community. Subjects A population sample of home-dwelling subjects aged 85 years or older (n = 555). Main outcome measures Fall rate and risk factors of falls. Results Altogether 512 falls occurred in 273 (49%) subjects, incidence rate 1.03/PY. According to a multivariate model, history of recurrent falling, trouble with vision when moving, use of antipsychotic drug, and feelings of anxiety, nervousness, or fear were independent risk factors for subsequent falls. Conclusion Appropriate care of poor vision and feelings of anxiety, nervousness, or fear, and avoidance of use of antipsychotic drugs might be useful in the prevention of falls among the most elderly home-dwellers. PMID:19065453

Safeguarding children in dentistry: 1. Child protection training, experience and practice of dental professionals with an interest in paediatric dentistry.

PubMed

Harris, J C; Elcock, C; Sidebotham, P D; Welbury, R R

2009-04-25

Following several highly publicised inquiries into the deaths of children from abuse and neglect, there has been much recent interest in the role and responsibility of all health professionals to protect children at risk of maltreatment. The findings of a postal questionnaire, sent in March 2005 to 789 dentists and dental care professionals with an interest in paediatric dentistry working in varied settings in the UK, are presented in a two-part report and discussed in the context of current multi-agency good practice in safeguarding and promoting the welfare of children. This first part explores reported child protection training, experience and practice. There was a significant gap between recognising signs of abuse and responding effectively: 67% of respondents had suspected abuse or neglect of a child patient at some time in their career but only 29% had ever made a child protection referral. The dental profession is alerted to the need to ensure necessary appropriate action to safeguard children is always taken when child abuse or neglect are suspected.

Application of a radiophotoluminescent glass dosimeter to nonreference condition dosimetry in the postal dose audit system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mizuno, Hideyuki, E-mail: h-mizuno@nirs.go.jp; Fukumura, Akifumi; Fukahori, Mai

Purpose: The purpose of this study was to obtain a set of correction factors of the radiophotoluminescent glass dosimeter (RGD) output for field size changes and wedge insertions. Methods: Several linear accelerators were used for irradiation of the RGDs. The field sizes were changed from 5 × 5 cm to 25 × 25 cm for 4, 6, 10, and 15 MV x-ray beams. The wedge angles were 15°, 30°, 45°, and 60°. In addition to physical wedge irradiation, nonphysical (dynamic/virtual) wedge irradiations were performed. Results: The obtained data were fitted with a single line for each energy, and correction factorsmore » were determined. Compared with ionization chamber outputs, the RGD outputs gradually increased with increasing field size, because of the higher RGD response to scattered low-energy photons. The output increase was about 1% per 10 cm increase in field size, with a slight difference dependent on the beam energy. For both physical and nonphysical wedged beam irradiation, there were no systematic trends in the RGD outputs, such as monotonic increase or decrease depending on the wedge angle change if the authors consider the uncertainty, which is approximately 0.6% for each set of measured points. Therefore, no correction factor was needed for all inserted wedges. Based on this work, postal dose audits using RGDs for the nonreference condition were initiated in 2010. The postal dose audit results between 2010 and 2012 were analyzed. The mean difference between the measured and stated doses was within 0.5% for all fields with field sizes between 5 × 5 cm and 25 × 25 cm and with wedge angles from 15° to 60°. The standard deviations (SDs) of the difference distribution were within the estimated uncertainty (1SD) except for the 25 × 25 cm field size data, which were not reliable because of poor statistics (n = 16). Conclusions: A set of RGD output correction factors was determined for field size changes and wedge insertions. The results obtained from recent postal dose audits were analyzed, and the mean differences between the measured and stated doses were within 0.5% for every field size and wedge angle. The SDs of the distribution were within the estimated uncertainty, except for one condition that was not reliable because of poor statistics.« less

"Do I really want to do this?" Longitudinal cohort study participants' perspectives on postal survey design: a qualitative study

PubMed Central

2011-01-01

Background Randomised controlled trials have investigated aspects of postal survey design yet cannot elaborate on reasons behind participants' decision making and survey behaviour. This paper reports participants' perspectives of the design of, and participation in, a longitudinal postal cohort survey. It describes strengths and weaknesses in study design from the perspectives of study participants and aims to contribute to the: 1) design of future cohort surveys and questionnaires generally and, 2) design of cohort surveys for people with musculoskeletal disorders (MSDs) specifically. Methods In-depth interviews explored the design of postal surveys previously completed by participants. Interviews used open ended questioning with a topic guide for prompts if areas of interest were not covered spontaneously. Thematic data analysis was undertaken based on the framework method. A second researcher verified all coding. Results Data from fourteen interviews were analysed within three main themes; participation, survey design and survey content. One of the main findings was the importance of clear communication aimed at the correct audience both when inviting potential participants to take part and within the survey itself. Providing enough information about the study, having a topic of interest and an explanation of likely benefits of the study were important when inviting people to participate. The neutrality of the survey and origination from a reputable source were both important; as was an explanation about why information was being collected within the survey itself. Study findings included participants' impressions when invited to take part, why they participated, the acceptability of follow-up of non-responders and why participants completed the follow-up postal survey. Also discussed were participants' first impression of the survey, its length, presentation and participants' views about specific questions within the survey. Conclusions Ideas generated in this study provide an insight into participants' decision making and survey behaviour and may enhance the acceptability of future surveys to potential participants. As well as clear communication, participants valued incentives and survey questions that were relevant to them. However, opinions varied as to the preferred format for responses with some advising more opportunity for open-ended feedback. We also found that some standard format questions can raise quandaries for individual participants. PMID:21269515

Internet-based treatment of stress urinary incontinence: a randomised controlled study with focus on pelvic floor muscle training

PubMed Central

Sjöström, Malin; Umefjord, Göran; Stenlund, Hans; Carlbring, Per; Andersson, Gerhard; Samuelsson, Eva

2013-01-01

What’s known on the subject? and What does the study add? Stress urinary incontinence (SUI) affects 10–35% of women, and it is sometimes very distressful. Pelvic floor exercises are the first line of treatment, but access barriers or embarrassment may prevent women from seeking help. There is a need for new, simple, and effective ways to deliver treatment. Management of SUI without face-to-face contact is possible, and Internet-based treatment is a new, promising treatment alternative. Objective To compare two treatment programmes for stress urinary incontinence (SUI) without face-to-face contact: one Internet-based and one sent by post. Patients and Methods Randomised, controlled trial conducted in Sweden 2009–2011. Computer-generated block-randomisation, allocation by independent administrator. No ‘blinding’. The study included 250 community-dwelling women aged 18–70 years, with SUI ≥1 time/week. Consecutive online recruitment. The women had 3 months of either; (i) An Internet-based treatment programme (124 women), including e-mail support and cognitive behavioural therapy assignments or (ii) A treatment programme sent by post (126). Both programmes focused mainly on pelvic floor muscle training. Primary outcomes: symptom-score (International Consultation on Incontinence Questionnaire Short Form, ICIQ-UI SF) and condition-specific quality of life (ICIQ-Lower Urinary Tract Symptoms Quality of Life, ICIQ-LUTSQoL). Secondary outcomes: (i) Patient Global Impression of Improvement, (ii) Incontinence aids, (iii) Patient satisfaction, (iv) Health-specific QoL (EQ5D-Visual Analogue Scale), and (v) Incontinence episode frequency. Follow-up after 4 months via self-assessed postal questionnaires. Results In all, 12% (30 women) were lost to follow-up. Intention-to-treat analysis showed highly significant improvements (P < 0.001) with large effect sizes (>0.8) with both interventions, but there were no significant differences between groups in primary outcomes. The mean (sd) changes in symptom-score were: Internet 3.4 (3.4), Postal 2.9 (3.1) (P = 0.27). The mean (sd) changes in condition-specific QoL were: Internet 4.8 (6.1), Postal 4.6 (6.7) (P = 0.52). Compared with the postal-group, more participants in the Internet-group perceived they were much or very much improved (40.9% (43/105) vs 26.5% (30/113), P = 0.01), reported reduced usage of incontinence aids (59.5% (47/79) vs 41.4% (34/82), P = 0.02) and were satisfied with the treatment programme (84.8% (89/105) vs 62.9% (71/113), P < 0.001). Health-specific QoL improved in the Internet-group (mean change 3.7 (10.9), P = 0.001), but not in the postal-group (1.9 (13.0), P = 0.13). Overall, 69.8% (120/172) of participants reported complete lack of leakage or reduced number of leakage episodes by >50%. Conclusions Concerning primary outcomes, treatment effects were similar between groups whereas for secondary outcomes the Internet-based treatment was more effective. Internet-based treatment for SUI is a new, promising treatment alternative. PMID:23350826

Internet-based treatment of stress urinary incontinence: a randomised controlled study with focus on pelvic floor muscle training.

PubMed

Sjöström, Malin; Umefjord, Göran; Stenlund, Hans; Carlbring, Per; Andersson, Gerhard; Samuelsson, Eva

2013-08-01

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Stress urinary incontinence (SUI) affects 10-35% of women, and it is sometimes very distressful. Pelvic floor exercises are the first line of treatment, but access barriers or embarrassment may prevent women from seeking help. There is a need for new, simple, and effective ways to deliver treatment. Management of SUI without face-to-face contact is possible, and Internet-based treatment is a new, promising treatment alternative. To compare two treatment programmes for stress urinary incontinence (SUI) without face-to-face contact: one Internet-based and one sent by post. Randomised, controlled trial conducted in Sweden 2009-2011. Computer-generated block-randomisation, allocation by independent administrator. No 'blinding'. The study included 250 community-dwelling women aged 18-70 years, with SUI ≥1 time/week. Consecutive online recruitment. The women had 3 months of either; (i) An Internet-based treatment programme (124 women), including e-mail support and cognitive behavioural therapy assignments or (ii) A treatment programme sent by post (126). Both programmes focused mainly on pelvic floor muscle training. symptom-score (International Consultation on Incontinence Questionnaire Short Form, ICIQ-UI SF) and condition-specific quality of life (ICIQ-Lower Urinary Tract Symptoms Quality of Life, ICIQ-LUTSQoL). (i) Patient Global Impression of Improvement, (ii) Incontinence aids, (iii) Patient satisfaction, (iv) Health-specific QoL (EQ5D-Visual Analogue Scale), and (v) Incontinence episode frequency. Follow-up after 4 months via self-assessed postal questionnaires. In all, 12% (30 women) were lost to follow-up. Intention-to-treat analysis showed highly significant improvements (P < 0.001) with large effect sizes (>0.8) with both interventions, but there were no significant differences between groups in primary outcomes. The mean (sd) changes in symptom-score were: Internet 3.4 (3.4), Postal 2.9 (3.1) (P = 0.27). The mean (sd) changes in condition-specific QoL were: Internet 4.8 (6.1), Postal 4.6 (6.7) (P = 0.52). Compared with the postal-group, more participants in the Internet-group perceived they were much or very much improved (40.9% (43/105) vs 26.5% (30/113), P = 0.01), reported reduced usage of incontinence aids (59.5% (47/79) vs 41.4% (34/82), P = 0.02) and were satisfied with the treatment programme (84.8% (89/105) vs 62.9% (71/113), P < 0.001). Health-specific QoL improved in the Internet-group (mean change 3.7 (10.9), P = 0.001), but not in the postal-group (1.9 (13.0), P = 0.13). Overall, 69.8% (120/172) of participants reported complete lack of leakage or reduced number of leakage episodes by >50%. Concerning primary outcomes, treatment effects were similar between groups whereas for secondary outcomes the Internet-based treatment was more effective. Internet-based treatment for SUI is a new, promising treatment alternative. © 2013 BJU International.

39 CFR 601.106 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false [Reserved] 601.106 Section 601.106 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.106 [Reserved] ...

39 CFR 601.106 - [Reserved

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false [Reserved] 601.106 Section 601.106 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.106 [Reserved] ...

75 FR 1280 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-11

...] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Final rule. SUMMARY: The Commission... competitive products is also consistent with new requirements in the law. DATES: Effective January 11, 2010... V. Ordering Paragraphs I. Introduction The Postal Service seeks to add a new product identified as...

77 FR 4376 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-27

... Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request to add Priority Mail Contract 38 to the competitive product list... 38 to the competitive product list.\\1\\ Priority mail contracts enable the Postal Service to provide...

77 FR 67839 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-14

... Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing concerning the addition of Priority Mail Contract 48 to the competitive product... Mail Contract 48 to the competitive product list.\\1\\ The Postal Service indicates that the instant...

76 FR 40285 - Energy Conservation Program for Consumer Products and Certain Commercial and Industrial Equipment...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-08

..., data, and information regarding the proposed determination for set-top boxes and network equipment... encryption. Postal Mail: Ms. Brenda Edwards, U.S. Department of Energy, Building Technologies Program... Energy, Building Technologies Program, 950 L'Enfant Plaza, SW., 6th Floor, Washington, DC 20024. Please...

76 FR 61052 - Service Standards for Market-Dominant Special Services Products

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-03

... POSTAL SERVICE 39 CFR Part 122 Service Standards for Market-Dominant Special Services Products... products set forth in our regulations. DATES: Effective date: November 2, 2011. FOR FURTHER INFORMATION... Service to establish modern service standards for its market-dominant products within a year of the law's...

39 CFR 959.26 - Motion for reconsideration.

Code of Federal Regulations, 2012 CFR

2012-07-01

... clearly setting forth the points of fact and of law relied upon in support of said motion. ... 39 Postal Service 1 2012-07-01 2012-07-01 false Motion for reconsideration. 959.26 Section 959.26... PRIVATE EXPRESS STATUTES § 959.26 Motion for reconsideration. A party may file a motion for...

39 CFR 959.26 - Motion for reconsideration.

Code of Federal Regulations, 2014 CFR

2014-07-01

... clearly setting forth the points of fact and of law relied upon in support of said motion. ... 39 Postal Service 1 2014-07-01 2014-07-01 false Motion for reconsideration. 959.26 Section 959.26... PRIVATE EXPRESS STATUTES § 959.26 Motion for reconsideration. A party may file a motion for...

39 CFR 959.26 - Motion for reconsideration.

Code of Federal Regulations, 2013 CFR

2013-07-01

... clearly setting forth the points of fact and of law relied upon in support of said motion. ... 39 Postal Service 1 2013-07-01 2013-07-01 false Motion for reconsideration. 959.26 Section 959.26... PRIVATE EXPRESS STATUTES § 959.26 Motion for reconsideration. A party may file a motion for...

39 CFR 959.26 - Motion for reconsideration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... clearly setting forth the points of fact and of law relied upon in support of said motion. ... 39 Postal Service 1 2011-07-01 2011-07-01 false Motion for reconsideration. 959.26 Section 959.26... PRIVATE EXPRESS STATUTES § 959.26 Motion for reconsideration. A party may file a motion for...

39 CFR 959.26 - Motion for reconsideration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... clearly setting forth the points of fact and of law relied upon in support of said motion. ... 39 Postal Service 1 2010-07-01 2010-07-01 false Motion for reconsideration. 959.26 Section 959.26... PRIVATE EXPRESS STATUTES § 959.26 Motion for reconsideration. A party may file a motion for...

78 FR 16213 - Refunds and Exchanges

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-14

... POSTAL SERVICE 39 CFR Part 111 Refunds and Exchanges AGENCY: Postal Service TM . ACTION: Proposed rule. SUMMARY: The Postal Service TM proposes to revise Mailing Standards of the United States Postal Service, Domestic Mail Manual (DMM[supreg]) 604.9, and other DMM sections, to remove obsolete standards...

39 CFR 265.4 - Inquiries.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Inquiries. 265.4 Section 265.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.4 Inquiries. Inquiries regarding the availability of Postal Service records should be directed to the appropriate records...

39 CFR 265.4 - Inquiries.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Inquiries. 265.4 Section 265.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.4 Inquiries. Inquiries regarding the availability of Postal Service records should be directed to the appropriate records...

39 CFR 265.4 - Inquiries.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Inquiries. 265.4 Section 265.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.4 Inquiries. Inquiries regarding the availability of Postal Service records should be directed to the appropriate records...

39 CFR 265.4 - Inquiries.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Inquiries. 265.4 Section 265.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.4 Inquiries. Inquiries regarding the availability of Postal Service records should be directed to the appropriate records...

39 CFR 265.4 - Inquiries.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Inquiries. 265.4 Section 265.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.4 Inquiries. Inquiries regarding the availability of Postal Service records should be directed to the appropriate records...

78 FR 63519 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-24

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2014-1 and CP2014-1; Order No. 1849] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... contemporaneously filed a redacted contract related to the proposed new product. Id. Attachment B. The instant...

75 FR 57303 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-20

... POSTAL REGULATORY COMMISSION [Docket Nos. CP2010-105 through CP2010-115; Order No. 535] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... concludes that its filings demonstrate that each of the new GEPS 3 contracts complies with the requirements...

39 CFR 255.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Purpose. 255.1 Section 255.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION ACCESS OF PERSONS WITH DISABILITIES TO POSTAL SERVICE PROGRAMS, ACTIVITIES, FACILITIES, AND ELECTRONIC AND INFORMATION TECHNOLOGY § 255.1 Purpose. (a...

75 FR 40853 - Postal Rate Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-14

... POSTAL REGULATORY COMMISSION [Order No. 485; Docket No. R2010-4] Postal Rate Changes AGENCY... implementing rate changes for market dominant postal products, which include First- Class Mail, was adopted. In general, the new approach envisions annual rate adjustments based on changes in a specified Consumer Price...

39 CFR 776.4 - Scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Scope. 776.4 Section 776.4 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Floodplain Management § 776.4 Scope. (a) The regulations in this subpart are applicable to the following proposed postal...

76 FR 22739 - Postal Service Market Test

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-22

... POSTAL REGULATORY COMMISSION [Docket No. MT2011-4; Order No. 717] Postal Service Market Test...-filed Postal Service proposal to conduct a limited market test involving a postage-refund guarantee for certain senders of First-Class Mail and Standard Mail. This document describes the proposed test...

77 FR 65023 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-24

... follows: Attachment A--a redacted copy of Governors' Decision No. 11-6, authorizing the new product... POSTAL REGULATORY COMMISSION [Docket Nos. CP2013-4 and MC2013-4; Order No. 1504] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a...

39 CFR 262.1 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Purpose and scope. 262.1 Section 262.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT... information management terms that are frequently used throughout Postal Service regulations and directives. ...

78 FR 52223 - Change in Postal Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

... POSTAL REGULATORY COMMISSION [Docket No. CP2013-77; Order No. 1812] Change in Postal Rates AGENCY... Service filing concerning the Postal Service's intention to change rates for Inbound International... intention to change rates for Inbound International Expedited Services 2, effective January 1, 2014.\\1\\ The...

75 FR 44819 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-29

... Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service filing to add Priority Mail Contract 27 to the competitive product list. The... to add Priority Mail Contract 27 to the competitive product list.\\1\\ The Postal Service asserts that...

78 FR 37851 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... POSTAL REGULATORY COMMISSION [Docket No. CP2013-68; Order No. 1750] New Postal Product AGENCY... filing concerning the addition of Global Expedited Package Services 3 Contract to the competitive product... GEPS 3 product. Notice at 2. \\1\\ Notice of United States Postal Service of Filing a Functionally...

Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey

PubMed Central

Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

2015-01-01

Objective To investigate the experience of users of out of hours general practitioner services in England, UK. Design Population based cross sectional postal questionnaire survey. Setting General Practice Patient Survey 2012-13. Main outcome measures Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial) and service users’ experience of out of hours care (timeliness, confidence and trust in the out of hours clinician, and overall experience of the service), rated on a scale of 0-100. Which sociodemographic/provider characteristics were associated with service users’ experience, the extent to which any observed differences could be because of clustering of service users of a particular sociodemographic group within poorer scoring providers, and the extent to which observed differences in experience varied across types of provider. Results The overall response rate was 35%; 971 232/2 750 000 patients returned surveys. Data from 902 170 individual service users were mapped through their registered practice to one of 86 providers of out of hours GP care with known organisation type. Commercial providers of out of hours GP care were associated with poorer reports of overall experience of care, with a mean difference of −3.13 (95% confidence interval −4.96 to −1.30) compared with not for profit providers. Asian service users reported lower scores for all three experience outcomes than white service users (mean difference for overall experience of care −3.62, −4.36 to −2.89), as did service users who were unable to take time away from work compared with service users who did not work (mean difference for overall experience of care −4.73, −5.29 to −4.17). Conclusions Commercial providers of out of hours GP care were associated with poorer experience of care. Targeted interventions aimed at improving experience for patients from ethnic minorities and patients who are unable to take time away from work might be warranted. PMID:25926616

The Oxford Participation and Activities Questionnaire: study protocol.

PubMed

Morley, David; Dummett, Sarah; Kelly, Laura; Dawson, Jill; Fitzpatrick, Ray; Jenkinson, Crispin

2013-01-01

With an ageing population and increasing demands on health and social care services, there is growing importance attached to the management of long-term conditions, including maximizing the cost-effectiveness of treatments. In line with this, there is increasing emphasis on the need to keep people both active and participating in daily life. Consequently, it is essential that well developed and validated instruments that can meaningfully assess levels of participation and activity are widely available. Current measures, however, are largely focused on disability and rehabilitation, and there is no measure of activity or participation for generic use that fully meets the standards set by regulatory bodies such as the US Food and Drug Administration. Here we detail a protocol for the development and validation of a new patient-reported outcome measure (PROM) for assessment of participation and activity in people experiencing a variety of health conditions, ie, the Oxford Participation and Activities Questionnaire (Ox-PAQ). The stages incorporated in its development are entirely in line with current regulations and represent best practice in the development of PROMs. Development of the Ox-PAQ is theoretically grounded in the World Health Organization International Classification of Functioning, Disability, and Health. The project incorporates a new strategy of engaging with stakeholders from the outset in an attempt to identify those characteristics of PROMs considered most important to a range of potential users. Items will be generated through interviews with patients from a range of conditions. Pretesting of the instrument will be via cognitive interviews and focus groups. A postal survey will be conducted, with data subject to factor and Rasch analysis in order to identify appropriate dimensions and redundant items. Reliability will be assessed by Cronbach's alpha and item-total correlations. A second, large-scale postal survey will follow, with the Ox-PAQ being administered in conjunction with generic measures of health status to further test the validity of the measure. The Ox-PAQ will again be administered at 2 weeks to assess test-retest reliability and at 3 months to assess responsiveness. The development of the Ox-PAQ is a timely one. With increasing emphasis being placed on the importance of keeping people active and participating in daily life, the instrument has the potential for significant uptake. Its primary use is intended to be in clinical trials and for evaluation of interventions targeted at maintaining activity and participation.

39 CFR 957.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Definitions. 957.3 Section 957.3 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO DEBARMENT AND... purchasing authority in the Postal Service or the Vice President's representative for the purpose of carrying...

77 FR 25596 - Inspection Service Authority; Seizure and Forfeiture

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-01

... POSTAL SERVICE 39 CFR Part 233 Inspection Service Authority; Seizure and Forfeiture AGENCY: Postal Service TM . ACTION: Final rule. SUMMARY: The Postal Service is revising its regulations with regard to... FURTHER INFORMATION CONTACT: R. Emmett Mattes III, Chief Counsel, U.S. Postal Inspection Service, 202-268...

76 FR 9381 - Change in Contractual Priority Mail Postal Prices

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-17

... Mail Postal Prices AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is... prices. This document provides public notice of the changes and addresses related procedural steps. DATES... INFORMATION: I. Introduction On February 9, 2011, the Postal Service filed notice of a change in prices...

77 FR 64367 - Removal of International Restricted Delivery From the Competitive Product List

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

... POSTAL SERVICE Removal of International Restricted Delivery From the Competitive Product List AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY: The Postal Service hereby provides notice that it has filed a request with the Postal Regulatory Commission to remove International Restricted Delivery...

78 FR 44438 - Notice of Organization Name and Address Change

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

... POSTAL SERVICE 39 CFR Part 501 Notice of Organization Name and Address Change AGENCY: Postal Service\\TM\\. ACTION: Final rule. SUMMARY: The Postal Service is revising the rules concerning... is the Office of Payment Technology (PT) or successor organization. All submissions to the Postal...

78 FR 70084 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-22

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2013-63 and CP2013-83; Order No. 1844] New Postal... (Request). The Postal Service contemporaneously filed a redacted contract related to the proposed new... Governors' Decision No. 11-6, authorizing the new product; Attachment B--a redacted copy of the contract...

78 FR 76332 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2014-9 and CP2014-10; Order No. 1898] New Postal... (Request). The Postal Service contemporaneously filed a redacted contract related to the proposed new... Governors' Decision No. 11-6, authorizing the new product; Attachment B--a redacted copy of the contract...

75 FR 80858 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2011-9 and CP2011-44; Order No. 610] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... Service contemporaneously filed a contract related to the proposed new product pursuant to 39 U.S.C. 3632...

39 CFR 775.2 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Policy. 775.2 Section 775.2 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS NATIONAL ENVIRONMENTAL POLICY ACT PROCEDURES § 775.2 Policy. It is the policy of the Postal Service to: (a) Interpret and administer applicable policies...

76 FR 34871 - Mobile Barcode Promotion

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... POSTAL SERVICE 39 CFR Part 111 Mobile Barcode Promotion AGENCY: Postal Service TM . ACTION: Final rule. SUMMARY: The Postal Service is revising the Mailing Standards of the United States Postal Service... mailpieces with mobile barcodes must be one of the following: 1. Presorted or automation First-Class Mail...

78 FR 70967 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-27

...). The Postal Service contemporaneously filed a redacted contract related to the proposed new product...: Attachment A--a redacted copy of Governors' Decision No. 11-6, authorizing the new product; Attachment B--a... POSTAL REGULATORY COMMISSION [Docket Nos. MC2014-8 and CP2014-9; Order No. 1889] New Postal...

39 CFR 261.3 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Policy. 261.3 Section 261.3 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT § 261.3 Policy. It is the policy of the Postal Service: (a) To, as appropriate, create, preserve, protect and...

39 CFR 261.3 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Policy. 261.3 Section 261.3 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT § 261.3 Policy. It is the policy of the Postal Service: (a) To, as appropriate, create, preserve, protect and...

39 CFR 261.3 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Policy. 261.3 Section 261.3 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT § 261.3 Policy. It is the policy of the Postal Service: (a) To, as appropriate, create, preserve, protect and...

39 CFR 261.3 - Policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Policy. 261.3 Section 261.3 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT § 261.3 Policy. It is the policy of the Postal Service: (a) To, as appropriate, create, preserve, protect and...

39 CFR 261.3 - Policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Policy. 261.3 Section 261.3 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT § 261.3 Policy. It is the policy of the Postal Service: (a) To, as appropriate, create, preserve, protect and...

77 FR 36585 - Postal Rate Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... POSTAL REGULATORY COMMISSION [Docket No. CP2012-32; Order No. 1367] Postal Rate Changes AGENCY... Service notice of rate and changes affecting Inbound Air Parcel Post at Universal Postal Union (UPU) rates... notice, in accordance with 39 CFR 3015.5, announcing changes in rates not of general applicability for...

39 CFR 267.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Purpose and scope. 267.1 Section 267.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION PROTECTION OF INFORMATION § 267.1... Postal Service throughout all phases of information flow and within all organization components, and...

78 FR 13713 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing concerning the addition of Express Mail Contract 14 to the competitive product list... 14 to the competitive product list.\\1\\ The Postal Service asserts that Express Mail Contract 14 is a...

76 FR 2930 - Product Change-Parcel Select Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-18

... POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: Postal Service notice of filing of a request with the Postal Regulatory... Add Parcel Select Contract 1 to Competitive Product List. Documents are available at http://www.prc...

77 FR 28410 - Product Change-Parcel Select Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

... POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal... Select Contract 1 to Competitive Product List. Documents are available at www.prc.gov , Docket Nos...

Anaesthetic training programmes in the UK: the role of the programme director.

PubMed

Barker, I

1998-02-01

Schools of anaesthesia provide anaesthetic training in the UK. Each school has at least one programme director undertaking some or all of the management duties. Most programme directors appears to be unresourced volunteers whose roles have developed in response to local requirements. A postal questionnaire was sent to all anaesthetic training programme directors in the UK, asking about their role. Respondents had a wide variation in duties and responsibilities towards anaesthetic training schemes. Few had terms of reference, clear lines of responsibility, remuneration or resources to undertake the role.

39 CFR 501.14 - Postage Evidencing System inventory control processes.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Postage Evidencing System inventory control processes. 501.14 Section 501.14 Postal Service UNITED STATES POSTAL SERVICE POSTAGE PROGRAMS AUTHORIZATION... affect Postal Service revenues, or of any memory component, or that affects the accuracy of the registers...

39 CFR 601.102 - Revocation of prior purchasing regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Revocation of prior purchasing regulations. 601.102 Section 601.102 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.102...

39 CFR 601.110 - Payment of claims.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Payment of claims. 601.110 Section 601.110 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.110 Payment of claims. Any claim...

39 CFR 601.101 - Effective date.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Effective date. 601.101 Section 601.101 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.101 Effective date. These regulations...

39 CFR 601.101 - Effective date.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Effective date. 601.101 Section 601.101 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.101 Effective date. These regulations...

39 CFR 601.102 - Revocation of prior purchasing regulations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Revocation of prior purchasing regulations. 601.102 Section 601.102 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.102...

39 CFR 601.112 - Review of adverse decisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Review of adverse decisions. 601.112 Section 601.112 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.112 Review of adverse...

39 CFR 447.61 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false General. 447.61 Section 447.61 Postal Service UNITED STATES POSTAL SERVICE PERSONNEL RULES OF CONDUCT FOR POSTAL EMPLOYEES Bribery, Undue Influence, or... employee to act or neglect to act in regard to his official responsibilities; and (2) Any information that...

39 CFR 960.17 - Settlement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Settlement. 960.17 Section 960.17 Postal Service... ACT IN POSTAL SERVICE PROCEEDINGS Procedures for Considering Applications § 960.17 Settlement. The applicant and the Postal Service may agree on a proposed settlement of the award before final action on the...

39 CFR 3002.2 - Statutory functions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Statutory functions. 3002.2 Section 3002.2 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL ORGANIZATION § 3002.2 Statutory functions. (a) Areas of jurisdiction. The Commission has jurisdiction over changes in postal rates and fees under 39 U.S.C. 3622, and...

39 CFR 447.21 - Prohibited conduct.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Prohibited conduct. 447.21 Section 447.21 Postal Service UNITED STATES POSTAL SERVICE PERSONNEL RULES OF CONDUCT FOR POSTAL EMPLOYEES Employee Conduct... for an examination of the Office of Personnel Management or Board of Examiners for the Foreign Service...

76 FR 71087 - Market Test of Experimental Product: “First-Class Tracer”

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-16

... POSTAL SERVICE Market Test of Experimental Product: ``First-Class Tracer'' AGENCY: Postal Service \\TM\\. ACTION: Notice. SUMMARY: The Postal Service gives notice of a market test of an experimental... ``First-Class Tracer'' experimental product on or after December 7, 2011. The Postal Service has filed...

39 CFR 912.14 - Conclusiveness of remedy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Conclusiveness of remedy. 912.14 Section 912.14 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURES TO ADJUDICATE CLAIMS FOR PERSONAL... of remedy. Payment by the Postal Service of the full amount claimed or acceptance by the claimant...

39 CFR 912.14 - Conclusiveness of remedy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Conclusiveness of remedy. 912.14 Section 912.14 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURES TO ADJUDICATE CLAIMS FOR PERSONAL... of remedy. Payment by the Postal Service of the full amount claimed or acceptance by the claimant...

39 CFR 3002.3 - Official seal.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Official seal. 3002.3 Section 3002.3 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL ORGANIZATION § 3002.3 Official seal. (a) Authority. The Seal described in this section is hereby established as the official seal of the Postal Rate Commission...

39 CFR 3002.3 - Official seal.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Official seal. 3002.3 Section 3002.3 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL ORGANIZATION § 3002.3 Official seal. (a) Authority. The Seal described in this section is hereby established as the official seal of the Postal Rate Commission...

39 CFR 3020.33 - Docket and notice.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Docket and notice. 3020.33 Section 3020.33 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PRODUCT LISTS Requests Initiated by the Postal Service To... on its Web site. The notice shall include: (a) The general nature of the proceeding; (b) A reference...

39 CFR 955.29 - Decisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Decisions. 955.29 Section 955.29 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE BEFORE THE POSTAL SERVICE BOARD OF CONTRACT... the offices of the Board, and may be made available on its official Web site and to commercial...

39 CFR 3020.92 - Public input.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Service submissions pursuant to § 3020.91 on its Web site and provide interested persons with an... 39 Postal Service 1 2010-07-01 2010-07-01 false Public input. 3020.92 Section 3020.92 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PRODUCT LISTS Requests Initiated by the Postal Service to...

39 CFR 265.2 - Policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Policy. 265.2 Section 265.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.2 Policy. (a) It is the policy of the Postal Service to make its official records available to the public to the maximum...

39 CFR 265.5 - Public reading rooms.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Public reading rooms. 265.5 Section 265.5 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.5 Public reading rooms. The Library of the Postal Service Headquarters, 475 L'Enfant Plaza SW, Washington, DC 20260...

39 CFR 265.5 - Public reading rooms.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Public reading rooms. 265.5 Section 265.5 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.5 Public reading rooms. The Library of the Postal Service Headquarters, 475 L'Enfant Plaza SW, Washington, DC 20260...

39 CFR 265.5 - Public reading rooms.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Public reading rooms. 265.5 Section 265.5 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.5 Public reading rooms. The Library of the Postal Service Headquarters, 475 L'Enfant Plaza SW, Washington, DC 20260...

39 CFR 265.2 - Policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Policy. 265.2 Section 265.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.2 Policy. (a) It is the policy of the Postal Service to make its official records available to the public to the maximum...

39 CFR 265.2 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Policy. 265.2 Section 265.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.2 Policy. (a) It is the policy of the Postal Service to make its official records available to the public to the maximum...

39 CFR 265.2 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Policy. 265.2 Section 265.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.2 Policy. (a) It is the policy of the Postal Service to make its official records available to the public to the maximum...

39 CFR 265.5 - Public reading rooms.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Public reading rooms. 265.5 Section 265.5 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.5 Public reading rooms. The Library of the Postal Service Headquarters, 475 L'Enfant Plaza SW, Washington, DC 20260...

39 CFR 265.5 - Public reading rooms.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Public reading rooms. 265.5 Section 265.5 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.5 Public reading rooms. The Library of the Postal Service Headquarters, 475 L'Enfant Plaza SW, Washington, DC 20260...

39 CFR 265.2 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Policy. 265.2 Section 265.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.2 Policy. (a) It is the policy of the Postal Service to make its official records available to the public to the maximum...

76 FR 7114 - International Mail: Mailing Services Price Change

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-09

... POSTAL SERVICE 39 CFR Part 20 International Mail: Mailing Services Price Change AGENCY: Postal... States Postal Service, International Mail Manual (IMM[supreg]) for Mailing Services. This price change correlates to the Postal Service's January 13, 2011 filing of Docket No. R2011-2, Notice of Price Adjustment...

76 FR 48722 - Domestic Mail Manual; Incorporation by Reference

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-09

... POSTAL SERVICE 39 CFR PART 111 Domestic Mail Manual; Incorporation by Reference AGENCY: Postal... 5, 2011, of the Mailing Standards of the United States Postal Service, Domestic Mail Manual (DMM... the Domestic Mail Manual (DMM) was issued on July 5, 2011. This Issue of the DMM contains all Postal...

77 FR 64724 - International Mail Manual; Incorporation by Reference

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-23

... POSTAL SERVICE 39 CFR Part 20 International Mail Manual; Incorporation by Reference AGENCY: Postal... Standards of the United States Postal Service, International Mail Manual (IMM[supreg]) dated June 24, 2012... International Mail Manual was issued on June 24, 2012, and was updated with postal bulletin revisions through...

78 FR 77508 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... POSTAL REGULATORY COMMISSION [Docket No. CP2014-14; Order No. 1910] New Postal Product AGENCY... redacted copy of the new rates; and Attachment 4--a copy of the certification required under 39 CFR 3015.5...' Decision, the new rates and related financial information. Id. at 3. The Postal Service filed redacted...

75 FR 44292 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2010-32 and CP2010-77; Order No. 497] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... contract related to the proposed new product pursuant to 39 U.S.C. 3632(b)(3) and 39 CFR 3015.5. The...

75 FR 65533 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2011-1 and CP2011-2; Order No. 554] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently... contemporaneously filed a contract related to the proposed new product pursuant to 39 U.S.C. 3632(b)(3) and 39 CFR...

75 FR 80860 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2011-12 and CP2011-48; Order No. 613] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... filed a contract related to the proposed new product pursuant to 39 U.S.C. 3632(b)(3) and 39 CFR 3015.5...

75 FR 54401 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-07

... POSTAL REGULATORY COMMISSION [Docket Nos. CP2010-102 and CP2010-103; Order No. 529] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... that each of the new GEPS 3 contracts complies with the requirements of 39 U.S.C. 3633 and is...

75 FR 18244 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2010-21 and CP2010-36; Order No. 437] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... contemporaneously filed a contract related to the proposed new product pursuant to 39 U.S.C. 3632(b)(3) and 39 CFR...

75 FR 65676 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2010-28 and CP2011-20 through CP2011-25; Order No. 564] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is... demonstrate that each of the new GEPS 3 contracts complies with the requirements of 39 U.S.C. 3633 and is...

78 FR 76334 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2014-10 and CP2014-11; Order No. 1899] New Postal...). The Postal Service contemporaneously filed a redacted contract related to the proposed new product. Id...' Decision No. 11-6, authorizing the new product; Attachment B--a redacted copy of the contract; Attachment C...

75 FR 61785 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... POSTAL REGULATORY COMMISSION [Docket Nos. CP2010-119, CP2010-120, CP2010-121, CP2010-122, CP2010- 123, CP2010-124, and CP2010-125; Order No. 548] New Postal Product AGENCY: Postal Regulatory... Service concludes that its filings demonstrate that each of the new GEPS 3 contracts complies with the...

75 FR 35102 - New Postal Products

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-21

... POSTAL REGULATORY COMMISSION [Docket Nos. CP2010-60 through CP2010-63; Order No. 472] New Postal... recently-filed Postal Service request to add new Global Expedited Package Services 2 products to the... Service also contends that its filing demonstrates that each of the new GEPS 2 contracts complies with the...

75 FR 57995 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-23

... POSTAL REGULATORY COMMISSION [Docket Nos. CP2010-116, CP2010-117, and CP2010-118; Order No. 541] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is... that each of the new GEPS 3 contracts complies with the requirements of 39 U.S.C. 3633 and is...

77 FR 304 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-04

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2012-3 and CP2012-7; Order No. 1072] New Postal Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... proposed new product under 39 U.S.C. 3632(b)(3) and 39 CFR 3015.5. Id. Attachment B. The instant contract...

39 CFR 3010.29 - Transition rule.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Transition rule. 3010.29 Section 3010.29 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS Rules for Applying the Price Cap § 3010.29 Transition rule. If the Postal Service initial exercise of its authority...

39 CFR 20.1 - International Mail Manual; incorporation by reference.

Code of Federal Regulations, 2010 CFR

2010-07-01

... reference. 20.1 Section 20.1 Postal Service UNITED STATES POSTAL SERVICE INTERNATIONAL MAIL INTERNATIONAL POSTAL SERVICE § 20.1 International Mail Manual; incorporation by reference. (a) Section 552(a) of Title... provided in this part, the U.S. Postal Service hereby incorporates by reference its International Mail...

39 CFR 951.5 - Complaint of misconduct.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Complaint of misconduct. 951.5 Section 951.5 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURE GOVERNING THE ELIGIBILITY OF PERSONS TO PRACTICE BEFORE THE POSTAL SERVICE § 951.5 Complaint of misconduct. (a) If the head of any department of...

39 CFR 951.5 - Complaint of misconduct.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Complaint of misconduct. 951.5 Section 951.5 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURE GOVERNING THE ELIGIBILITY OF PERSONS TO PRACTICE BEFORE THE POSTAL SERVICE § 951.5 Complaint of misconduct. (a) If the head of any department of...

39 CFR 951.5 - Complaint of misconduct.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Complaint of misconduct. 951.5 Section 951.5 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURE GOVERNING THE ELIGIBILITY OF PERSONS TO PRACTICE BEFORE THE POSTAL SERVICE § 951.5 Complaint of misconduct. (a) If the head of any department of...

39 CFR 951.5 - Complaint of misconduct.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Complaint of misconduct. 951.5 Section 951.5 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURE GOVERNING THE ELIGIBILITY OF PERSONS TO PRACTICE BEFORE THE POSTAL SERVICE § 951.5 Complaint of misconduct. (a) If the head of any department of...

39 CFR 951.5 - Complaint of misconduct.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Complaint of misconduct. 951.5 Section 951.5 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURE GOVERNING THE ELIGIBILITY OF PERSONS TO PRACTICE BEFORE THE POSTAL SERVICE § 951.5 Complaint of misconduct. (a) If the head of any department of...

39 CFR 268.1 - General principles.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false General principles. 268.1 Section 268.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION PRIVACY OF INFORMATION-EMPLOYEE RULES OF CONDUCT § 268.1 General principles. In order to conduct its business, the Postal Service has the...

39 CFR 964.22 - Public information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Public information. 964.22 Section 964.22 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE GOVERNING DISPOSITION OF MAIL WITHHELD FROM DELIVERY PURSUANT TO 39 U.S.C. 3003, 3004 § 964.22 Public information. The Librarian of the Postal...

39 CFR 959.30 - Public information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Public information. 959.30 Section 959.30 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE PRIVATE EXPRESS STATUTES § 959.30 Public information. The Librarian of the Postal Service maintains for public...

39 CFR 965.14 - Public information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Public information. 965.14 Section 965.14 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO MAIL DISPUTES § 965.14 Public information. The Librarian of the Postal Service maintains for public inspection in the...

39 CFR 952.33 - Public information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Public information. 952.33 Section 952.33 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS § 952.33 Public information. The Librarian of the Postal Service maintains for...

39 CFR 957.26 - Public information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Public information. 957.26 Section 957.26 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO DEBARMENT AND SUSPENSION FROM CONTRACTING § 957.26 Public information. The Librarian of the Postal Service shall maintain...

39 CFR 946.9 - Reconsideration of claims.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Reconsideration of claims. 946.9 Section 946.9 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PROCEDURE RELATING TO THE DISPOSITION OF STOLEN MAIL MATTER AND PROPERTY ACQUIRED BY THE POSTAL INSPECTION SERVICE FOR USE AS EVIDENCE § 946.9...

39 CFR 946.9 - Reconsideration of claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Reconsideration of claims. 946.9 Section 946.9 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PROCEDURE RELATING TO THE DISPOSITION OF STOLEN MAIL MATTER AND PROPERTY ACQUIRED BY THE POSTAL INSPECTION SERVICE FOR USE AS EVIDENCE § 946.9...

39 CFR 263.2 - Policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Policy. 263.2 Section 263.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS RETENTION AND DISPOSITION § 263.2 Policy. It is the policy of the U.S. Postal Service to establish and maintain schedules specifying the...

39 CFR 263.2 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Policy. 263.2 Section 263.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS RETENTION AND DISPOSITION § 263.2 Policy. It is the policy of the U.S. Postal Service to establish and maintain schedules specifying the...

39 CFR 264.2 - Policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Policy. 264.2 Section 264.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION VITAL RECORDS § 264.2 Policy. It is the policy of the U.S. Postal Service to ensure the availability of all records considered critical to the...

39 CFR 264.2 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Policy. 264.2 Section 264.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION VITAL RECORDS § 264.2 Policy. It is the policy of the U.S. Postal Service to ensure the availability of all records considered critical to the...

39 CFR 20.3 - Availability of the International Mail Manual.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Availability of the International Mail Manual. 20.3 Section 20.3 Postal Service UNITED STATES POSTAL SERVICE INTERNATIONAL MAIL INTERNATIONAL POSTAL SERVICE § 20.3 Availability of the International Mail Manual. Copies of the International Mail Manual may...

39 CFR 20.3 - Availability of the International Mail Manual.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Availability of the International Mail Manual. 20.3 Section 20.3 Postal Service UNITED STATES POSTAL SERVICE INTERNATIONAL MAIL INTERNATIONAL POSTAL SERVICE § 20.3 Availability of the International Mail Manual. Copies of the International Mail Manual may...

75 FR 4593 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-28

... POSTAL REGULATORY COMMISSION [Docket No. CP2010-20; Order No. 397] New Postal Product AGENCY... Service request to add GEPS 2 (CP2009-50) to the Competitive Product List. The Postal Service has also... Global Expedited Package Services 2 to the Competitive Product List, August 28, 2009 (Order No. 290). \\4...

39 CFR 959.30 - Public information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Public information. 959.30 Section 959.30 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE PRIVATE EXPRESS STATUTES § 959.30 Public information. The Librarian of the Postal Service maintains for public...

39 CFR 952.33 - Public Information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Public Information. 952.33 Section 952.33 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS § 952.33 Public Information. The Librarian of the Postal Service maintains for...

39 CFR 964.22 - Public information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Public information. 964.22 Section 964.22 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE GOVERNING DISPOSITION OF MAIL WITHHELD FROM DELIVERY PURSUANT TO 39 U.S.C. 3003, 3004 § 964.22 Public information. The Librarian of the Postal...

39 CFR 965.14 - Public Information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Public Information. 965.14 Section 965.14 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO MAIL DISPUTES § 965.14 Public Information. The Librarian of the Postal Service maintains for public inspection in the...

39 CFR 957.26 - Public information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Public information. 957.26 Section 957.26 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO DEBARMENT AND SUSPENSION FROM CONTRACTING § 957.26 Public information. The Librarian of the Postal Service shall maintain...

39 CFR 3050.13 - Additional documentation required in the Postal Service's section 3652 report.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Service's section 3652 report. 3050.13 Section 3050.13 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.13 Additional documentation required in the Postal Service's section... recent Annual Compliance Determination was issued and the reasons that those changes were accepted. ...

78 FR 63521 - Product Change-Parcel Select & Parcel Return Service Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-24

... POSTAL SERVICE Product Change--Parcel Select & Parcel Return Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request... Request of the United States Postal Service to Add Parcel Select & Parcel Return Service Contract 5 to...

77 FR 28409 - Product Change-Parcel Select & Parcel Return Service Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

... POSTAL SERVICE Product Change--Parcel Select & Parcel Return Service Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request... States Postal Service to Add Parcel Select & Parcel Return Service Contract 3 to Competitive Product List...

77 FR 37078 - Product Change-Parcel Select and Parcel Return Service Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-20

... POSTAL SERVICE Product Change--Parcel Select and Parcel Return Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a... Postal Service to Add Parcel Select & Parcel Return Service Contract 4 to Competitive Product List...

A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study

PubMed Central

McManus, I C; Smithers, Eleni; Partridge, Philippa; Keeling, A; Fleming, Peter R

2003-01-01

Objective To assess whether A level grades (achievement) and intelligence (ability) predict doctors' careers. Design Prospective cohort study with follow up after 20 years by postal questionnaire. Setting A UK medical school in London. Participants 511 doctors who had entered Westminster Medical School as clinical students between 1975 and 1982 were followed up in January 2002. Main outcome measures Time taken to reach different career grades in hospital or general practice, postgraduate qualifications obtained (membership/fellowships, diplomas, higher academic degrees), number of research publications, and measures of stress and burnout related to A level grades and intelligence (result of AH5 intelligence test) at entry to clinical school. General health questionnaire, Maslach burnout inventory, and questionnaire on satisfaction with career at follow up. Results 47 (9%) doctors were no longer on the Medical Register. They had lower A level grades than those who were still on the register (P < 0.001). A levels also predicted performance in undergraduate training, performance in postregistration house officer posts, and time to achieve membership qualifications (Cox regression, P < 0.001; b=0.376, SE=0.098, exp(b)=1.457). Intelligence did not independently predict dropping off the register, career outcome, or other measures. A levels did not predict diploma or higher academic qualifications, research publications, or stress or burnout. Diplomas, higher academic degrees, and research publications did, however, significantly correlate with personality measures. Conclusions Results of achievement tests, in this case A level grades, which are particularly used for selection of students in the United Kingdom, have long term predictive validity for undergraduate and postgraduate careers. In contrast, a test of ability or aptitude (AH5) was of little predictive validity for subsequent medical careers. PMID:12869457

The spontaneous resolution of heavy menstrual bleeding in the perimenopausal years

PubMed Central

Shapley, M; Blagojevic, M; Jordan, KP; Croft, PR

2012-01-01

Objective To obtain estimates of the rate of spontaneous resolution of heavy menstrual bleeding and to explore any association with specific menstrual symptoms. Design Two-year prospective cohort study. Setting Seven general practices, with 67 100 registered patients. Population All women aged 40–54 years on the practices age–sex registers. Methods Baseline postal questionnaire, with follow-up questionnaires sent to naturally menstruating respondents at 6, 12, 18 and 24 months. Main outcome measures Rate of spontaneous resolution of heavy menstrual bleeding in naturally menstruating women. Results A total of 7121 baseline questionnaires were sent out, with an initial response rate of 63%. We recruited 2051 naturally menstruating women for the prospective cohort study. The spontaneous rate of resolution of heavy menstrual bleeding varied from 8.1% (95% CI 5.3–12%) in women aged 45–49 years, who had resolution without recurrence for 24 months, to 35% (95% CI 30–41%) in women aged 50–54 years, who had resolution without recurrence for 6 months. Rates were lower in those who reported interference with life from heavy menstrual bleeding. There was a strong association between the spontaneous resolution of heavy menstrual bleeding and skipped periods in women aged over 45 years. The association with ‘cycle too variable to say’ was significant, but weaker. Conclusion There is a high prevalence, incidence and significant spontaneous rate of resolution of heavy menstrual bleeding in naturally menstruating women during the perimenopausal years. The rates have potential use for individual women, clinical decisions, devising and implementing interventions and planning the care of populations. Please cite this paper as: Shapley M, Blagojevic M, Jordan K, Croft P. The spontaneous resolution of heavy menstrual bleeding in the perimenopausal years. BJOG 2012;119:545–553. PMID:22313942

Advances and Limitations of Modern Macroseismic Data Gathering

NASA Astrophysics Data System (ADS)

Wald, D. J.; Dewey, J. W.; Quitoriano, V. P. R.

2016-12-01

All macroseismic data are not created equal. At about the time that the European Macroseismic Scale 1998 (EMS-98; itself a revision of EMS-92) formalized a procedure to account for building vulnerability and damage grade statistics in assigning intensities from traditional field observations, a parallel universe of internet-based intensity reporting was coming online. The divergence of intensities assigned by field reconnaissance and intensities based on volunteered reports poses unique challenges. U.S. Geological Survey's Did You Feel It? (DYFI) and its Italian (National Institute of Geophysics and Volcanology) counterpart use questionnaires based on the traditional format, submitted by volunteers. The Italian strategy uses fuzzy logic to assign integer values of intensity from questionnaire responses, whereas DYFI assigns weights to macroseismic effects and computes real-valued intensities to a 0.1 MMI unit precision. DYFI responses may be grouped together by postal code, or by smaller latitude-longitude boxes; calculated intensities may vary depending on how observations are grouped. New smartphone-based procedures depart further from tradition by asking respondents to select from cartoons corresponding to various intensity levels that best fit their experience. While nearly instantaneous, these thumbnail-based intensities are strictly integer values and do not record specific macroseismic effects. Finally, a recent variation on traditional intensity assignments derives intensities not from field surveys or questionnaires sent to target audiences but rather from media reports, photojournalism, and internet posts that may or may not constitute the representative observations needed for consistent EMS-98 assignments. We review these issues and suggest due-diligence strategies for utilizing varied macroseismic data sets within real-time applications and in quantitative hazard and engineering analyses.

The feasibility and cost of a large multicentre audit of process and outcome of prostatectomy.

PubMed Central

Emberton, M; Neal, D E; Black, N; Harrison, M; Fordham, M; McBrien, M P; Williams, R E; McPherson, K; Develin, H B

1995-01-01

Objective--To determine the feasibility of performing multicentre process and outcome audits of common interventions taking prostatic procedures as an example. Design--Prospective, cohort study. Setting--All National Health Service and independent hospitals in Northern, Wessex, Mersey, and South West Thames health regions. Patients--5361 men undergoing prostatectomy identified by 103 of the 107 urologists and general surgeons performing prostatectomy in the study regions. Main measures-- Rates of participation by surgeons and patients; completeness of clinical data provided by surgeons; patient response rate and completeness of patient derived data; and cost. Results--Most surgeons (103,96%) agreed to participate. Overall, the proportion of eligible patients invited to take part was high (89%), although this was only measured in South West Thames, where dedicated data collectors were employed. Few men (80, 1.5%) declined to participate. Of those surviving for three months after surgery, 82.4% (4226) completed and returned the postal questionnaire. The response rate was higher in South West Thames (86.7%) than in the other regions (80.6%-80.8%). The audit was well received: 91% of patients found the questionnaire easy to complete and only 2.3% of them disapproved. Completeness of data was high with both the hospital and patient questionnaires. Missing data occurred in less than 5% of responses to most questions. The attributable cost was 34.50 pounds per patient identified or 44 pounds for patients in whom either the treatment outcome or vital status was known three months after their prostatectomy. Conclusions--This multicentre audit of process and outcome of prostatectomy proved feasible in terms of surgeon participation, patient identification, and the quantity and quality of data collection. Whether the cost was warranted will depend on how surgeons use the audit data to modify their practice. PMID:10156395

The re-identification risk of Canadians from longitudinal demographics

PubMed Central

2011-01-01

Background The public is less willing to allow their personal health information to be disclosed for research purposes if they do not trust researchers and how researchers manage their data. However, the public is more comfortable with their data being used for research if the risk of re-identification is low. There are few studies on the risk of re-identification of Canadians from their basic demographics, and no studies on their risk from their longitudinal data. Our objective was to estimate the risk of re-identification from the basic cross-sectional and longitudinal demographics of Canadians. Methods Uniqueness is a common measure of re-identification risk. Demographic data on a 25% random sample of the population of Montreal were analyzed to estimate population uniqueness on postal code, date of birth, and gender as well as their generalizations, for periods ranging from 1 year to 11 years. Results Almost 98% of the population was unique on full postal code, date of birth and gender: these three variables are effectively a unique identifier for Montrealers. Uniqueness increased for longitudinal data. Considerable generalization was required to reach acceptably low uniqueness levels, especially for longitudinal data. Detailed guidelines and disclosure policies on how to ensure that the re-identification risk is low are provided. Conclusions A large percentage of Montreal residents are unique on basic demographics. For non-longitudinal data sets, the three character postal code, gender, and month/year of birth represent sufficiently low re-identification risk. Data custodians need to generalize their demographic information further for longitudinal data sets. PMID:21696636

A nationwide postal questionnaire survey: the presence of airway guidelines in anaesthesia department in Sweden

PubMed Central

2014-01-01

Background In Sweden, airway guidelines aimed toward improving patient safety have been recommended by the Swedish Society of Anaesthesia and Intensive Care Medicine. Adherence to evidence-based airway guidelines is known to be generally poor in Sweden. The aim of this study was to determine whether airway guidelines are present in Swedish anaesthesia departments. Methods A nationwide postal questionnaire inquiring about the presence of airway guidelines was sent out to directors of Swedish anaesthesia departments (n = 74). The structured questionnaire was based on a review of the Swedish Society of Anaesthesia and Intensive Care voluntary recommendations of guidelines for airway management. Mean, standard deviation, minimum/maximum, percentage (%) and number of general anaesthesia performed per year as frequency (n), were used to describe, each hospital type (university, county, private). For comparison between hospitals type and available written airway guidelines were cross tabulation used and analysed using Pearson’s Chi-Square tests. A p- value of less than 0 .05 was judged significant. Results In total 68 directors who were responsible for the anaesthesia departments returned the questionnaire, which give a response rate of 92% (n 68 of 74). The presence of guidelines showing an airway algorithm was reported by 68% of the departments; 52% reported having a written patient information card in case of a difficult airway and guidelines for difficult airways, respectively; 43% reported the presence of guidelines for preoperative assessment; 31% had guidelines for Rapid Sequence Intubation; 26% reported criteria for performing an awake intubation; and 21% reported guidelines for awake fibre-optic intubation. A prescription for the registered nurse anaesthetist for performing tracheal intubation was reported by 24%. The most frequently pre-printed preoperative elements in the anaesthesia record form were dental status and head and neck mobility. Conclusions Despite recommendations from the national anaesthesia society, the presence of airway guidelines in Swedish anaesthesia departments is low. From the perspective of safety for both patients and the anaesthesia staff, airway management guidelines should be considered a higher priority. PMID:24708670

Best practice guidance for the use of strategies to improve retention in randomized trials developed from two consensus workshops.

PubMed

Brueton, Valerie; Stenning, Sally P; Stevenson, Fiona; Tierney, Jayne; Rait, Greta

2017-08-01

To develop best practice guidance for the use of retention strategies in randomized clinical trials (RCTs). Consensus development workshops conducted at two UK Clinical Trials Units. Sixty-six statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs participated. The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions. Workshops commenced with a presentation of the evidence for incentives, communication, questionnaire format, behavioral, case management, and methodological retention strategies identified by a Cochrane review and associated qualitative study. Three simultaneous group discussions followed focused on (1) how convinced the workshop participants were by the evidence for retention strategies, (2) barriers to the use of effective retention strategies, (3) types of RCT follow-up that retention strategies could be used for, and (4) strategies for future research. Summaries of each group discussion were fed back to the workshop. Coded content for both workshops was compared for agreement and disagreement. Agreed consensus on best practice guidance for retention was identified. Workshop participants agreed best practice guidance for the use of small financial incentives to improve response to postal questionnaires in RCTs. Use of second-class post was thought to be adequate for postal communication with RCT participants. The most relevant validated questionnaire was considered best practice for collecting RCT data. Barriers identified for the use of effective retention strategies were: the small improvements seen in questionnaire response for the addition of monetary incentives, and perceptions among trialists that some communication strategies are outdated. Furthermore, there was resistance to change existing retention practices thought to be effective. Face-to-face and electronic follow-up technologies were identified as retention strategies for further research. We developed best practice guidance for the use of retention strategies in RCTs and identified potential barriers to the use of effective strategies. The extent of agreement on best practice is limited by the variability in the currently available evidence. This guidance will need updating as new retention strategies are developed and evaluated. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

39 CFR 601.111 - Interest on claim amounts.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Interest on claim amounts. 601.111 Section 601.111 Postal Service UNITED STATES POSTAL SERVICE PROCUREMENT SYSTEM FOR THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.111 Interest on claim amounts...

39 CFR 927.3 - Other remedies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Other remedies. 927.3 Section 927.3 Postal Service... § 927.3 Other remedies. The procedures and other requirements of this part apply only where the Postal... remedies available to the Postal Service, including such remedies as summary action to withhold tender of...

39 CFR 927.3 - Other remedies.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Other remedies. 927.3 Section 927.3 Postal Service... § 927.3 Other remedies. The procedures and other requirements of this part apply only where the Postal... remedies available to the Postal Service, including such remedies as summary action to withhold tender of...

39 CFR 233.7 - Forfeiture authority and procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Forfeiture authority and procedures. 233.7 Section 233.7 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION INSPECTION SERVICE... behalf of the Postal Service and the Office of Inspector General to enforce 18 U.S.C. 981, 2254, and 21 U...

39 CFR 3007.10 - Submission of non-public materials under seal.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Submission of non-public materials under seal. 3007.10 Section 3007.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL TREATMENT OF NON-PUBLIC MATERIALS PROVIDED BY THE POSTAL SERVICE § 3007.10 Submission of non-public materials under seal. (a) Non...

39 CFR 3007.30 - Termination of non-public status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Termination of non-public status. 3007.30 Section 3007.30 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL TREATMENT OF NON-PUBLIC MATERIALS PROVIDED BY THE POSTAL SERVICE § 3007.30 Termination of non-public status. Ten years after the date of...

39 CFR 265.1 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Purpose and scope. 265.1 Section 265.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.1... section 552 of title 5, U.S.C., the “Freedom of Information Act,” insofar as it applies to the Postal...

39 CFR 265.1 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Purpose and scope. 265.1 Section 265.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.1... section 552 of title 5, U.S.C., the “Freedom of Information Act,” insofar as it applies to the Postal...

39 CFR 265.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Purpose and scope. 265.1 Section 265.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.1... section 552 of title 5, U.S.C., the “Freedom of Information Act,” insofar as it applies to the Postal...

39 CFR 265.1 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Purpose and scope. 265.1 Section 265.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.1... section 552 of title 5, U.S.C., the “Freedom of Information Act,” insofar as it applies to the Postal...

39 CFR 265.1 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Purpose and scope. 265.1 Section 265.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELEASE OF INFORMATION § 265.1... section 552 of title 5, U.S.C., the “Freedom of Information Act,” insofar as it applies to the Postal...

39 CFR 955.21 - Nature of hearings.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Nature of hearings. 955.21 Section 955.21 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE BEFORE THE POSTAL SERVICE BOARD OF CONTRACT APPEALS § 955.21 Nature of hearings. Hearings shall be as informal as may be reasonable and...

39 CFR 955.21 - Nature of hearings.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Nature of hearings. 955.21 Section 955.21 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE BEFORE THE POSTAL SERVICE BOARD OF CONTRACT APPEALS § 955.21 Nature of hearings. Hearings shall be as informal as may be reasonable and...

75 FR 65675 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... POSTAL REGULATORY COMMISSION [Docket Nos. MC2010-37 and CP2010-126; Order No. 553] New Postal.... It is also noticing a contemporaneous Postal Service notice that new rates for inbound Express Mail... notice pursuant to 39 U.S.C. 3632(b)(3) and 39 CFR 3015.5 that new rates for inbound Express Mail Service...

39 CFR 3001.5 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Definitions. 3001.5 Section 3001.5 Postal Service... § 3001.5 Definitions. Link to an amendment published at 79 FR 33406, June 10, 2014. (a) Act means title 39, United States Code, as amended. (b) Postal Service means the U.S. Postal Service established by...

39 CFR 111.4 - Approval of the Director of the Federal Register.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Approval of the Director of the Federal Register. 111.4 Section 111.4 Postal Service UNITED STATES POSTAL SERVICE POST OFFICE SERVICES [DOMESTIC MAIL] GENERAL INFORMATION ON POSTAL SERVICE § 111.4 Approval of the Director of the Federal Register...

39 CFR 501.5 - Burden of proof standard.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Burden of proof standard. 501.5 Section 501.5 Postal Service UNITED STATES POSTAL SERVICE POSTAGE PROGRAMS AUTHORIZATION TO MANUFACTURE AND DISTRIBUTE POSTAGE EVIDENCING SYSTEMS § 501.5 Burden of proof standard. The burden of proof is on the Postal Service...

77 FR 63898 - New Postal Product; Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... Postal Service contemporaneously filed a redacted contract related to the proposed new product under 39 U...: Attachment A--a redacted copy of Governors' Decision No. 11-6, authorizing the new product; Attachment B--a... POSTAL REGULATORY COMMISSION [Docket Nos. MC2013-1 and CP2013-1; Order No. 1492] New Postal...

39 CFR 4.1 - Chairman.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Chairman. 4.1 Section 4.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE OFFICIALS (ARTICLE IV) § 4.1... the Board. The Chairman: (1) Shall preside at all regular and special meetings of the Board, and shall...

39 CFR 955.21 - Nature of hearings.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Nature of hearings. 955.21 Section 955.21 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE BEFORE THE POSTAL SERVICE BOARD OF CONTRACT APPEALS § 955.21 Nature of hearings. Hearings shall be as informal as may be reasonable and...

39 CFR 955.21 - Nature of hearings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Nature of hearings. 955.21 Section 955.21 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE BEFORE THE POSTAL SERVICE BOARD OF CONTRACT APPEALS § 955.21 Nature of hearings. Hearings shall be as informal as may be reasonable and...

39 CFR 955.21 - Nature of hearings.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Nature of hearings. 955.21 Section 955.21 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE BEFORE THE POSTAL SERVICE BOARD OF CONTRACT APPEALS § 955.21 Nature of hearings. Hearings shall be as informal as may be reasonable and...

39 CFR 2.5 - Authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Authority. 2.5 Section 2.5 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE GENERAL AND TECHNICAL PROVISIONS (ARTICLE II) § 2.5 Authority. These bylaws are adopted by the Board under the authority conferred upon the...

75 FR 34182 - Notice of Intent To Prepare a Programmatic Environmental Assessment for Proposed Mobile Fueling...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... Mobile Fueling Operations, Nationwide AGENCY: Postal Service. ACTION: Notice of intent to prepare a...) for the use of mobile fueling contractors to fuel postal vehicles on-site at selected Postal Service... utilize mobile fueling contractors to fuel vehicles on site at selected postal facilities located...

39 CFR 6.1 - Regular meetings, annual meeting.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Regular meetings, annual meeting. 6.1 Section 6.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE MEETINGS (ARTICLE VI) § 6.1 Regular meetings, annual meeting. The Board shall meet regularly on a schedule...

Prevalence of Barriers and Facilitators to Enhancing Conservative Kidney Management for Older Adults in the Primary Care Setting.

PubMed

Tam-Tham, Helen; King-Shier, Kathryn M; Thomas, Chandra M; Quinn, Robert R; Fruetel, Karen; Davison, Sara N; Hemmelgarn, Brenda R

2016-11-07

Conservative management of adults with stage 5 CKD (eGFR<15 ml/min per 1.73 m 2 ) is increasingly being provided in the primary care setting. We aimed to examine perceived barriers and facilitators for conservative management of older adults by primary care physicians. In 2015, we conducted a cross-sectional, population-based survey of all primary care physicians in Alberta, Canada. Eligible participants had experience caring for adults ages ≥75 years old with stage 5 CKD not planning on initiating dialysis. Questionnaire items were on the basis of a qualitative descriptive study informed by the Behavior Change Wheel and tested for face and content validity. Physicians were contacted via postal mail and/or fax on the basis of a modified Dillman method. Four hundred nine eligible primary care physicians completed the questionnaire (9.6% response rate). The majority of respondents were men (61.6%), were ages 40-60 years old (62.6%), and practiced in a large/medium population center (68.0%). The most common barrier to providing conservative care in the primary care setting was the inability to access support to maintain patients in the home setting (39.1% of respondents; 95% confidence interval, 34.6% to 43.6%). The second most common barrier was working with nonphysician providers with limited kidney-specific clinical expertise (32.3%; 95% confidence interval, 28.0% to 36.7%). Primary care physicians indicated that the two most common strategies that would enhance their ability to provide conservative management would be the ability to use the telephone to contact a nephrologist or clinical staff from the conservative care clinic (86.9%; 95% confidence interval, 83.7% to 90.0% and 85.6%; 95% confidence interval, 82.4% to 88.9%, respectively). We identified important areas to inform clinical programs to reduce barriers and enhance facilitators to improve primary care physicians' provision of conservative kidney care. In particular, primary care physicians require additional resources for maintaining patients in their home and telephone access to nephrologists and conservative care specialists. Copyright © 2016 by the American Society of Nephrology.

Quality of life in adults with Gilles de la Tourette Syndrome

PubMed Central

2012-01-01

Background Few studies have used standardized QOL instruments to assess the quality of life (QOL) in Gilles de la Tourette Syndrome (GTS) patients. This work investigates the QOL of adult GTS patients and examines the relationships between physical and psychological variables and QOL. Methods Epidemiological investigation by anonymous national postal survey of QOL of patients of the French Association of Gilles de la Tourette Syndrome (AFGTS) aged 16 years or older. The clinical and QOL measures were collected by four questionnaires: a sociodemographic and GTS-related symptoms questionnaire, the World Health Organization Quality Of Life questionnaire (WHOQOL-26), the Functional Status Questionnaire (FSQ), and a self-rating questionnaire on psychiatric symptoms (SCL-90), all validated in French. We used stepwise regression analysis to explicitly investigate the relationships between physical and psychological variables and QOL domains in GTS. Results Questionnaires were posted to 303 patients, of whom 167 (55%) completed and returned them. Our results, adjusted for age and gender, show that patients with GTS have a worse QOL than the general healthy population. In particular, the “Depression” psychological variable was a significant predictor of impairment in all WHOQOL-26 domains, psychological but also physical and social. Conclusions The present study demonstrates a strong relationship between QOL in GTS and psychiatric symptoms, in particular those of depression. PMID:22888766

Quality of life in adults with Gilles de la Tourette Syndrome.

PubMed

Jalenques, Isabelle; Galland, Fabienne; Malet, Laurent; Morand, Dominique; Legrand, Guillaume; Auclair, Candy; Hartmann, Andreas; Derost, Philippe; Durif, Franck

2012-08-13

Few studies have used standardized QOL instruments to assess the quality of life (QOL) in Gilles de la Tourette Syndrome (GTS) patients. This work investigates the QOL of adult GTS patients and examines the relationships between physical and psychological variables and QOL. Epidemiological investigation by anonymous national postal survey of QOL of patients of the French Association of Gilles de la Tourette Syndrome (AFGTS) aged 16 years or older. The clinical and QOL measures were collected by four questionnaires: a sociodemographic and GTS-related symptoms questionnaire, the World Health Organization Quality Of Life questionnaire (WHOQOL-26), the Functional Status Questionnaire (FSQ), and a self-rating questionnaire on psychiatric symptoms (SCL-90), all validated in French. We used stepwise regression analysis to explicitly investigate the relationships between physical and psychological variables and QOL domains in GTS. Questionnaires were posted to 303 patients, of whom 167 (55%) completed and returned them. Our results, adjusted for age and gender, show that patients with GTS have a worse QOL than the general healthy population. In particular, the "Depression" psychological variable was a significant predictor of impairment in all WHOQOL-26 domains, psychological but also physical and social. The present study demonstrates a strong relationship between QOL in GTS and psychiatric symptoms, in particular those of depression.

Introduction of Business-Commercial-Technical French into the Secondary Curriculum.

ERIC Educational Resources Information Center

Buzash, Michael D.

This set of materials is designed to help incorporate business and technical French into the secondary school second language curriculum. It consists of a list of goals for introduction of such content, vocabulary lists and related exercises, and a variety of instructional materials and visual aids. Topics addressed include: postal services;…

39 CFR 957.22 - Motion for reconsideration.

Code of Federal Regulations, 2012 CFR

2012-07-01

... clearly setting forth the points of fact and of law relied upon in support of said motion. ... 39 Postal Service 1 2012-07-01 2012-07-01 false Motion for reconsideration. 957.22 Section 957.22... DEBARMENT AND SUSPENSION FROM CONTRACTING § 957.22 Motion for reconsideration. Within 10 days from the date...

39 CFR 957.22 - Motion for reconsideration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... clearly setting forth the points of fact and of law relied upon in support of said motion. ... 39 Postal Service 1 2011-07-01 2011-07-01 false Motion for reconsideration. 957.22 Section 957.22... DEBARMENT AND SUSPENSION FROM CONTRACTING § 957.22 Motion for reconsideration. Within 10 days from the date...

39 CFR 957.22 - Motion for reconsideration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... clearly setting forth the points of fact and of law relied upon in support of said motion. ... 39 Postal Service 1 2010-07-01 2010-07-01 false Motion for reconsideration. 957.22 Section 957.22... DEBARMENT AND SUSPENSION FROM CONTRACTING § 957.22 Motion for reconsideration. Within 10 days from the date...

39 CFR 957.22 - Motion for reconsideration.

Code of Federal Regulations, 2013 CFR

2013-07-01

... clearly setting forth the points of fact and of law relied upon in support of said motion. ... 39 Postal Service 1 2013-07-01 2013-07-01 false Motion for reconsideration. 957.22 Section 957.22... DEBARMENT AND SUSPENSION FROM CONTRACTING § 957.22 Motion for reconsideration. Within 10 days from the date...

39 CFR 957.22 - Motion for reconsideration.

Code of Federal Regulations, 2014 CFR

2014-07-01

... clearly setting forth the points of fact and of law relied upon in support of said motion. ... 39 Postal Service 1 2014-07-01 2014-07-01 false Motion for reconsideration. 957.22 Section 957.22... DEBARMENT AND SUSPENSION FROM CONTRACTING § 957.22 Motion for reconsideration. Within 10 days from the date...

39 CFR 3050.26 - Documentation of demand elasticities and volume forecasts.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Documentation of demand elasticities and volume forecasts. 3050.26 Section 3050.26 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.26 Documentation of demand elasticities and volume forecasts. By January 20 of each year, the Postal Service shall provide econometric...

77 FR 2573 - International Product Change-Global Plus 1C and 2C Negotiated Service Agreements

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-18

... POSTAL SERVICE International Product Change--Global Plus 1C and 2C Negotiated Service Agreements... a request with the Postal Regulatory Commission to add Global Plus 1C and 2C Negotiated Service... with the Postal Regulatory Commission, Requests of United States Postal Service to Add Global Plus 1C...

39 CFR 3007.33 - Standard for decision for early termination of non-public status.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Standard for decision for early termination of non-public status. 3007.33 Section 3007.33 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL TREATMENT OF NON-PUBLIC MATERIALS PROVIDED BY THE POSTAL SERVICE § 3007.33 Standard for decision for early...

39 CFR 3007.33 - Standard for decision for early termination of non-public status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Standard for decision for early termination of non-public status. 3007.33 Section 3007.33 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL TREATMENT OF NON-PUBLIC MATERIALS PROVIDED BY THE POSTAL SERVICE § 3007.33 Standard for decision for early...

39 CFR 3007.31 - Request for early termination of non-public status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Request for early termination of non-public status. 3007.31 Section 3007.31 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL TREATMENT OF NON-PUBLIC MATERIALS PROVIDED BY THE POSTAL SERVICE § 3007.31 Request for early termination of non-public status. (a...

39 CFR 3007.31 - Request for early termination of non-public status.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Request for early termination of non-public status. 3007.31 Section 3007.31 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL TREATMENT OF NON-PUBLIC MATERIALS PROVIDED BY THE POSTAL SERVICE § 3007.31 Request for early termination of non-public status. (a...

39 CFR 230.3 - Cooperation with the Office of Inspector General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Cooperation with the Office of Inspector General. 230.3 Section 230.3 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION OFFICE OF INSPECTOR GENERAL General Policy and Authority § 230.3 Cooperation with the Office of Inspector General. (a) All Postal Service employees shall...

39 CFR 3002.10 - The Commission and its offices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false The Commission and its offices. 3002.10 Section 3002.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL ORGANIZATION § 3002.10 The Commission and its offices. (a) The Commissioners. The Postal Regulatory Commission is an independent establishment of the executive branch of the U.S. Government...

39 CFR 6.2 - Special meetings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Special meetings. 6.2 Section 6.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE MEETINGS (ARTICLE VI) § 6.2 Special meetings. Consistent with the provisions of §§ 6.6 and 7.5 of these bylaws, the Chairman...

Perceptions of good medical practice in the NHS: a survey of senior health professionals.

PubMed

Hutchinson, A; Williams, M; Meadows, K; Barbour, R S; Jones, R

1999-12-01

To categorize senior health professionals' experience with poor medical practice in hospitals and in general practice, to describe perceptions which senior NHS staff have of good medical practice, and to describe how problems of poor medical practice are currently managed. A postal questionnaire survey. The questionnaire sought perceptions of good medical practice, asked participants to characterise deviations from good practice, and to describe experience with managing poor performance at the time of the introduction of the General Medical Council (GMC) performance procedures. A range of NHS settings in the UK: hospital trusts, health authorities/boards, local medical committees, community health councils. Senior health professionals involved in the management of medical professional performance. Perceptions of what constitutes good medical practice. Most respondents considered that persistent problems related to clinical practice (diagnosis, management, and outcome and prescribing) would require local management and, possibly, referral to the GMC performance procedures. Informal mechanisms, including informal discussion, education, training, and work shifting, were the most usual means of handling a doctor whose performance was poor. Many took a less serious view of deficiencies in performance on manner and attitude and communication, although consultation skills rather than technical skills comprised the greatest number of complaints about doctors. Senior NHS professionals seem reluctant to consider persistently poor consultation skills in the same critical light as they do persistently poor technical practice. These attitudes may need to change with the implementation of clinical governance and updated guidance from the GMC on what constitutes good medical practice.

A survey on regenerative surgery performed by Swiss specialists in periodontology with special emphasis on the application of enamel matrix derivatives in infrabony defects.

PubMed

Schröen, Ola; Sahrmann, Philipp; Roos, Malgorzata; Attin, Thomas; Schmidlin, Patrick R

2011-01-01

This survey aimed to evaluate the common practice of regenerative periodontal surgery with special regard to the use of enamel matrix derivatives (EMD, Emdogain® ) by board-certified specialists in periodontology and non-certified, but active members of the Swiss Society of Periodontology (SSP). A cross-sectional postal survey of 533 dentists, representing all members of the SSP practising in Switzerland, was conducted. The questionnaire consisted of three sections, assessing: 1) general personal information regarding the practice setting and education, 2) general questions regarding periodontal surgery practices and 3) specific questions regarding the use of EMD. The information obtained was compared and differences between specialists and non-specialists were calculated. P-values smaller than 5% were considered significant. Sixty-nine percent of the specialists answered the questionnaire, compared to only 37.4% of the non-specialists (overall: 42.4%). In general, specialists performed surgeries more frequently, and presented a significantly higher percentage of EMD users than the non-specialists. The application guidelines were followed in general. Some differences were observed in application and selection criteria. The subjective perception of clinical success varied greatly among clinicians. Residual pockets were reported to be present in approximately one third of the defects after therapy. In conclusion, this survey revealed that EMD was used on a regular basis by dentists performing periodontal therapy. In addition, the answers by both groups generally corresponded well with the current available literature.

Atopic conditions and mental health problems: a 3-year follow-up study.

PubMed

Lien, Lars; Green, Kristian; Thoresen, Magne; Bjertness, Espen

2010-09-01

The aim of this study was to test the hypothesis that atopic conditions at 15/16 years of age affect both internalized and externalized mental health problems 3 years later. Combined school and postal survey was conducted in urban and rural settings. A total of 3,674 adolescents (70.1% response rate) were followed at two time points and interviewed with similar questionnaires at baseline and follow-up. Hopkins Symptoms Checklist (HSCL-10) was used to assess internalized problems, and two subscales (conduct problems and hyperactivity) from the Strength and Difficulties Questionnaire to measure externalized mental health problems. The atopic conditions investigated were asthma, hay fever and eczema by asking the adolescents whether these conditions were present or not. There was an increase in the prevalence of internalized mental health problems from about 17-25% and a decrease in externalized mental health problems and number of atopic conditions in the follow-up period. Of the atopic conditions, hay fever was most prevalent with about 34% at 15 years of age and 20% at 18. The asthma prevalence was at 10 and 5% and eczema at 25 and 10%, respectively. Internalized mental health problems among girls were significantly associated with atopic conditions 3 years earlier, also after controlling for confounding variables. To live with atopic conditions seem to affect the mood and level of anxiety among adolescent girls. This should be kept in mind by health professionals treating young girls with atopic conditions.

Survey Methods to Optimize Response Rate in the National Dental Practice-Based Research Network.

PubMed

Funkhouser, Ellen; Vellala, Kavya; Baltuck, Camille; Cacciato, Rita; Durand, Emily; McEdward, Deborah; Sowell, Ellen; Theisen, Sarah E; Gilbert, Gregg H

2017-09-01

Surveys of health professionals typically have low response rates, and these rates have been decreasing in the recent years. We report on the methods used in a successful survey of dentist members of the National Dental Practice-Based Research Network. The objectives were to quantify the (1) increase in response rate associated with successive survey methods, (2) time to completion with each successive step, (3) contribution from the final method and personal contact, and (4) differences in response rate and mode of response by practice/practitioner characteristics. Dentist members of the network were mailed an invitation describing the study. Subsequently, up to six recruitment steps were followed: initial e-mail, two e-mail reminders at 2-week intervals, a third e-mail reminder with postal mailing a paper questionnaire, a second postal mailing of paper questionnaire, and staff follow-up. Of the 1,876 invited, 160 were deemed ineligible and 1,488 (87% of 1,716 eligible) completed the survey. Completion by step: initial e-mail, 35%; second e-mail, 15%; third e-mail, 7%; fourth e-mail/first paper, 11%; second paper, 15%; and staff follow-up, 16%. Overall, 76% completed the survey online and 24% on paper. Completion rates increased in absolute numbers and proportionally with later methods of recruitment. Participation rates varied little by practice/practitioner characteristics. Completion on paper was more likely by older dentists. Multiple methods of recruitment resulted in a high participation rate: Each step and method produced incremental increases with the final step producing the largest increase.

Scope of practice and supervision of orthodontic therapists in the United Kingdom: Part 2: a national cross-sectional survey of orthodontic therapists.

PubMed

Ahmed, Farooq; Dugdale, Charlotte; Malik, Ovais; Waring, David

2018-03-01

Orthodontic therapists (OTs) are the most recent addition to the orthodontic clinical team. The General Dental Council (GDC) and the British Orthodontic Society have formulated guidance and guidelines relating to their scope of practice and level of supervision, however there has been no contemporary UK-based research investigating practice and supervision of OTs. The aim of this study was to investigate the scope of practice and level of supervision of OTs working in the UK. Ethical approval was received from the University of Manchester Research Ethics Committee. An anonymous postal questionnaire was dispatched using postal details acquired through the British Orthodontic Societies mailing list. Three mailings of the questionnaire were conducted. A 74% response rate was achieved. OTs routinely conducted 16 of the 20 procedures from their scope of practice. Uncommon procedures included fitting headgear (24%), lingual appliances (27%), inserting or removing temporary anchorage devices (20%), and taking facebow record (18%). A total of 62% of OTs took patient consent for treatment. 59% were supervised through a written prescription with no direct supervision. OTs were directly supervised for only a quarter of their clinical practice. Orthodontists viewing frequency for OTs varied significantly, and was found to be the following: every 2-4 visits (36%), every other visit (35%), and every visit (26%). OTs mostly carried out the scope of practice as permitted by the GDC. Procedures uncommon to routine orthodontic practice were also uncommon to Orthodontic therapist clinical practice. OTs work mostly through written prescription with no direct supervision.

Career choices for obstetrics and gynaecology: national surveys of graduates of 1974-2002 from UK medical schools.

PubMed

Turner, G; Lambert, T W; Goldacre, M J; Barlow, D

2006-03-01

To report the trends in career choices for obstetrics and gynaecology among UK medical graduates. Postal questionnaire surveys of qualifiers from all UK medical schools in nine qualification years since 1974. United Kingdom. All graduates from UK medical schools in 1974, 1977, 1980, 1983, 1993, 1996, 1999, 2000 and 2002. Postal questionnaire surveys. Career choices for obstetrics and gynaecology and factors influencing career choices for obstetrics and gynaecology. Seventy-four percent (24,623/33,417) and 73% (20,709/28,468) of doctors responded at 1 and 3 years after qualification. Choices for obstetrics and gynaecology fell sharply during the 1990s from 4.2% of 1996 qualifiers to 2.2% of 1999 qualifiers, and rose slightly to 2.8% of 2002 qualifiers. Only 0.8% of male graduates of 2002 chose obstetrics and gynaecology compared with 4.1% of women. Forty-six percent of those who chose obstetrics and gynaecology 1 year after qualification were working in it 10 years after qualifying. Experience of the subject as a student, and the influence of a particular teacher or department, affected long-term career choices more for obstetrics and gynaecology than for other careers. The unwillingness of young doctors to enter obstetrics and gynaecology may be attributable to concerns about workforce planning and career progression problems, rather than any lack of enthusiasm for the specialty. The number of men choosing obstetrics and gynaecology is now very small; the reasons and the future role of men in the specialty need to be debated.

How is the high vaginal swab used to investigate vaginal discharge in primary care and how do GPs' expectations of the test match the tests performed by their microbiology services?

PubMed

Noble, H; Estcourt, C; Ison, C; Goold, P; Tite, L; Carter, Y H

2004-06-01

To describe the management of vaginal discharge in general practice, with particular regard to the use of the high vaginal swab (HVS), and to compare GPs' expectations of this test with the processing and reporting undertaken by different laboratories. A postal questionnaire survey of 2146 GPs in the North Thames area and postal questionnaire study of the 22 laboratories serving the same GPs were carried out. GPs were asked how they would manage a young woman with vaginal discharge and what information they would like on an HVS report. Laboratories were asked how they would process and report on the HVS sample from the same patient. Response rate was 26%. 72% of GPs would take an HVS and 62% would refer on to a genitourinary medicine (GUM) clinic. 45% would offer empirical therapy and 47% of these would treat for candida initially. 75% of GPs routinely request "M,C&S" on HVS samples but 55% only want to be informed about specific pathogens. Routine processing of HVS samples varies widely between laboratories and 86% only report specific pathogens. 78% of GPs would like to be offered a suggested diagnosis on HVS reports, and 74% would like a suggested treatment. 43% of laboratories ever provide a diagnosis, and 14% provide a suggested treatment. GPs frequently manage vaginal discharge and most of them utilise the HVS. GPs' expectations of the test are not well matched to laboratory processing or reporting of the samples.

Precautions against cross-infection during operations for maxillofacial trauma.

PubMed

Pigadas, N; Avery, C M

2000-04-01

One hundred oral and maxillofacial units in the UK were sent a postal questionnaire. Surgical staff of all grades were asked which infection-control measures were taken during the treatment of maxillofacial fractures. Two hundred and ninety-four questionnaires were completed, a response rate of 49%. If the patient was known to be infected by a blood-borne viral disease, significantly more surgeons used standard barrier precautions such as eye protection, fluid-resistant gowns, drapes, ball-ended clips, adhesive tapes and intermediate trays (P<0.0001). Bone-plating techniques were used in preference to wire osteosynthesis (P<0.0001). Only 31 (10.5%) of surgeons routinely used double gloves but 250 (85%) did so if the patient was an infection risk (P<0.0001). Universal precautions were not applied equally to all patients. Copyright 2000.

How to Measure the Intervention Process? An Assessment of Qualitative and Quantitative Approaches to Data Collection in the Process Evaluation of Organizational Interventions

PubMed Central

Abildgaard, Johan S.; Saksvik, Per Ø.; Nielsen, Karina

2016-01-01

Organizational interventions aiming at improving employee health and wellbeing have proven to be challenging to evaluate. To analyze intervention processes two methodological approaches have widely been used: quantitative (often questionnaire data), or qualitative (often interviews). Both methods are established tools, but their distinct epistemological properties enable them to illuminate different aspects of organizational interventions. In this paper, we use the quantitative and qualitative process data from an organizational intervention conducted in a national postal service, where the Intervention Process Measure questionnaire (N = 285) as well as an extensive interview study (N = 50) were used. We analyze what type of knowledge about intervention processes these two methodologies provide and discuss strengths and weaknesses as well as potentials for mixed methods evaluation methodologies. PMID:27713707

How to Measure the Intervention Process? An Assessment of Qualitative and Quantitative Approaches to Data Collection in the Process Evaluation of Organizational Interventions.

PubMed

Abildgaard, Johan S; Saksvik, Per Ø; Nielsen, Karina

2016-01-01

Organizational interventions aiming at improving employee health and wellbeing have proven to be challenging to evaluate. To analyze intervention processes two methodological approaches have widely been used: quantitative (often questionnaire data), or qualitative (often interviews). Both methods are established tools, but their distinct epistemological properties enable them to illuminate different aspects of organizational interventions. In this paper, we use the quantitative and qualitative process data from an organizational intervention conducted in a national postal service, where the Intervention Process Measure questionnaire ( N = 285) as well as an extensive interview study ( N = 50) were used. We analyze what type of knowledge about intervention processes these two methodologies provide and discuss strengths and weaknesses as well as potentials for mixed methods evaluation methodologies.

[Cooperation, Job Satisfaction and Burn Out - Sustainability in Outpatient Mental Health Care among Medical Specialists in Germany].

PubMed

Baumgardt, Johanna; Moock, Jörn; Rössler, Wulf; Kawohl, Wolfram

2017-04-01

Objective Cooperation, job satisfaction, and burn out risk are indicators of sustainability in mental health services. Thus they were assessed among registered medical specialists in outpatient mental health care in Germany. Method A postal survey consisting of three questionnaires about cooperation, job satisfaction, and burnout was carried out among all registered medical specialists in outpatient mental health care in Germany (n = 4,430). Results 14.1 % (n = 626) of the specialists responded to the survey. Quality and quantity of cooperation regarding mental health care services were rated diverse, job satisfaction was assessed medium to high, and burnout risk was low to medium. Higher job satisfaction correlated with good quality of cooperation, fewer years of practice, fewer patients' chronically ill, more patients who as well seek psychotherapy, and less time spent on cooperation. Low burn out risk correlated with good quality of cooperation, higher age, single practice setting and a higher amount of patients who as well seek psychotherapy. Conclusion Quality and quantity of cooperation in outpatient mental health care - especially regarding community mental health care institutions - should be fostered. Aspects to be considered to reinforce job satisfaction and minimize burn out risk are age, years of practice, quality and quantity of cooperation, practice setting, and the mixture of patients. © Georg Thieme Verlag KG Stuttgart · New York.

[Preventable drug-related morbidity: determining valid indicators for primary care in Portugal].

PubMed

Guerreiro, Mara Pereira; Cantrill, Judith A; Martins, Ana Paula

2007-01-01

Preventable drug-related morbidity (PDRM) indicators are operational measures of therapeutic risk management. These clinical indicators, which cover a wide range of drugs, combine process and outcome in the same instrument. They were developed in the US and have been validated for primary care settings in the US, UK and Canada. This study is part of a research programme; it aimed to determine a valid set of PDRM indicators for adult patients in primary care in Portugal. Face validity of 61 US and UK-derived indicators translated to Portuguese was preliminarily determined by means of a postal questionnaire using a purposive sample of four Portuguese pharmacists with different backgrounds. Preliminary content validity of indicators approved in the previous stage was determined by cross-checking each definition of PDRM with standard drug information sources in Portugal. Face and content validity of indicators yielded by preliminary work were then established by a 37 expert panel (20 community pharmacists and 17 general practitioners) using a two-round Delphi survey. Data were analysed using SPSS release 11.5. Nineteen indicators were ruled out in preliminary validation. Changes were made in the content of eight of the remaining 42 indicators; these were related to differences in the drugs being marketed and patterns of drug monitoring between countries. Thirty-five indicators were consensus approved as PDRM for adult patients in Portuguese primary care by the Delphi panel.

39 CFR 3.3 - Matters reserved for decision by the Board.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Matters reserved for decision by the Board. 3.3 Section 3.3 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE BOARD OF GOVERNORS (ARTICLE III) § 3.3 Matters reserved for decision by the Board. The following matters...

39 CFR 3.3 - Matters reserved for decision by the Board.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Matters reserved for decision by the Board. 3.3 Section 3.3 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE BOARD OF GOVERNORS (ARTICLE III) § 3.3 Matters reserved for decision by the Board. The following matters...

39 CFR 3.3 - Matters reserved for decision by the Board.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Matters reserved for decision by the Board. 3.3 Section 3.3 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE BOARD OF GOVERNORS (ARTICLE III) § 3.3 Matters reserved for decision by the Board. The following matters...

39 CFR 3.3 - Matters reserved for decision by the Board.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Matters reserved for decision by the Board. 3.3 Section 3.3 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE BOARD OF GOVERNORS (ARTICLE III) § 3.3 Matters reserved for decision by the Board. The following matters...