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Sample records for self-administered subjective gerd

  1. GERD

    MedlinePlus

    ... a burning in the chest or throat called heartburn. Sometimes, you can taste stomach fluid in the ... GERD. You can also have GERD without having heartburn. Your symptoms could include a dry cough, asthma ...

  2. Subjective responses and cardiovascular effects of self-administered cocaine in cocaine-abusing men and women.

    PubMed

    Lynch, Wendy J; Kalayasiri, Rasmon; Sughondhabirom, Atapol; Pittman, Brian; Coric, Vladimir; Morgan, Peter T; Malison, Robert T

    2008-09-01

    This study aimed to examine sex differences in cocaine self-administration and cocaine-induced subjective and cardiovascular measures. The research was based on secondary analysis of data collected in our human laboratory in which subjects self-administered cocaine infusions (8, 16 and 32 mg/70 kg) over a 2-hour period under a fixed ratio 1, 5 minute time out schedule in three test sessions. Subjects were 10 women and 21 men with a history of either cocaine abuse or dependence who were not currently seeking treatment. Women and men self-administered similar amounts of cocaine. None of the subjective effects measures showed a significant main effect of sex during the cocaine self-administration session. Significant interactions were observed for subjective ratings of 'high' (sex x time) and 'stimulated' (sex x time x dose), with women reporting lower ratings over time/doses than men. Relative to men, cocaine produced dose- and time-dependent increases in feelings of hunger (i.e., reduced appetite suppression) in women. Systolic and diastolic blood pressures showed different patterns of change in men and women, with women showing less robust cocaine-induced increases than men. Taken together, these findings suggest that women and men may differ in their subjective and cardiovascular responses to self-administered cocaine. Further research that prospectively controls for hormonal influences upon these measures is needed.

  3. A within-subject assessment of the discriminative stimulus and reinforcing effects of self-administered cocaine in rhesus monkeys

    PubMed Central

    Martelle, Jennifer L.

    2009-01-01

    Rationale Drug discrimination (DD) and drug self-administration (SA) are frequently used preclinical assays. All preclinical studies with cocaine have examined the discriminative stimulus (SD) and reinforcing (SR) effects in separate groups of subjects. Objective The objective of the study is to train drug-naïve rhesus macaques to discriminate self-administered cocaine from saline and to assess SD and SR effects using a within-subjects design. Materials and methods Adult male rhesus monkeys (n=4) were trained to self-administer cocaine (0.1 mg/kg per injection) under a progressive-ratio (PR) reinforcement schedule. Next, they were trained to discriminate self-administered cocaine (0.45 or 0.56 mg/kg) or saline under a fixed-ratio (FR) 50 schedule of food presentation. The final schedule combined DD and SA into a multiple [chained FR 50 SA (cocaine or saline), food-reinforced DD] and PR SA schedule. Results Each subject acquired SA under a PR schedule with significant differences in breakpoint between saline and cocaine evident by session 5. Self-administered cocaine was established as an SD, such that 80% of responding before delivery of the first reinforcer and 90% of all responding occurred on the injection-appropriate lever. In all monkeys, there was at least one cocaine dose that did not engender cocaine-appropriate responding during DD (i.e., <20% cocaine-appropriate responding) yet functioned as a reinforcer during PR SA, suggesting that cocaine-like SD effects are not necessary for cocaine reinforcement. Conclusions This within-subject model may provide new information related to the behavioral mechanisms of action leading to the high abuse potential of cocaine; such information may lead to novel pharmacological treatment strategies for addiction. PMID:18807249

  4. Detrimental Effects of a Self-reward Contracting Program on Subjects' Involvement in Self-administered Desensitization

    ERIC Educational Resources Information Center

    Barrera, Manuel Jr.; Rosen, Gerald M.

    1977-01-01

    Assesses a self-reward contracting procedure intended to facilitate completion of self-administered desensitization. Self-referred snake phobics received either (a) self-administered desensitization; (b) self-administered desensitization with self-reward contracting; or (c) a self-administered placebo with self-reward contracting. Results show the…

  5. Defining GERD.

    PubMed

    Sontag, S J

    1999-01-01

    "It is not the death of GERD that I seek, but that it turns from its evil ways and follows the path of righteousness." The reflux world is fully aware of what GERD is and what GERD does. What the world does not know, however, is the answer to the most important yet least asked question surrounding GERD's raison-d'etre: Why is GERD here and why do we have it? What GERD is: abnormal gastric reflux into the esophagus that causes any type of mischief. What GERD does: causes discomfort and/or pain with or without destroying the mucosa; causes stricture or stenosis, preventing food from being swallowed; sets the stage for the development of esophageal adenocarcinoma; invades the surrounding lands to harass the peaceful oropharyngeal, laryngeal and broncho-pulmonary territories; reminds us that we are not only human, but that we are dust and ashes. Why GERD is here: We propose three separate and distinct etiologies of GERD, and we offer the following three hypotheses to explain why, after 1.5 million years of standing erect, we have evolved into a species (specifically Homosapiens sapiens) that is destined to live with the scourge of GERD. Hypothesis 1: congenital. The antireflux barrier, comprising the smooth-muscled lower esophageal sphincter, the skeletal-muscled right crural diaphragm and the phreno-esophageal ligament does not completely develop due to a developmental anomaly or incomplete gestation. Hypothesis 2: acute trauma: The antireflux barrier in adults suffering acute traumatic injury to the abdomen or chest is permanently disrupted by unexpected forces, such as motor vehicle accidents (with steering wheel crush impact), blows to the abdomen (from activities such as boxing, etc.), heavy lifting or moving (e.g., pianos, refrigerators) or stress positions (e.g., hand stands on parallel gym bars). The trauma creates a hiatal hernia that renders the antireflux mechanism useless and incapable of preventing GERD. Hypothesis 3: chronic trauma: The antireflux barrier

  6. Gastroesophageal Reflux Disease (GERD)

    MedlinePlus

    ... A Week of Healthy Breakfasts Shyness Gastroesophageal Reflux Disease (GERD) KidsHealth > For Teens > Gastroesophageal Reflux Disease (GERD) ... foods garlic and onions mint flavorings spicy foods tomato-based foods, like spaghetti sauce, chili, and pizza ...

  7. Reflux and GERD (in Children)

    MedlinePlus

    ... Z Celiac Disease Eosinophilic Esophagitis Inflammatory Bowel Disease Nutrition & Obesity Reflux & GERD Reflux & GERD in Infants GERD in ... Nutrition (NASPGHAN) Celiac Disease Eosinophilic Esophagitis Pediatric IBD Nutrition & Obesity Reflux & GERD Research & Grants Our Supporters Site Map © ...

  8. Reflux and GERD in Infants

    MedlinePlus

    ... Z Celiac Disease Eosinophilic Esophagitis Inflammatory Bowel Disease Nutrition & Obesity Reflux & GERD Reflux & GERD in Infants Symptoms & Diagnosis ... Nutrition (NASPGHAN) Celiac Disease Eosinophilic Esophagitis Pediatric IBD Nutrition & Obesity Reflux & GERD Research & Grants Our Supporters Site Map © ...

  9. Self-administered pain-relieving manoeuvres in primary headaches.

    PubMed

    Zanchin, G; Maggioni, F; Granella, F; Rossi, P; Falco, L; Manzoni, G C

    2001-09-01

    We investigated the use of self-administered pain-relieving manoeuvres on a sample of 400 patients with primary headaches--represented by an even distribution of migraine without aura (MO), migraine with aura (MA), episodic tension-type headache (TH), and cluster headache (CH)--consecutively seen at Padua and Parma Headache Centres. Manoeuvres on various regions of the head were used by 258 patients (65% of the cases). The most applied procedures were: compression (114 out of 382 manoeuvres; 30%), application of cold (27%), massage (25%) and application of heat (8%). A significant (P < 0.001) relationship was found between headache diagnoses and type of manoeuvre. In MO patients the application of cold (38% of the manoeuvres) and compression (36%), used mainly on the forehead and temples, prevailed; compression, mainly on the temples, was the most frequent procedure (44%) in MA patients. Massage on the temples and nape was the predominant manoeuvre (43%) in TH patients, whereas in the CH group, which more often required heterogeneous procedures, none of the above-mentioned manoeuvres was prevalent. Compression, as a diagnostic criterion for MO, had a sensitivity of 33% and a specificity of 86%; for the application of cold the figures were 36% and 84%, respectively. Massage had a sensitivity of 33% and a specificity of 80% for TH. The efficacy of the self-administered manoeuvres in reducing pain was scarce. Only 8% of the manoeuvres, in fact, resulted in a good or excellent pain control. Moreover, the efficacy of the manoeuvre was often momentary, wearing off when the manoeuvre stopped. In spite of this, 46% of the subjects used the manoeuvres constantly, at each attack.

  10. Dilated intercellular spaces as a marker of GERD.

    PubMed

    Orlando, Lori A; Orlando, Roy C

    2009-06-01

    Gastroesophageal reflux disease (GERD) is typically heralded by the substernal burning pain of heartburn. On endoscopic examination, about one third of GERD subjects with heartburn have erosive disease, and the remainder have nonerosive reflux disease (NERD). Unlike patients with erosive disease, those with NERD (approximately 50%) often do not respond to therapy with proton pump inhibitors (PPIs), raising the question of whether they have NERD and, if they do, whether the cause of their symptoms is similar to those who respond to PPIs. Recently, biopsies established that subjects with heartburn and PPI-responsive NERD, like those with erosive esophagitis, have lesions within the esophageal epithelium known as dilated intercellular space (DIS). In this article, we discuss the physicochemical basis for DIS in acid-injured esophageal epithelium and its significance in GERD. Although DIS is not pathognomic of GERD, it is a marker of a break in the epithelial (junctional) barrier reflecting an increase in paracellular permeability.

  11. GERD (Gastroesophageal Reflux) and LPR (Laryngopharyngeal Reflux)

    MedlinePlus

    ... persist. What role does an ear, nose, and throat specialist have in treating GERD and LPR? A ... for GERD. But there are ear, nose, and throat problems that are caused by reflux reaching beyond ...

  12. Psychology of computer use: IX. A menu of self-administered microcomputer-based neurotoxicology tests

    NASA Technical Reports Server (NTRS)

    Kennedy, R. S.; Baltzley, D. R.; Wilkes, R. L.; Kuntz, L. A.

    1989-01-01

    This study examined the feasibility of repeated self-administration of a newly developed battery of mental acuity tests which may have application in screening for fitness-for-duty or for persons who may be exposed to environmental stress, toxic agents, or disease. 16 subjects self-administered 18 microcomputer-based tests (13 new, 5 "core"), without proctors, over 10 sessions. The hardware performed well throughout the study and the tests appeared to be easily self-administered. Stabilities and reliabilities of the tests from the "core" battery were comparable to those obtained previously under more controlled experimental conditions. Eight of the new tests exceeded minimum criteria for metric and practical requirements and can be recommended as additions to the menu. Although the average retest reliability was high, cross-correlations between tests were low, implying factorial diversity. The menu can be used to form batteries with flexible total testing time which are likely to tap different mental processes and functions.

  13. Psychology of computer use: IX. A menu of self-administered microcomputer-based neurotoxicology tests

    NASA Technical Reports Server (NTRS)

    Kennedy, R. S.; Baltzley, D. R.; Wilkes, R. L.; Kuntz, L. A.

    1989-01-01

    This study examined the feasibility of repeated self-administration of a newly developed battery of mental acuity tests which may have application in screening for fitness-for-duty or for persons who may be exposed to environmental stress, toxic agents, or disease. 16 subjects self-administered 18 microcomputer-based tests (13 new, 5 "core"), without proctors, over 10 sessions. The hardware performed well throughout the study and the tests appeared to be easily self-administered. Stabilities and reliabilities of the tests from the "core" battery were comparable to those obtained previously under more controlled experimental conditions. Eight of the new tests exceeded minimum criteria for metric and practical requirements and can be recommended as additions to the menu. Although the average retest reliability was high, cross-correlations between tests were low, implying factorial diversity. The menu can be used to form batteries with flexible total testing time which are likely to tap different mental processes and functions.

  14. Endotherapy and surgery for GERD.

    PubMed

    Triadafilopoulos, George

    2007-07-01

    Today, there are several modalities to treat gastroesophageal reflux disease (GERD) (medications, endoscopic therapies, surgery) and such therapies can be used either singly, or in tandem, or in combination with the others, aiming at "normalization" of the patient's GERD-related quality of life and, if possible, esophageal acid exposure. Several intermediate end points or clinically significant outcomes have not been reached by some therapeutic modalities and no single modality is or can be perfect. Statistically significant improvements in these intermediate end points have been shown in "some" but not all studies. Although healing of esophagitis can be accomplished with either medical or surgical therapy, there is inadequate data with endotherapies, because most patients treated with endotherapies have had prior trials of proton pump inhibitors (PPIs) and hence healed their esophagitis. Effective prevention of complications, such as esophageal adenocarcinoma, remains challenging for all modalities. Patients who have not normalized their GERD-related quality of life with once or twice daily PPI therapy should undergo functional esophageal evaluation with pH testing and esophageal motility study and they should be evaluated by both an endoscopist and a surgeon. The decision on how to proceed should be made on the basis of the criteria for endotherapy and surgery, availability of local endoscopic and surgical expertise and patients' preference. Such multimodality therapy model is in many ways similar to the long-term management of coronary artery disease where pharmacotherapy, angioplasty, and bypass surgery are frequently used in tandem or in combination. Multimodality therapy aiming at normalization of GERD-related quality of life is an option today, and should be available to all patients in need of therapy. The target population for GERD endotherapy currently consists of PPI-dependent GERD patients, who have a small (<2-cm-long) or no sliding hiatal hernia, and

  15. Conditioned reinforcement in rats established with self-administered nicotine and enhanced by noncontingent nicotine

    PubMed Central

    Liu, Xiu; Matteson, Gina L.; Donny, Eric C.; Caggiula, Anthony R.; Sved, Alan F.

    2010-01-01

    Rationale Nicotine is widely assumed to convey reinforcing properties upon tobacco-related stimuli through associative learning. We have proposed that the reinforcement derived from these conditional stimuli can be inflated by a nonassociative “reinforcement-enhancing” effect of nicotine. Objectives Experiment 1 investigated whether nicotine could establish a stimulus as a conditioned reinforcer. Using the same subjects, Experiment 2 examined whether responding for a nicotine-associated stimulus was enhanced by response-independent administration of nicotine. Materials and methods Self-administered nicotine (Paired group, 0.03 mg kg1 infusion−1) or saline (conditional stimulus or CS-Only group) was paired with a stimulus light (CS). An Unpaired group, yoked to the Paired group, received equal exposure to nicotine and the CS, but each event was temporally separated. To test for conditioning, the CS was then made contingent upon a novel lever-pressing response. In Experiment 2, a subset of the paired rats (self-administering) continued to lever press while receiving contingent nicotine and the CS. To determine whether nicotine enhanced responding for the CS, two remaining subsets of the Paired group responded for the CS while receiving nicotine (YNIC) or saline (YSAL) yoked to the self-administering rats. All remaining control groups received response-contingent CS presentations, together with yoked nicotine or saline. Results Pairing self-administered nicotine with the CS promoted the acquisition of a novel response for the CS. In Experiment 2, the Paired YNIC group responded at higher rates than control groups receiving YNIC or YSAL. Conclusions Nicotine can establish stimuli as conditioned reinforcers for which noncontingent nicotine can enhance responding. PMID:17676401

  16. Conditioned reinforcement in rats established with self-administered nicotine and enhanced by noncontingent nicotine.

    PubMed

    Palmatier, Matthew I; Liu, Xiu; Matteson, Gina L; Donny, Eric C; Caggiula, Anthony R; Sved, Alan F

    2007-12-01

    Nicotine is widely assumed to convey reinforcing properties upon tobacco-related stimuli through associative learning. We have proposed that the reinforcement derived from these conditional stimuli can be inflated by a nonassociative "reinforcement-enhancing" effect of nicotine. Experiment 1 investigated whether nicotine could establish a stimulus as a conditioned reinforcer. Using the same subjects, Experiment 2 examined whether responding for a nicotine-associated stimulus was enhanced by response-independent administration of nicotine. Self-administered nicotine (Paired group, 0.03 mg kg(1) infusion(-1)) or saline (conditional stimulus or CS-Only group) was paired with a stimulus light (CS). An Unpaired group, yoked to the Paired group, received equal exposure to nicotine and the CS, but each event was temporally separated. To test for conditioning, the CS was then made contingent upon a novel lever-pressing response. In Experiment 2, a subset of the paired rats (self-administering) continued to lever press while receiving contingent nicotine and the CS. To determine whether nicotine enhanced responding for the CS, two remaining subsets of the Paired group responded for the CS while receiving nicotine (YNIC) or saline (YSAL) yoked to the self-administering rats. All remaining control groups received response-contingent CS presentations, together with yoked nicotine or saline. Pairing self-administered nicotine with the CS promoted the acquisition of a novel response for the CS. In Experiment 2, the Paired YNIC group responded at higher rates than control groups receiving YNIC or YSAL. Nicotine can establish stimuli as conditioned reinforcers for which noncontingent nicotine can enhance responding.

  17. Rats self-administer carbachol directly into the nucleus accumbens.

    PubMed

    Ikemoto, S; Glazier, B S; Murphy, J M; McBride, W J

    1998-03-01

    The potential reinforcing effect of the muscarinic cholinergic agonist carbachol within the nucleus accumbens (ACB) was examined in female Wistar rats by using the technique of intracranial self-administration. Rats dose dependently self-administered solutions of 0.0-6.6 mM (in a volume of 100 nL per injection) directly into the ACB. Rats self-administered the 3.3 and 6.6 mM doses significantly more than the group given only vehicle. The caudate putamen did not support reliable self-administration of the 6.6-mM dose. Rats exhibited preference for the lever that produced infusions of 3.3 and 6.6 mM carbachol into the ACB over the lever that had no consequence. The self-infusion of the 6.6-mM dose into the ACB was inhibited by the coadministration of the muscarinic antagonist scopolamine (0.25 mM), but not by the nicotinic antagonist mecamylamine (6.6 mM). The present results suggest that direct activation of muscarinic receptors within the ACB supports self-administration and could result from reinforcement or from elicitation of a novel stimulus.

  18. Poor Sleep Quality and Obstructive Sleep Apnea in Patients with GERD and Barrett’s Esophagus

    PubMed Central

    Vela, Marcelo F.; Kramer, Jennifer R.; Richardson, Peter A.; Dodge, Rhiannon; El-Serag, Hashem B.

    2014-01-01

    Background Gastroesophageal reflux disease (GERD) reduces sleep quality. Whether Barrett’s esophagus (BE) affects sleep differently is unknown. Obstructive sleep apnea (OSA) often coexists with GERD and may disrupt sleep; whether GERD reduces sleep quality independently of OSA is unknown. Our aims were to compare the effect of GERD and BE on sleep quality, and assess the impact of OSA on this association. Methods Validated questionnaires for GERD symptoms, sleep quality, and OSA risk were prospectively administered to subjects undergoing upper endoscopy. GERD was defined by erosive esophagitis and/or reflux symptoms >1/week. BE was defined histologically. Controls had normal endoscopy and were asymptomatic. Poor sleep quality was defined by a Pittsburgh Sleep Quality Index score >5. Risk of OSA was defined by a positive Berlin Questionnaire. The risk poor sleep quality in GERD, BE, and controls was evaluated in multivariate models. Key Results 83 GERD, 63 BE, and 75 controls were included. OSA and poor sleep quality were significantly more frequent in GERD (65% and 60%) but not BE (52% and 46%) compared with controls (48% and 39%). Controlling for age, race, gender, smoking, BMI, and hypertension, the risk of poor sleep quality was significantly increased in GERD compared with controls (odds ratio [OR] = 2.79, 95% confidence interval [CI]: 1.08 – 6.80), significance was lost after adding OSA to the model (OR = 2.27, 95% CI: 0.87 – 5.85). Conclusions and Inferences GERD but not BE increases the risk of poor sleep quality. This association is not independent of OSA. PMID:24460751

  19. A Controlled Study to Assess the Clinical Efficacy of Totally Self-Administered Systematic Desensitization

    ERIC Educational Resources Information Center

    Rosen, Gerald M.; And Others

    1976-01-01

    Highly anxious self-referred snake phobics received either (a) therapist-administered desensitization, (b) self-administered desensitization with weekly therapist phone calls, (c) totally self-administered desensitization, (d) self-administered double-blind placebo control, or (e) no treatment. Pretreatment to posttreatment measures revealed…

  20. A Controlled Study to Assess the Clinical Efficacy of Totally Self-Administered Systematic Desensitization

    ERIC Educational Resources Information Center

    Rosen, Gerald M.; And Others

    1976-01-01

    Highly anxious self-referred snake phobics received either (a) therapist-administered desensitization, (b) self-administered desensitization with weekly therapist phone calls, (c) totally self-administered desensitization, (d) self-administered double-blind placebo control, or (e) no treatment. Pretreatment to posttreatment measures revealed…

  1. GERD

    MedlinePlus

    ... as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn ... heartburn, but major studies have not proved a benefit. Ask your doctor whether acupuncture is safe for you. References ... Accessed ...

  2. Evaluation of a Self-Administered Oral Glucose Tolerance Test

    PubMed Central

    Bethel, M. Angelyn; Price, Hermione C.; Sourij, Harald; White, Sarah; Coleman, Ruth L.; Ring, Arne; Kennedy, Irene E.C.; Tucker, Lynne; Holman, Rury R.

    2013-01-01

    OBJECTIVE To assess the feasibility of using a disposable, self-administered, capillary blood sampling oral glucose tolerance test (OGTT) device in a community setting. RESEARCH DESIGN AND METHODS Eighteen healthy and 12 type 2 diabetic volunteers underwent six 75-g OGTTs using a prototype device in the following three settings: unaided at home (twice); unaided but observed in clinic (twice); and performed by a nurse with simultaneous laboratory glucose assays of 0- and 120-min venous plasma samples (twice). The device displayed no results. A detachable data recorder returned to the clinic provided plasma-equivalent 0- and 120-min glucose values and key parameters, including test date, start and end times, and time taken to consume the glucose drink. RESULTS The device was universally popular with participants and was perceived as easy to use, and the ability to test at home was well liked. Device failures meant that 0- and 120-min glucose values were obtained for only 141 (78%) of the 180 OGTTs performed, independent of setting. Device glucose measurements showed a mean bias compared with laboratory-measured values of +0.9 at 5.0 mmol/L increasing to +4.4 at 15.0 mmol/L. Paired device glucose values were equally reproducible across settings, with repeat testing showing no training effect regardless of setting order. CONCLUSIONS Self-administered OGTTs can be performed successfully by untrained individuals in a community setting. With improved device reliability and appropriate calibration, this novel technology could be used in routine practice to screen people who might need a formal OGTT to confirm the presence of impaired glucose tolerance or diabetes. PMID:23321216

  3. Evaluation of a self-administered oral glucose tolerance test.

    PubMed

    Bethel, M Angelyn; Price, Hermione C; Sourij, Harald; White, Sarah; Coleman, Ruth L; Ring, Arne; Kennedy, Irene E C; Tucker, Lynne; Holman, Rury R

    2013-06-01

    To assess the feasibility of using a disposable, self-administered, capillary blood sampling oral glucose tolerance test (OGTT) device in a community setting. Eighteen healthy and 12 type 2 diabetic volunteers underwent six 75-g OGTTs using a prototype device in the following three settings: unaided at home (twice); unaided but observed in clinic (twice); and performed by a nurse with simultaneous laboratory glucose assays of 0- and 120-min venous plasma samples (twice). The device displayed no results. A detachable data recorder returned to the clinic provided plasma-equivalent 0- and 120-min glucose values and key parameters, including test date, start and end times, and time taken to consume the glucose drink. The device was universally popular with participants and was perceived as easy to use, and the ability to test at home was well liked. Device failures meant that 0- and 120-min glucose values were obtained for only 141 (78%) of the 180 OGTTs performed, independent of setting. Device glucose measurements showed a mean bias compared with laboratory-measured values of +0.9 at 5.0 mmol/L increasing to +4.4 at 15.0 mmol/L. Paired device glucose values were equally reproducible across settings, with repeat testing showing no training effect regardless of setting order. Self-administered OGTTs can be performed successfully by untrained individuals in a community setting. With improved device reliability and appropriate calibration, this novel technology could be used in routine practice to screen people who might need a formal OGTT to confirm the presence of impaired glucose tolerance or diabetes.

  4. Opponent process properties of self-administered cocaine.

    PubMed

    Ettenberg, Aaron

    2004-01-01

    Over the past decade, data collected in our laboratory have demonstrated that self-administered cocaine produces Opponent-Process-like behavioral effects. Animals running a straight alley once each day for IV cocaine develop over trials an approach-avoidance conflict about re-entering the goal box. This conflict behavior is characterized by a stop in forward locomotion (usually at the very mouth of the goal box) followed by a turn and 'retreat' back toward the goal box. The results of a series of studies conducted over the past decade collectively suggest that the behavioral ambivalence exemplified by rats running the alley for IV cocaine stems from concurrent and opponent positive (rewarding) and negative (anxiogenic) properties of the drug--both of which are associated with the goal box. These opponent properties of cocaine have been shown to result from temporally distinct affective states. Using a conditioned place preference test, we have been able to demonstrate that while the initial immediate effects of IV cocaine are reinforcing, the state present 15 min post-injection is aversive. In our most recent work, the co-administration of IV cocaine with either oral ethanol or IV heroin was found to greatly diminish the development and occurrence of retreat behaviors in the runway. It may therefore be that the high incidence of co-abuse of cocaine with either ethanol or heroin, stems from the users' motivation to alleviate some of the negative side effects of cocaine. It would seem then that the Opponent Process Theory has provided a useful conceptual framework for the study of the behavioral consequences of self-administered cocaine including the notion that both positive and negative reinforcement mechanisms are involved in the development and maintenance of cocaine abuse.

  5. GERD: Can Certain Medications Increase Severity?

    MedlinePlus

    ... Conditions GERD I've heard that some medications can aggravate the symptoms of GERD. Can you tell me more? Answers from Michael F. Picco, M.D. Certain medications and dietary supplements can irritate the lining of your esophagus, causing heartburn ...

  6. A menu of self-administered microcomputer-based neurotoxicology tests

    NASA Technical Reports Server (NTRS)

    Kennedy, Robert S.; Wilkes, Robert L.; Kuntz, Lois-Ann; Baltzley, Dennis R.

    1988-01-01

    This study examined the feasibility of repeated self-administration of a newly developed battery of mental acuity tests. Researchers developed this battery to be used to screen the fitness for duty of persons in at-risk occupations (astronauts, race car drivers), or those who may be exposed to environmental stress, toxic agents, or disease. The menu under study contained cognitive and motor tests implemented on a portable microcomputer including: a five-test core battery, lasting six minutes, which had demonstrable reliabilities and stability from several previous repeated-measures studies, and also 13 new tests, lasting 42 minutes, which had appeared in other batteries but had not yet been evaluated for repeated-measures implementation in this medium. Sixteen subjects self-administered the battery over 10 repeated sessions. The hardware performed well throughout the study and the tests appeared to be easily self-administered. Stabilities and reliabilities of the test from the core battery were comparable to those obtained previously under more controlled experimental conditions. Analyses of metric properties of the remaining 13 tests produced eight additional tests with satisfactory properties. Although the average retest reliability was high, cross-correlations between tests were low, indicating factorial richness. The menu can be used to form batteries of flexible total testing time which are likely to tap different mental processes and functions.

  7. Review of the integrity of a Self Administered Motivational Instrument.

    PubMed

    Duffy, Tim; McCaig, Marie; McGrandles, Amanda; Rimmer, Russell; Martin, Colin R

    2014-04-01

    Motivational interviewing (MI) was developed by Miller and Rollnick as an evidence-based counselling approach for use in supporting people with alcohol problems. Over the years the principles and spirit of MI have been reviewed and fine-tuned and the approach has been embraced by practitioners worldwide and across fields. Since 2001 a number of instruments have been designed to evaluate the fidelity of MI practice. For the purposes of this study, one such instrument is used to assess a self-administered motivational instrument, known as the SAMI, which takes the interviewer role. The SAMI is evaluated against the MITI 3.1.1, which is designed to assess the extent to which MI interventions perform on five global dimensions. These are evocation, collaboration, autonomy/support, direction and empathy. The SAMI was assembled based on the principles and spirit of MI, problem solving and goal-setting. The targeted behaviour changes were student learning styles and approaches to study. The SAMI was distributed, completed and submitted electronically via the university virtual learning environment. Thirty three mature students of a university which delivered online nursing programme were invited to complete the SAMI. Of these, 25 submitted completed transcripts. Transcripts of a sample of six completed SAMIs were assessed by a group of teachers and researchers with experience in the use and evaluation of MI, using five-point Likert scales to assess the SAMI on the five dimensions. Overall, an average score exceeding 4.5 was attained across the five dimensions. Conventionally, such a score is recognised as competency in MI. However, on one dimension (empathy), the rating was three. This current research confirms that global principles have been observed in the online delivery of MI using the SAMI to probe approaches to study. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Refractory heartburn: comparison of intercellular space diameter in documented GERD vs. functional heartburn.

    PubMed

    Vela, Marcelo F; Craft, Brandon M; Sharma, Neeraj; Freeman, Janice; Hazen-Martin, Debra

    2011-05-01

    Refractory heartburn despite acid suppression may be explained by ongoing gastroesophageal reflux disease (GERD) or functional heartburn (FH), i.e., symptoms without evidence of GERD. Impedance-pH monitoring (impedance-pH) detects acid and nonacid reflux and is useful for evaluating acid-suppressed, refractory patients. Intercellular space diameter (ISD) of esophageal epithelium measured by transmission electron microscopy (TEM) is a marker of epithelial damage present in both erosive and nonerosive reflux disease. ISD has not been used to study refractory heartburn or FH. Our aim was to compare ISD in healthy controls and refractory heartburn patients with GERD and FH. In refractory heartburn patients (heartburn more than twice/week for at least 2 months despite proton pump inhibitor (PPI) b.i.d.), erosive esophagitis and/or abnormal impedance-pH (increased acid exposure or positive symptom index) defined GERD; normal esophagogastroduodenoscopy (EGD)/impedance-pH defined FH. Asymptomatic, healthy controls had normal EGD and pH-metry. Mean ISD in each subject, determined by blinded TEM of esophageal biopsies, was the average of 100 measurements (10 measurements in each of 10 micrographs). In all, 11 healthy controls, 11 FH, and 15 GERD patients were studied. Mean ISD was significantly higher in GERD compared with controls (0.87 vs. 0.32 μm, P=0.003) and FH (0.87 vs. 0.42 μm, P=0.012). Mean ISD was similar in FH and controls (0.42 vs. 0.32 μm, P=0.1). The proportion of patients with abnormal ISD was significantly higher for GERD compared with FH (60 vs. 9%, P=0.014). ISD is increased in refractory heartburn patients with GERD but not those with FH. Our findings suggest that measurement of ISD by TEM might be a useful tool to distinguish GERD from FH in patients with refractory heartburn.

  9. Laparoscopic Anti-Reflux (GERD) Surgery

    MedlinePlus

    ... Sponsorship Opportunities Log In Laparoscopic Anti-Reflux (GERD) Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Surgery for “Heartburn” If you suffer from moderate to ...

  10. Acid Reflux (GER & GERD) in Infants

    MedlinePlus

    ... Infants Related Topics Section Navigation Digestive Diseases Abdominal Adhesions Acid Reflux (GER & GERD) in Adults Definition & Facts ... Eating, Diet, & Nutrition Clinical Trials Cyclic Vomiting Syndrome Dental Enamel Defects and Celiac Disease Dermatitis Herpetiformis Dermatitis ...

  11. Acid Reflux (GER & GERD) in Children & Teens

    MedlinePlus

    ... Teens Related Topics Section Navigation Digestive Diseases Abdominal Adhesions Acid Reflux (GER & GERD) in Adults Definition & Facts ... Eating, Diet, & Nutrition Clinical Trials Cyclic Vomiting Syndrome Dental Enamel Defects and Celiac Disease Dermatitis Herpetiformis Dermatitis ...

  12. Comparative Discussion on Psychophysiological Effect of Self-administered Facial Massage by Treatment Method

    NASA Astrophysics Data System (ADS)

    Nozawa, Akio; Takei, Yuya

    The aim of study was to quantitatively evaluate the effects of self-administered facial massage, which was done by hand or facial roller. In this study, the psychophysiological effects of facial massage were evaluated. The central nerves system and the autonomic nervous system were administered to evaluate physiological system. The central nerves system was assessed by Electroencephalogram (EEG). The autonomic nervous system were assessed by peripheral skin temperature(PST) and heart rate variability (HRV) with spectral analysis. In the spectral analysis of HRV, the high-frequency components (HF) were evaluated. State-Trait Anxiety Inventory (STAI), Profile of Mood Status (POMS) and subjective sensory amount with Visual Analog Scale (VAS) were administered to evaluate psychological status. These results suggest that kept brain activity and had strong effects on stress alleviation.

  13. Dose and elasticity of demand for self-administered cocaine in rats.

    PubMed

    Kearns, David N; Silberberg, Alan

    2016-04-01

    The present experiment tested whether the elasticity of demand for self-administered cocaine in rats is dose-dependent. Subjects lever pressed for three different doses of intravenous cocaine - 0.11, 0.33, and 1.0 mg/kg/infusion - on a demand procedure where the number of lever presses required per infusion increased within a session. The main finding was that demand for the 0.11 mg/kg dose was more elastic than it was for the two larger doses. There was no difference in demand elasticity between the 0.33 and 1.0 mg/kg doses. These results parallel findings previously reported in monkeys. The present study also demonstrated that a within-session procedure can be used to generate reliable demand curves.

  14. Attenuated incubation of cocaine seeking in male rats trained to self-administer cocaine during periadolescence.

    PubMed

    Li, Chen; Frantz, Kyle J

    2009-07-01

    Although onset of drug use during adolescence appears to increase long-term vulnerability to drug dependence in humans, relatively little is known about extinction and reinstatement of drug seeking after periadolescent onset of drug self-administration in laboratory animals. Furthermore, although cue-induced reinstatement of cocaine seeking increases progressively during abstinence from cocaine self-administration in adult subjects, this "incubation of cocaine craving" remains unexplored after adolescent drug intake in animal models. We allowed periadolescent (postnatal day (PND) 35 at start) and adult (PND 83-95 at start) male Wistar rats to self-administer cocaine (0.36 mg/kg/infusion) in 2-h daily sessions on a fixed ratio 1 schedule of reinforcement over 14 days. Then, we compared extinction and cue-induced or cocaine priming-induced reinstatement (10 mg/kg cocaine, intraperitoneal) of cocaine seeking in both age groups after 30 days of abstinence in home cages. In separate cohorts, we tested for time-dependent increases in cue-induced reinstatement over approximately 1, 14, 30, or 60 days of abstinence in both age groups. Adolescent and adult rats self-administered similar amounts of cocaine. Subsequent cue-induced reinstatement was lower in the adolescent-onset group after a 30-day abstinence period, but cocaine priming-induced reinstatement did not differ across ages. Also, extinction responding and time-dependent increases in cue-induced reinstatement (incubation) were less pronounced in rats that took cocaine as adolescents compared with adults. Surprisingly, these results may reflect resistance among adolescent subjects to some enduring effects of drug self-administration, such as reward learning.

  15. Development of a self-administered early inflammatory arthritis detection tool

    PubMed Central

    2010-01-01

    Background Barriers to care limit the potential benefits of pharmacological intervention for inflammatory arthritis. A self-administered questionnaire for early inflammatory arthritis (EIA) detection may complement contemporary triage interventions to further reduce delays to rheumatologic care. The objective of this study was to develop a self-administered EIA detection tool for implementation in pre-primary care settings. Methods A core set of dimensions and constructs for EIA detection were systematically derived from the literature and augmented by investigative team arbitration. Identified constructs were formulated into lay language questions suitable for self-administration. A three-round Delphi consensus panel of EIA experts and stakeholders evaluated the relevance of each question to EIA detection and suggested additional items. Questions accepted by less than 70% of respondents in rounds one or two were eliminated. In round three, questions accepted by at least 80% of the panel were selected for the tool. Results Of 584 citations identified, data were extracted from 47 eligible articles. Upon arbitration of the literature synthesis, 30 constructs encompassing 13 dimensions were formulated into lay language questions and posed to the Delphi panel. A total of 181 EIA experts and stakeholders participated on the Delphi panel: round one, 60; round two, 59; and, round three, 169; 48 participated in all three rounds. The panel evaluated the 30 questions derived from the literature synthesis, suggested five additional items, and eliminated a total of 24. The eleven-question instrument developed captured dimensions of articular pain, swelling, and stiffness, distribution of joint involvement, function, and diagnostic and family history. Conclusions An eleven-question, EIA detection tool suitable for self-administration was developed to screen subjects with six to 52 weeks of musculoskeletal complaints. Psychometric and performance property testing of the tool is

  16. Generalization of the effects of teacher- and self-administered token reinforcers to nontreated students.

    PubMed Central

    Fantuzzo, J W; Clement, P W

    1981-01-01

    Ten, black, second-grade boys served in a series of single-subject studies. They were from poor families, did not do well in arithmetic, were deficient in sustained attention, and presented behavior problems at school. One boy was a therapeutic confederate. Of the remaining nine nontreated students, three observed the confederate reinforced by a teacher, three observed the confederate self-reinforce without having an opportunity to use "self-reinforcement" themselves, and three observed self-reinforcement while having an opportunity to use "self-reinforcement." The target behavior was attending. Other measures of outcome were glancing, academic achievement, and accuracy of reinforcement. The basic experimental design consisted of an ABAB withdrawal applied to the confederate while the nontreated students remained on baseline. Generalization was expressed as a ratio (i.e., percent change in the generalization measure divided by percent change in the target behavior). Teacher-administered reinforcers to the confederate did not produce generalization of any kind. Both arrangements of self-administered reinforcers to the confederate produced across-subjects generalization and subject-response generalization. Additionally, the confederate manifested response generalization. PMID:7328068

  17. [Surgical treatment for gastroesophageal reflux disease (GERD)].

    PubMed

    Iida, Atsushi; Yamaguchi, Akio

    2007-05-01

    Proton pump inhibitor (PPI) is major treatment for acid reflux. It reduces major symptom of GERD and effective. However, the cause of GERD is the insufficiency of anti-reflux mechanism of cardia. Only surgical treatment can care for hiatal hernia as the main cause of the disruption. Redundant reflux against conservative treatment or obvious hiatal hernia is indication for laparoscopic Nissen fundoplication. Late diagnosis might request radical operation, so we need to know the indication for laparoscopic treatment. For the safer laparoscopic procedure, we perform curtain retraction technique and Floppy Nissen -short cuff method. The former contribute to prevent hemorrhage or pneumothorax, and the latter can reduce the post-operative disphagia.

  18. Greater loss of productivity among Japanese workers with gastro-esophageal reflux disease (GERD) symptoms that persist vs resolve on medical therapy.

    PubMed

    Suzuki, H; Matsuzaki, J; Masaoka, T; Inadomi, J M

    2014-06-01

    Gastro-esophageal reflux disease (GERD) impairs quality of life; however, the association between GERD and work productivity has not been well investigated in Japan. This study was designed to compare the impact of GERD on productivity between Japanese workers with GERD symptoms that persisted vs resolved on medical therapy. A cross-sectional Web-based survey was conducted in workers. The impact of GERD on work and daily productivity was evaluated using a Web-reported Work Productivity and Activity Impairment Questionnaire for patients with GERD and a GERD symptom severity Questionnaire. Demographic information, clinical history, and satisfaction with GERD medication were also ascertained. A total of 20 000 subjects were invited to the survey. After the exclusion of patients with a history of gastrointestinal (GI) malignancy, peptic ulcer, upper GI surgery, and unemployment, 650 participants were included in the analysis. Participants with persistent GERD symptoms reported a significantly greater losses of work productivity (11.4 ± 13.4 h/week), absenteeism (0.7 ± 3.1 h/week), presenteeism (10.7 ± 12.6 h/week), costs (20 100 ± 26 800 JPY/week), and lower daily productivity (71.3% [95% confidence interval, 69.0-73.7]) than those whose symptoms were alleviated with medications. The level of dissatisfaction with GERD medications among participants with persistent GERD symptoms was significantly correlated with loss of work and daily productivity (p < 0.001). GERD places a significant burden on work and daily productivity despite medical therapy. Ineffective GERD therapy is associated with greater productivity loss. © 2014 John Wiley & Sons Ltd.

  19. The ABCs of GERD | NIH MedlinePlus the Magazine

    MedlinePlus

    ... issue contents The ABCs of GERD Follow us The ABCs of GERD Photo: AdobeStock HEALTH TIPS - Gastroesophageal ... if you are concerned. For more information, visit the National Institute of Diabetes and Digestive and Kidney ...

  20. Validation of a self-administered questionnaire for assessing occupational and environmental exposures of pregnant women

    SciTech Connect

    Eskenazi, B.; Pearson, K.

    1988-11-01

    The present investigation sought to determine whether a self-administered questionnaire could be used to obtain occupational information from pregnant women attending the obstetrical clinics at the University of California, San Francisco from July to November 1986. The authors compared the accuracy of responses of 57 women on the self-administered questionnaire with those obtained on a detailed clinical interview by an occupational health professional. The self-administered questionnaire and the clinical interview included information on the woman's job title, the type of company she worked for, the level of physical activity, her exposures on the job and at home, and her partner's occupation. The authors also examined whether the validity of the self-administered questionnaire could be improved on review by an industrial hygienist. The questionnaire took less than 20 minutes to complete, with over 90% of the women answering three-quarters of it. It was substantially accurate in obtaining information on number of hours worked during pregnancy, type of shift worked, and stress level in the workplace; exposure to radiation, video display terminals, fumes, gases, and cigarette smoke in the workplace; and exposure to pesticides, paint, and cigarette smoke at home. On those variables for which the responses on the self-administered questionnaire were less accurate, review by the industrial hygienist improved the level of accuracy considerably. These findings suggest that a self-administered questionnaire can be used to obtain valid information from pregnant women attending a prenatal clinic.

  1. Not asthma, but GERD: case report.

    PubMed

    Wang, Zhonggao

    2007-02-01

    Asthma is a disorder of the lungs characterized by increased responsiveness of the airways, as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth muscle contraction, edema of the mucosa, and mucus in the lumen of the bronchi and bronchioles. The stimuli vary widely and include antigens, infection, air pollutants, respiratory tract irrtants, exercise, and emotional factors. This condition is completely different from distress breathing because of laryngotracheal spasm. One of its causes is the gastric content reflux through the pharynx to the larynx because of gastroesophageal reflux disease (GERD), in addition to the typical human avian flu that may cause immediate suffocation by laryngospasm owing to acute larygotrachitis. A patient suffered from GERD without esophageal symptoms, which was diagnosed and treated as bronchial asthma during his five emergency admissions. The admissions were because of episodic attacks of severe air hunger owing to an extreme throat tightening. The patient was being treated for as long as two years. After the correct diagnosis was made and treatment of laporascopic fundaplication was performed, the longstanding "bronchial asthma", after all, completely disappeared. The concept of "not asthma, but GERD" seems undervalued, unappreciated, even misunderstood among patients with intractable asthma. Therefore, such a case is reported in detail, similar cases are mentioned briefly as well, and a mechanism responsible for GERD-originated larryngo-or laryngotracho-spasm is proposed.

  2. [Lifestyle modification as a medical treatment for GERD].

    PubMed

    Kurosawa, Susumu

    2007-05-01

    Lifestyles such as obesity, smoking, alcohol or fatty meal are long-time considered to related with the deterioration of GERD. Basic studies indicate that smoking and alcohol decrease LES pressure. However, the clinical studies of the relationship between lifestyle and GERD sometimes show coflicting results. Lifestyle modification as a medical treatment of GERD were reviewed.

  3. Use of an electrostatic dust cloth for self-administered home allergen collection.

    PubMed

    Cozen, Wendy; Avol, Ed; Diaz-Sanchez, David; McConnell, Rob; Gauderman, W James; Cockburn, Myles G; Zadnick, John; Jyrala, Minna; Mack, Thomas M

    2008-04-01

    Most epidemiologic studies employ a vacuum cleaner used by a trained technician to collect household allergens. This approach is labor intensive, equipment dependent, and impractical if study subjects reside over a wide geographic area. We examined the feasibility of a self-administered dust collection method, using an electrostatic cloth sent by conventional mail, to obtain allergen measurements. Thirty-two nonasthmatic twins from the California Twin Program wiped areas in the family room, kitchen, and bedroom, according to standardized instructions, and returned the cloths by mail. Allergen concentrations for Der-p-1, Der-f-1, Fel-d-1, and Bla-g-2 were determined using ELISA, and intrahouse and room-to-room concentrations were compared. Der-p-1 and Fel-d-1 were found in most homes, with highest concentrations in bedrooms and kitchens, respectively. Der-f-1 and Bla-g-2 were rarely found. Intrahouse Der-p-1 and Fel-d-1 concentrations were highly correlated and statistically significant (for Der-p-1, bedroom vs. kitchen, p=.0003, bedroom vs. family room, p=.0001, and family room vs. kitchen, p=.002; for Fel-d-1, bedroom vs. kitchen, p=.0004, bedroom vs. family room, p<.0001, and family room vs. kitchen, p=.0001). Reported cat ownership was strongly correlated with household Fel-d-1 concentrations (p<.005). In another comparison from different homes of children enrolled in the La Casa atopy prevention study, allergen concentrations measured from dust collected by a single operator from the left and right half of the same room in 21 homes were compared. Levels of Bla-g-2, Der-p-1, and Fel-d-1 concentrations collected from right and left halves of the same room were highly correlated, with r2 ranging from .7 to .9, and were highly statistically significant (all p values<.01). We conclude that nonintrusive and self-administered dust collection, using commercially available electrostatic dust cloths, sent by conventional mail services, is a promising alternative to

  4. Effects of self-administered methamphetamine on discrimination learning and reversal in nonhuman primates.

    PubMed

    Kangas, Brian D; Bergman, Jack

    2016-02-01

    Frequent exposure to methamphetamine has been reported to adversely influence cognitive behavior and, in particular, inhibitory control processes. The present studies were conducted in squirrel monkeys to assess the effects of daily intravenous methamphetamine self-administration on touch screen-based repeated acquisition and discrimination reversal tasks thought to reflect behavioral dimensions of, respectively, learning and response inhibition. First, stable methamphetamine-maintained behavior was established in each subject (0.35-1.6 mg/kg/session), and subsequently, a second daily session of discrimination learning was conducted (20 h later). Subjects first learned to discriminate between two simultaneously presented stimuli (acquisition) and, subsequently, to re-learn the discrimination with the contingencies switched (reversal). The role of the interval between self-administration and touch screen sessions was evaluated, as well as the effects of abrupt methamphetamine discontinuation. Results indicate that daily methamphetamine self-administration markedly disrupted the development of discrimination learning, initially requiring nearly twice the number of trials to master discriminations. The magnitude of adverse effects in individual subjects correlated to the level of daily methamphetamine intake. Importantly, however, behavioral disruption of discrimination learning was surmounted following remedial training. Once criterion levels of discrimination performance were achieved, subsequent development of reversal performance was largely unaffected except when the interval between self-administration and touch screen session was short and, thus, likely a result of methamphetamine’s direct effects. Discontinuation of methamphetamine produced no disruption in acquisition or reversal. These results indicate that self-administered methamphetamine can markedly disrupt learning processes and highlight key differences in its effects on different aspects of

  5. Self-Administered Nicotine Suppresses Body Weight Gain Independent of Food Intake in Male Rats.

    PubMed

    Rupprecht, Laura E; Smith, Tracy T; Donny, Eric C; Sved, Alan F

    2016-09-01

    The action of nicotine to suppress body weight is often cited as a factor impacting smoking initiation and the failure to quit. Despite the weight-suppressant effects of nicotine, smokers and nonsmokers report equal daily caloric intake. The weight-suppressive effects of nicotine in animal models of smoking are poorly understood. Furthermore, the Food and Drug Administration has authority to implement a policy markedly reducing nicotine levels in cigarettes; such a reduction could reduce smoking behavior, but have detrimental effects on body weight. The aim of this investigation was to examine the effects of self-administered nicotine on body weight and food intake in rats. In Experiment 1, rats with ad libitum access to chow responded for intravenous infusions of nicotine (60 µg/kg/infusion) or saline in daily 1-hour sessions; body weight and 24-hour food intake were measured. Experiment 2 tested the effects of subcutaneous injections of nicotine on food intake. In Experiment 3, rats were food restricted and self-administered nicotine across a range of doses (3.75-60 µg/kg/infusion) while body weight was measured. In Experiment 4, rats self-administered 60 µg/kg/infusion nicotine before reduction to one of several doses (1.875-15 µg/kg/infusion) for 50 days. Self-administered nicotine suppressed weight gain independent of food intake. In food restricted rats, self-administered nicotine dose-dependently suppressed body weight gain. In rats self-administering 60 µg/kg/infusion nicotine, dose reduction increased body weight. Self-administered nicotine, even at low doses, suppressed body independent of food intake; this may have important implications for nicotine reduction policy. The results of the present studies demonstrate that self-administered nicotine suppresses body weight independent of food intake in rats. Further, the present studies establish that self-administered nicotine suppresses body weight even at very low doses and that reduction of nicotine

  6. Self-Administered Nicotine Suppresses Body Weight Gain Independent of Food Intake in Male Rats

    PubMed Central

    Rupprecht, Laura E.; Smith, Tracy T.; Donny, Eric C.

    2016-01-01

    Introduction: The action of nicotine to suppress body weight is often cited as a factor impacting smoking initiation and the failure to quit. Despite the weight-suppressant effects of nicotine, smokers and nonsmokers report equal daily caloric intake. The weight-suppressive effects of nicotine in animal models of smoking are poorly understood. Furthermore, the Food and Drug Administration has authority to implement a policy markedly reducing nicotine levels in cigarettes; such a reduction could reduce smoking behavior, but have detrimental effects on body weight. The aim of this investigation was to examine the effects of self-administered nicotine on body weight and food intake in rats. Methods: In Experiment 1, rats with ad libitum access to chow responded for intravenous infusions of nicotine (60 µg/kg/infusion) or saline in daily 1-hour sessions; body weight and 24-hour food intake were measured. Experiment 2 tested the effects of subcutaneous injections of nicotine on food intake. In Experiment 3, rats were food restricted and self-administered nicotine across a range of doses (3.75–60 µg/kg/infusion) while body weight was measured. In Experiment 4, rats self-administered 60 µg/kg/infusion nicotine before reduction to one of several doses (1.875–15 µg/kg/infusion) for 50 days. Results: Self-administered nicotine suppressed weight gain independent of food intake. In food restricted rats, self-administered nicotine dose-dependently suppressed body weight gain. In rats self-administering 60 µg/kg/infusion nicotine, dose reduction increased body weight. Conclusions: Self-administered nicotine, even at low doses, suppressed body independent of food intake; this may have important implications for nicotine reduction policy. Implications: The results of the present studies demonstrate that self-administered nicotine suppresses body weight independent of food intake in rats. Further, the present studies establish that self-administered nicotine suppresses

  7. GERD: Diagnosing and treating the burn.

    PubMed

    Alzubaidi, Mohammed; Gabbard, Scott

    2015-10-01

    Gastroesophageal reflux disease (GERD) is chronic, very common, and frequently encountered in internal medicine and subspecialty clinics. It is often diagnosed on clinical grounds, but specialized testing such as endoscopy and pH monitoring may be necessary in certain patients. Although proton pump inhibitors (PPIs) are the mainstay of treatment, clinicians should be aware of their short-term and long-term side effects. Copyright © 2015 Cleveland Clinic.

  8. Psychological factors influence the gastroesophageal reflux disease (GERD) and their effect on quality of life among firefighters in South Korea.

    PubMed

    Jang, Seung-Ho; Ryu, Han-Seung; Choi, Suck-Chei; Lee, Sang-Yeol

    2016-10-01

    The purpose of this study was to examine psychosocial factors related to gastroesophageal reflux disease (GERD) and their effects on quality of life (QOL) in firefighters. Data were collected from 1217 firefighters in a Korean province. We measured psychological symptoms using the scale. In order to observe the influence of the high-risk group on occupational stress, we conduct logistic multiple linear regression. The correlation between psychological factors and QOL was also analyzed and performed a hierarchical regression analysis. GERD was observed in 32.2% of subjects. Subjects with GERD showed higher depressive symptom, anxiety and occupational stress scores, and lower self-esteem and QOL scores relative to those observed in GERD - negative subject. GERD risk was higher for the following occupational stress subcategories: job demand, lack of reward, interpersonal conflict, and occupational climate. The stepwise regression analysis showed that depressive symptoms, occupational stress, self-esteem, and anxiety were the best predictors of QOL. The results suggest that psychological and medical approaches should be combined in GERD assessment.

  9. Effects of Self-Administered Methamphetamine on Discrimination Learning and Reversal in Nonhuman Primates

    PubMed Central

    Kangas, Brian D.; Bergman, Jack

    2015-01-01

    Rationale Frequent exposure to methamphetamine has been reported to adversely influence cognitive behavior and, in particular, inhibitory control processes. Objective The present studies were conducted in squirrel monkeys to assess the effects of daily intravenous methamphetamine self-administration on touchscreen-based repeated acquisition and discrimination reversal tasks thought to reflect behavioral dimensions of, respectively, learning and response inhibition. Methods First, stable methamphetamine-maintained behavior was established (0.35-1.6 mg/kg/session) and, subsequently, a second daily session of discrimination learning was conducted (20 hr later). Subjects first learned to discriminate between two simultaneously presented stimuli (acquisition) and, subsequently, to re-learn the discrimination with the contingencies switched (reversal). The role of the interval between self-administration and touchscreen sessions was evaluated, as well as the effects of abrupt methamphetamine discontinuation. Results Results indicate that daily methamphetamine self-administration markedly disrupted the development of discrimination learning, initially requiring nearly twice the number of trials to master discriminations. The magnitude of adverse effects in individual subjects correlated to the level of daily methamphetamine intake. Importantly, however, behavioral disruption of discrimination learning was surmounted following remedial training. Once criterion levels of discrimination performance were achieved, subsequent development of reversal performance was largely unaffected except when the interval between self-administration and touchscreen session was short and, thus, likely vulnerable to methamphetamine’s direct effects. Discontinuation of methamphetamine produced no disruption in acquisition or reversal. Conclusion These results indicate that self-administered methamphetamine can markedly disrupt learning processes and, as well, highlights key differences in

  10. Stereoselective Differences between the Reinforcing and Motivational Effects of Cathinone-Derived 4-Methylmethcathinone (Mephedrone) In Self-Administering Rats.

    PubMed

    Philogene-Khalid, Helene L; Simmons, Steven J; Nayak, Sunil; Martorana, Rose M; Su, Shu H; Caro, Yohanka; Ranieri, Brona; DiFurio, Kathryn; Mo, Lili; Gentile, Taylor A; Murad, Ali; Reitz, Allen B; Muschamp, John W; Rawls, Scott M

    2017-09-22

    Mephedrone (4-methylmethcathinone (4-MMC)) (MEPH) is a new psychoactive substance (NPS) of the synthetic cathinone class. MEPH has a chiral center and exists as two enantiomers (R-,S-MEPH), yet stereospecific effects of MEPH have not been extensively investigated in preclinical assays. Because significant behavioral and neurochemical differences can exist between enantiomers, probing effects of stereochemistry on biological activity enables separation of adverse and therapeutic effects. Our prior work showed that R-MEPH, relative to S-MEPH, produced greater locomotor activation, place preference, and facilitation of brain reward thresholds in rodents. The present study sought to determine if MEPH enantiomers display stereospecific reward and reinforcement in rat self-administration assays. In Experiment 1, rats were trained to self-administer racemic MEPH (0.50 mg/kg/inf), and dose substitution effects of R-MEPH (0.50 mg/kg/inf) and S-MEPH (0.25, 0.50, 2.00 mg/kg/inf) were examined. In Experiment 2, separate rats were trained to self-administer R-MEPH (0.25, 0.50, 2.00 mg/kg/inf) or S-MEPH (0.25, 0.50, 2.00 mg/kg/inf) and were thereafter evaluated under progressive-ratio access conditions. Within this cohort, 50 kHz ultrasonic vocalizations (USVs) were recorded to measure potential differences in subjective positive affect associated with MEPH enantiomer self-administration. We identified enantiomer- and dose-dependent effects on infusions earned during self-administration following acquisition of racemic MEPH, with greatest infusions under low-effort, fixed-ratio 1 access conditions from low-dose S-MEPH self-administration. When taxed with progressive-ratio access conditions, rats trained to self-administer R-MEPH showed higher break points than those of rats trained to self-administer S-MEPH. Additionally, R-MEPH elicited greatest rates of 50 kHz USVs compared to S-MEPH. Taken together, these data suggest that the R-enantiomer of MEPH is primarily responsible for

  11. Effect of survey mode on response patterns: comparison of face-to-face and self-administered modes in health surveys.

    PubMed

    Christensen, Anne Illemann; Ekholm, Ola; Glümer, Charlotte; Juel, Knud

    2014-04-01

    While face-to-face interviews are considered the gold standard of survey modes, self-administered questionnaires are often preferred for cost and convenience. This article examines response patterns in two general population health surveys carried out by face-to-face interview and self-administered questionnaire, respectively. Data derives from a health interview survey in the Region of Southern Denmark (face-to-face interview) and The Danish Health and Morbidity Survey 2010 (self-administered questionnaire). Identical questions were used in both surveys. Data on all individuals were obtained from administrative registers and linked to survey data at individual level. Multiple logistic regression analyses were used to examine the effect of survey mode on response patterns. The non-response rate was higher in the self-administered survey (37.9%) than in the face-to-face interview survey (23.7%). Marital status, ethnic background and highest completed education were associated with non-response in both modes. Furthermore, sex and age were associated with non-response in the self-administered mode. No significant mode effects were observed for indicators related to use of health services, but significant mode effects were observed for indicators related to self-reported health-related quality of life, health behaviour, social relations and morbidity (long-standing illness). The same factors were generally associated with non-response in both modes. Indicators based on factual questions with simple answers categories were overall more comparable according to mode than indicators based on questions that involved more subjective assessments. Other measures such as efficiency and cost-effectiveness of the mode should also be considered when determining the most appropriate form of data collection.

  12. Comparison Between a Self-Administered and Supervised Version of a Web-Based Cognitive Test Battery: Results From the NutriNet-Santé Cohort Study.

    PubMed

    Assmann, Karen E; Bailet, Marion; Lecoffre, Amandine C; Galan, Pilar; Hercberg, Serge; Amieva, Hélène; Kesse-Guyot, Emmanuelle

    2016-04-05

    Dementia is a major public health problem, and repeated cognitive data from large epidemiological studies could help to develop efficient measures of early prevention. Data collection by self-administered online tools could drastically reduce the logistical and financial burden of such large-scale investigations. In this context, it is important to obtain data concerning the comparability of such new online tools with traditional, supervised modes of cognitive assessment. Our objective was to compare self-administration of the Web-based NutriNet-Santé cognitive test battery (NutriCog) with administration by a neuropsychologist. The test battery included four tests, measuring, among others aspects, psychomotor speed, attention, executive function, episodic memory, working memory, and associative memory. Both versions of the cognitive battery were completed by 189 volunteers (either self-administered version first, n=99, or supervised version first, n=90). Subjects also completed a satisfaction questionnaire. Concordance was assessed by Spearman correlation. Agreement between both versions varied according to the investigated cognitive task and outcome variable. Spearman correlations ranged between .42 and .73. Moreover, a majority of participants responded that they "absolutely" or "rather" agreed that the duration of the self-administered battery was acceptable (184/185, 99.5%), that the tasks were amusing (162/185, 87.6%), that the instructions were sufficiently detailed (168/185; 90.8%) and understandable (164/185, 88.7%), and that they had overall enjoyed the test battery (182/185, 98.4%). The self-administered version of the Web-based NutriCog cognitive test battery provided similar information as the supervised version. Thus, integrating repeated cognitive evaluations into large cohorts via the implementation of self-administered online versions of traditional test batteries appears to be feasible.

  13. Comparison Between a Self-Administered and Supervised Version of a Web-Based Cognitive Test Battery: Results From the NutriNet-Santé Cohort Study

    PubMed Central

    Bailet, Marion; Lecoffre, Amandine C; Galan, Pilar; Hercberg, Serge; Amieva, Hélène; Kesse-Guyot, Emmanuelle

    2016-01-01

    Background Dementia is a major public health problem, and repeated cognitive data from large epidemiological studies could help to develop efficient measures of early prevention. Data collection by self-administered online tools could drastically reduce the logistical and financial burden of such large-scale investigations. In this context, it is important to obtain data concerning the comparability of such new online tools with traditional, supervised modes of cognitive assessment. Objective Our objective was to compare self-administration of the Web-based NutriNet-Santé cognitive test battery (NutriCog) with administration by a neuropsychologist. Methods The test battery included four tests, measuring, among others aspects, psychomotor speed, attention, executive function, episodic memory, working memory, and associative memory. Both versions of the cognitive battery were completed by 189 volunteers (either self-administered version first, n=99, or supervised version first, n=90). Subjects also completed a satisfaction questionnaire. Concordance was assessed by Spearman correlation. Results Agreement between both versions varied according to the investigated cognitive task and outcome variable. Spearman correlations ranged between .42 and .73. Moreover, a majority of participants responded that they “absolutely” or “rather” agreed that the duration of the self-administered battery was acceptable (184/185, 99.5%), that the tasks were amusing (162/185, 87.6%), that the instructions were sufficiently detailed (168/185; 90.8%) and understandable (164/185, 88.7%), and that they had overall enjoyed the test battery (182/185, 98.4%). Conclusions The self-administered version of the Web-based NutriCog cognitive test battery provided similar information as the supervised version. Thus, integrating repeated cognitive evaluations into large cohorts via the implementation of self-administered online versions of traditional test batteries appears to be feasible. PMID

  14. Stress Management for Special Educators: The Self-Administered Tool for Awareness and Relaxation (STAR)

    ERIC Educational Resources Information Center

    Williams, Krista; Poel, Elissa Wolfe

    2006-01-01

    The Self-Administered Tool for Awareness and Relaxation (STAR) is a stress management strategy designed to facilitate awareness of the physical, mental, emotional, and physiological effects of stress through the interconnectedness of the brain, body, and emotions. The purpose of this article is to present a stress-management model for teachers,…

  15. Psychomotor and Motor Speed in Power Athletes Self-Administering Testosterone and Anabolic Steroids.

    ERIC Educational Resources Information Center

    Era, Pertti; And Others

    1988-01-01

    Self-administered testosterone and anabolic steroids resulted in insignificant improvement in psychomotor and motor speed tests of power athletes. This study is part of a larger study on the effects of such drugs on endocrinology, metabolism and neuromuscular functions. Methodolgy and results are discussed. (Author/JL)

  16. Validity of a Self-Administered 3-Day Physical Activity Recall in Young Adults

    ERIC Educational Resources Information Center

    Han, Jennifer L.; Dinger, Mary K.

    2009-01-01

    Background: Most physical activity recall questionnaires assess activity over a 7-day period. However, questionnaires have been validated in adolescents and adults using shorter recall timeframes. Purpose: The purpose of this study was to assess the validity of a self-administered 3-day physical activity recall instrument (3DR) in young adults.…

  17. Psychomotor and Motor Speed in Power Athletes Self-Administering Testosterone and Anabolic Steroids.

    ERIC Educational Resources Information Center

    Era, Pertti; And Others

    1988-01-01

    Self-administered testosterone and anabolic steroids resulted in insignificant improvement in psychomotor and motor speed tests of power athletes. This study is part of a larger study on the effects of such drugs on endocrinology, metabolism and neuromuscular functions. Methodolgy and results are discussed. (Author/JL)

  18. Assessment of informal caregiver's needs by self-administered instruments: a literature review.

    PubMed

    Lefranc, Anne; Pérol, David; Plantier, Morgane; Chatelain, Pierre; de Rohan-Chabot, Henri; Schell, Matthias

    2017-10-01

    Clinicians, researchers and politicians are seeking to better assess caregiver's needs. Challenges exist in broadly implementing this so as to provide appropriate support. The aim of this review was to compile self-administered instruments for assessment of caregiver's needs that are deemed to be scientifically robust. The Medline database was searched for publications reporting self-administered instruments assessing caregiver's needs with acceptable psychometric properties. These instruments were analyzed in terms of the development context, target population, concept, purpose, structure, content and psychometric properties. The dimensions of the needs were listed and categorized. A total of nine self-administered instruments were analyzed. They averaged 32 items, they were specifically developed for a targeted subpopulation of caregivers and dedicated to epidemiological research. Response devices were based on Likert scales. The main dimensions of the needs identified were 'Health and Care', 'Psychological - Emotional Support', 'Information-Knowledge', 'Social Life-Work-Finance'. None was specifically geared toward caregivers for the elderly, children or teenagers. In the absence of transcultural validation, no instrument was directly usable in Europe. Assessing caregivers' needs is a key part in providing caregivers with appropriate support. The development of self-administered instruments constitutes a complex field that is still underexplored at the international level; strict specifications with psychometric validation are essential. To be efficient, the instrument should be integrated in a larger process including: upstream, recognition, identification and assessment of the overall situation of the caregiver; and downstream, guidance, establishment and follow-up of a suitable action plan.

  19. Can the BASNEF Model Help to Develop Self-Administered Healthy Behavior in Iranian Youth?

    PubMed

    Shahnazi, Hossein; Bee Koon, Poh; Abd Talib, Ruzita; Lubis, Syarif Husin; Ganjali Dashti, Marjan; Khatooni, Elham; Bahreini Esfahani, Nimah

    2016-03-01

    The stage of youth is critical for human development in several ways. On the one hand, it can lead people towards the adoption of a healthy lifestyle during adulthood based on these earlier practices. On the other hand, it can comprise the development of healthy living practices later on in live, an outcome which is often caused by the youth adopting a risky lifestyle early on. The primary objective of this study was to determine the effectiveness of implementing an educational intervention program based on the BASNEF Model (a simplified approach to understanding behavior), designed to cultivate self-administered lifestyle control skills in youths. This was a quasi-experimental intervention study, implemented during 2010 - 2011. A total of 288 randomly selected high-school students between the ages of 15 and 17 participated in this study. These students were later divided into experimental and control groups. Subjects completed a BASNEF questionnaire at the baseline (pre-test), one month later (post-test) and three months after the educational intervention (follow-up). Four educational sessions were held, each of a 120 - 150 minute duration. After the data had been collected, the ANOVA test was used to compare trends in changes. The Pearson correlation coefficient was then used to analyze the correlation between components of the BASNEF model. Finally, regression analysis was used to determine the predictive power of the study. Results from the intervention study reveal that the beliefs and attitudes about nutrition of the intervention group, calculated in terms of scores, improved significantly for both male and female subjects (P < 0.001) as compared to the control group. The mean BASNEF scores for improvements in beliefs among girls and boys were 79.2% and 70.1%, respectively and for attitudes, 61.2% and 59.4%. The increase was significantly higher in the intervention group (P < 0.001). Furthermore, participation in physical activity was more frequent among

  20. Can the BASNEF Model Help to Develop Self-Administered Healthy Behavior in Iranian Youth?

    PubMed Central

    Shahnazi, Hossein; Bee Koon, Poh; Abd Talib, Ruzita; Lubis, Syarif Husin; Ganjali Dashti, Marjan; Khatooni, Elham; Bahreini Esfahani, Nimah

    2016-01-01

    Background: The stage of youth is critical for human development in several ways. On the one hand, it can lead people towards the adoption of a healthy lifestyle during adulthood based on these earlier practices. On the other hand, it can comprise the development of healthy living practices later on in live, an outcome which is often caused by the youth adopting a risky lifestyle early on. Objectives: The primary objective of this study was to determine the effectiveness of implementing an educational intervention program based on the BASNEF Model (a simplified approach to understanding behavior), designed to cultivate self-administered lifestyle control skills in youths. Materials and Methods: This was a quasi-experimental intervention study, implemented during 2010 - 2011. A total of 288 randomly selected high-school students between the ages of 15 and 17 participated in this study. These students were later divided into experimental and control groups. Subjects completed a BASNEF questionnaire at the baseline (pre-test), one month later (post-test) and three months after the educational intervention (follow-up). Four educational sessions were held, each of a 120 - 150 minute duration. After the data had been collected, the ANOVA test was used to compare trends in changes. The Pearson correlation coefficient was then used to analyze the correlation between components of the BASNEF model. Finally, regression analysis was used to determine the predictive power of the study. Results: Results from the intervention study reveal that the beliefs and attitudes about nutrition of the intervention group, calculated in terms of scores, improved significantly for both male and female subjects (P < 0.001) as compared to the control group. The mean BASNEF scores for improvements in beliefs among girls and boys were 79.2% and 70.1%, respectively and for attitudes, 61.2% and 59.4%. The increase was significantly higher in the intervention group (P < 0.001). Furthermore

  1. The endogenous cannabinoid 2-arachidonoylglycerol is intravenously self-administered by squirrel monkeys.

    PubMed

    Justinová, Zuzana; Yasar, Sevil; Redhi, Godfrey H; Goldberg, Steven R

    2011-05-11

    Two endogenous ligands for cannabinoid CB1 receptors, anandamide (N-arachidonoylethanolamine) and 2-arachidonoylglycerol (2-AG), have been identified and characterized. 2-AG is the most prevalent endogenous cannabinoid ligand in the brain, and electrophysiological studies suggest 2-AG, rather than anandamide, is the true natural ligand for cannabinoid receptors and the key endocannabinoid involved in retrograde signaling in the brain. Here, we evaluated intravenously administered 2-AG for reinforcing effects in nonhuman primates. Squirrel monkeys that previously self-administered anandamide or nicotine under a fixed-ratio schedule with a 60 s timeout after each injection had their self-administration behavior extinguished by vehicle substitution and were then given the opportunity to self-administer 2-AG. Intravenous 2-AG was a very effective reinforcer of drug-taking behavior, maintaining higher numbers of self-administered injections per session and higher rates of responding than vehicle across a wide range of doses. To assess involvement of CB1 receptors in the reinforcing effects of 2-AG, we pretreated monkeys with the cannabinoid CB(1) receptor inverse agonist/antagonist rimonabant [N-piperidino-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methylpyrazole-3-carboxamide]. Rimonabant produced persistent blockade of 2-AG self-administration without affecting responding maintained by food under similar conditions. Thus, 2-AG was actively self-administered by monkeys with or without a history of cannabinoid self-administration, and the reinforcing effects of 2-AG were mediated by CB1 receptors. Self-administration of 2-AG by squirrel monkeys provides a valuable procedure for studying abuse liability of medications that interfere with 2-AG signaling within the brain and for investigating mechanisms involved in the reinforcing effects of endocannabinoids.

  2. Self-Administered Home Series Fecal "Minitransplants" for Recurrent Clostridium difficile Infection on a Rectal Remnant.

    PubMed

    Popa, Daniel; Laszlo, Mihaela; Ciobanu, Lidia; Ucenic, Elena; Mihalache, Manuela; Pascu, Oliviu

    2015-12-01

    A fecal microbiota transplant has proved to be an extremely effective method for patients with recurrent infections with Clostridium difficile. We present the case of a 65-year-old female patient with multiple Clostridium difficile infection (CDI) relapses on the rectal remnant, post-colectomy for a CDI-related toxic megacolon. The patient also evidenced associated symptomatic Clostridium difficile vaginal infection. She was successfully treated with serial fecal "minitransplants" (self-administered at home) and metronidazole ovules.

  3. The safety of self-administered allergen immunotherapy during the buildup and maintenance phases

    PubMed Central

    Schaffer, Frederick M.; Naples, Andrew R.; Ebeling, Myla; Hulsey, Thomas C.; Garner, Larry M.

    2015-01-01

    Background Self-administered allergen immunotherapy is considered controversial. We believe the implementation of a self-administration protocol characterized by patient preselection and a slow buildup phase is safe. Methods We analyzed 23,614 patient records and associated immunotherapy injections for systemic reactions (SR) during a 1-year period (2011 to 2012). SRs were graded in accordance with the World Allergy Organization (WAO) criteria. Results Thirty-seven SRs were reported for 23,614 patients who self-administered 2,021,600 injections yielding an annual SR rate of 0.16% (per patient) or 0.002% (per injection). Only 9 of 4643 pediatric (0.19%) and 28 of 18,971 adult patients (0.15%) experienced 1 or more SRs. No deaths (grade V SR) occurred. From 2009 through early 2014, over 90,000 patients received more than 10 million injections in accordance with the United Allergy Services (UAS) protocol without fatalities. Conclusion We believe this safety profile is due to a preselection of patients to exclude those with a high risk for adverse reactions and a slow immunotherapy buildup phase. In contrast, previous studies documented office-based SRs ranging from approximately 3% to greater than 14%. Thus, the UAS home-immunotherapy SR rate is significantly lower than office-based immunotherapy SR rates (p < 0.0001). The enhanced safety of this protocol results in a decreased frequency and severity of SRs. This safety report, derived from analyses of one of the largest patient cohorts studied, corroborates and expands the observations of previous studies of self-administered subcutaneous immunotherapy in a low-risk patient population by assessing self-administered allergen immunotherapy during the buildup and maintenance phases. PMID:25476041

  4. Evaluation of a Self-Administered Computerized Cognitive Battery in an Older Population

    PubMed Central

    Koyama, Alain K.; Hagan, Kaitlin A.; Okereke, Olivia I.; Weisskopf, Marc G.; Rosner, Bernard; Grodstein, Francine

    2015-01-01

    Objective To assess the utility of the Cogstate self-administered computerized neuropsychological battery in a large population of older men. Methods We invited 7,167 men (mean age: 75 years) from the Health Professionals Follow-up Study, a prospective cohort of male health professionals. We considered individual Cogstate scores and composite scores measuring psychomotor speed and attention, learning and working memory, and overall cognition. Multivariate linear regression was used to assess the association between risk factors measured 4 and 28 years prior to cognitive testing and each outcome. Results The 1,866 men who agreed to complete Cogstate testing were similar to the 5,301 non-responders. Many expected risk factors were associated with Cogstate scores in multivariate-adjusted models. Increasing age was significantly associated with worse performance on all outcomes (p < 0.001). For risk factors measured four years prior to testing and overall cognition, a history of hypertension was significantly associated with worse performance (mean difference=−0.08 standard units [95% CI −0.16, 0.00]) and higher nut consumption was significantly associated with better performance (>2 servings/week vs. <1 serving/month: 0.15 [0.03, 0.27]). Conclusions The self-administered Cogstate battery showed significant associations with several risk factors known to be associated with cognitive function. Future studies of cognitive aging may benefit from the numerous advantages of self-administered computerized testing. PMID:26501919

  5. Pair housing differentially affects motivation to self-administer cocaine in male and female rats.

    PubMed

    Westenbroek, Christel; Perry, Adam N; Becker, Jill B

    2013-09-01

    Female rats exhibit greater intake and motivation to self-administer cocaine. In females but not males, isolation by itself is a stressor, which could lead to increased drug intake. Therefore, we hypothesized that social housing would buffer against stress and reduce the motivation to self-administer cocaine primarily in females. Male and female Sprague-Dawley rats were housed individually or in same-sex pairs. The individually housed rats and one of each pair were allowed to self-administer (SA) a low dose of cocaine (0.2 mg/kg/inf) on a fixed ratio (FR1) schedule for one week. Motivation for cocaine SA was measured for an additional 2 weeks on a progressive ratio schedule. Isolated females had greater cocaine-intake on the FR1 schedule and greater motivation to take cocaine than males. Pair-housing in females, but not males, attenuated the motivation to take cocaine. Isolated females, but not males, showed escalation of their motivation to take cocaine, which was attenuated by pair housing of females. Concluding, the motivation to take cocaine escalates in females but not males, and pair-housing of females attenuates this escalation.

  6. The relative reinforcing strength of methamphetamine and D-amphetamine in monkeys self-administering cocaine.

    PubMed

    Lile, Joshua A; Charnigo, Richard J; Nader, Michael A

    2013-09-01

    Epidemiological data indicate that rates of methamphetamine misuse surpass those of D-amphetamine, but self-administration research in animals and humans has not typically demonstrated differences in their reinforcing effects. The present study used a within-session, exponentially increasing progressive-ratio schedule and extended-access conditions to assess the relative reinforcing strength of D-amphetamine and methamphetamine in rhesus monkeys (n=5) trained to self-administer cocaine. A range of doses of methamphetamine (0.003-0.1 mg/kg/injection), D-amphetamine (0.003-0.1 mg/kg/injection), and cocaine (0.003-0.3 mg/kg/injection) was tested to capture the ascending and descending limbs of the dose-effect functions. Each drug functioned as a reinforcer, but the peak number of self-administered D-amphetamine injections was significantly lower compared with methamphetamine and cocaine; the peak number of self-administered injections of cocaine and methamphetamine did not differ. Although differences in availability and other social factors likely impact relative rates of abuse, the present data suggest that the greater reinforcing strength of methamphetamine contributes to its increased use compared with D-amphetamine.

  7. The Relative Reinforcing Strength of Methamphetamine and d-Amphetamine in Monkeys Self-Administering Cocaine

    PubMed Central

    Lile, Joshua A.; Charnigo, Richard J.; Nader, Michael A.

    2013-01-01

    Epidemiological data indicate that rates of methamphetamine misuse surpass those of d-amphetamine, but self-administration research in animals and humans has not typically demonstrated differences in their reinforcing effects. The present study used a within-session, exponentially-increasing progressive-ratio schedule and extended-access conditions to assess the relative reinforcing strength of d-amphetamine and methamphetamine in rhesus monkeys (n=5) trained to self-administer cocaine. A range of doses of methamphetamine (0.003–0.1 mg/kg/injection), d-amphetamine (0.003–0.1 mg/kg/injection) and cocaine (0.003–0.3 mg/kg/injection) was tested to capture the ascending and descending limbs of the dose-effect functions. Each drug functioned as a reinforcer, but the peak number of self-administered d-amphetamine injections was significantly lower compared to methamphetamine and cocaine; the peak number of self-administered injections of cocaine and methamphetamine did not differ. Although differences in availability and other social factors likely impact relative rates of abuse, the present data suggest that the greater reinforcing strength of methamphetamine contributes to its increased use compared to d-amphetamine. PMID:23907377

  8. Treatment of verb anomia in aphasia: efficacy of self-administered therapy using a smart tablet.

    PubMed

    Lavoie, Monica; Routhier, Sonia; Légaré, Annie; Macoir, Joël

    2016-01-01

    Aphasia is a chronic condition that usually requires long-term rehabilitation. However, even if many effective treatments can be offered to patients and families, speech therapy services for individuals with aphasia often remain limited because of logistical and financial considerations, especially more than 6 months after stroke. Therefore, the need to develop tools to maximize rehabilitation potential is unquestionable. The aim of this study was to test the efficacy of a self-administered treatment delivered with a smart tablet to improve written verb naming skills in CP, a 63-year-old woman with chronic aphasia. An ABA multiple baseline design was used to compare CP's performance in verb naming on three equivalent lists of stimuli trained with a hierarchy of cues, trained with no cues, and not trained. Results suggest that graphemic cueing therapy, done four times a week for 3 weeks, led to better written verb naming compared to baseline and to the untrained list. Moreover, generalization of the effects of treatment was observed in verb production, assessed with a noun-to-verb production task. Results of this study suggest that self-administered training with a smart tablet is effective in improving naming skills in chronic aphasia. Future studies are needed to confirm the effectiveness of new technologies in self-administered treatment of acquired language deficits.

  9. Reliability of a self-administered postal questionnaire on the use of food supplements in an italian adult population.

    PubMed

    Giammarioli, Stefania; Boniglia, Concetta; Carratù, Brunella; Ciarrocchi, Marco; Chiarotti, Flavia; Sanzini, Elisabetta

    2010-12-01

    The objective of this study was to evaluate the reliability of a self-administered postal questionnaire on the use of food supplements. The study was carried out in subjects representative of an Italian adult population. Eight thousand eight hundred twenty-three subjects received the questionnaire; 1723 subjects completed it of which 102 twice (baseline and 1-month re-administration). The latter 204 questionnaires were used to test reliability using Cohen's kappa statistic (k) and the intra-class correlation coefficient (ICC) for categorical and quantitative variables, respectively. Subjects' characteristics such as sociodemographic and physical data, lifestyles, dietary habits, and most health characteristics showed very good agreement (ICC or k 1.00-0.55) between questionnaires, with the exception of answers about the consumption of some medicines (k 0.37-0.40). The reliability concerning the use of food supplements was satisfactory on the whole (k 0.69) and fairly satisfactory for different categories of food supplements (k 0.83-0.41). With regard to additional information about users of food supplements, the reliability of responses was fairly satisfactory on the whole (k 0.93-0.41), with some exceptions. The concordance/correlation coefficient values generally showed that the questionnaire is fairly reliable over the entire sample for collecting information on the use of food supplements.

  10. A computer-controlled olfactometer for a self-administered odor identification test.

    PubMed

    Schriever, Valentin Alexander; Körner, Johannes; Beyer, Robert; Viana, Samanta; Seo, Han-Seok

    2011-09-01

    Odor identification tests are widely used for the general screening of olfactory function. However, the administration of odor identification tests is often limited due to a lack of investigators' time. Therefore, we attempted to design a computer-controlled olfactometer to present a self-administered odor identification test. The results produced by means of this olfactometer were evaluated in terms of validity and test-retest reliability. To test the validity, participants' performance in the odor identification test using the olfactometer was compared with their performance in the odor identification test using the validated assessment of the "Sniffin' Sticks" test. The ten-item odor identification test was performed two times using two different methods: (1) the self-administered test using the computer-controlled olfactometer and (2) the foreign-administered test using the "Sniffin' sticks." To examine test-retest reliability, 20 participants were asked to repeat these tests on a different day. Participants reached significantly higher scores on a foreign-administered odor identification test using the "Sniffin' sticks" than on the olfactometer-based test; however, this effect was driven by two less correctly identified odors in the olfactometer-based test. The significant difference between both methods in the mean scores disappeared after excluding two odors from the analysis. In addition, both methods showed no significant difference in scores obtained during the first and second session, indicating that results were consistent between sessions. In conclusion, our findings demonstrate that the computer-controlled olfactometer designed in this study can be used for a self-administered odor identification test.

  11. [Assessment of the outcome of anorexia nervosa: construction of a self-administered questionnaire based on the patients' perception].

    PubMed

    Ronze, M; Mamelle, N; Combe, C; Pugeat, M

    2010-02-01

    Our working hypothesis is that a better insight into the outcome of patients suffering from anorexia nervosa should contribute to preventing relapses and further complications and assessing treatment efficiency. Through anorexia nervosa, the patients express the difficulty they have to view themselves as specific subjects. The current classic outcome evaluation is based on the study of objective events, which only partially reflect the reality of the patients' outcome at a subjective level. The objective of this study was to set up a new assessing instrument of the outcome of patients suffering from anorexia nervosa, essentially based on the patients' perception of their experience. The methodology used has been based on: (1) the conduct by the main investigator of unstructured interviews using "free association", with the help of an interview guide. The anorexia nervosa patients were recruited among those who were hospitalized on an isolation contract, or among outpatients under a psychiatrist/psychoanalyst's supervision, aged over 25 years old so that they may have started their reproductive life. The study included 30 patients; (2) the analysis of the interview contents backed by preexisting hypotheses and by new ones suggested by the expression of the patients' perception, so as to set up an inventory of new themes; (3) the construction of a self-administered questionnaire starting from the development of each theme into several questions taking up the patients' own words and offering 4 possible answers (disagree completely, disagree, agree, quite agree). The analysis of the interviews contents has led to the development of 11 themes. The self-administered questionnaire includes a total of 124 items stemming from the development of each theme into between 9 and 16 items that were mixed in the version submitted to patients. This original interpretation of the outcome of the patients through their experience provides a better understanding of their relation to

  12. Community Cognitive Screening Using the Self-Administered Gerocognitive Examination (SAGE).

    PubMed

    Scharre, Douglas W; Chang, Shu Ing; Nagaraja, Haikady N; Yager-Schweller, Jennifer; Murden, Robert A

    2014-01-01

    This study investigated the functionality of the Self-Administered Gerocognitive Examination (SAGE) for cognitive screening in community settings and examined its characteristics as a cognitive screening assessment tool. From 45 community events, 1,047 individuals over age 50 were screened with SAGE. Cognitive impairment was identified in 28%. Principal-component and correlation analysis indicate that SAGE is an internally-consistent test that is very well balanced, with language, cognition, visuospatial, executive, and memory domains. Community cognitive screening using SAGE was found to be feasible and efficient in diverse settings with both small and large groups.

  13. Effect of self-administered stretching on NIRS-measured oxygenation dynamics.

    PubMed

    Kruse, Nicholas T; Scheuermann, Barry W

    2016-03-01

    This study determined human skeletal muscle oxygenation dynamics during and after a single bout of self-administered stretching (SAS) of the plantar flexors. Nine healthy recreationally fit men (n = 7; age = 25·7 years) and women (n = 2; age = 23·5 years) performed two protocols: (i) one bout of SAS for 4 min and (ii) one bout of moderate intensity cycling for 4 min. We used near infrared spectroscopy to measure changes in muscle deoxygenated haemoglobin-myoglobin ([HHb]) and blood volume ([Hbtot ]) of gastrocnemius medialis muscle before, during and after stretching. The SAS caused an increase (P<0·05) in [HHb] during stretching between 60 and 240 s relative to baseline, but not at 30 s. No significant difference was found for [Hbtot ] at any time interval during SAS. Furthermore, the increase in local blood flow (suggested by [Hbtot ] changes) was found to be significantly increased relative to baseline at 1, 5 and 10 min after SAS, thus providing novel evidence for a poststretch hyperaemia. No significant interaction for [HHb] was found between stretching and cycling conditions, suggesting that the metabolic disturbance during stretching closely resembles moderate intensity exercise. These findings suggest that a single self-administered stretch for 60 s can produce a substantial microcirculatory event and that blood flow may be enhanced for up to 10 min after stretching.

  14. Self-administered health literacy instruments for people with diabetes: systematic review of measurement properties.

    PubMed

    Lee, Eun-Hyun; Kim, Chun-Ja; Lee, Jiyeon; Moon, Seung Hei

    2017-09-01

    The aims of this study were to identify all available self-administered instruments measuring health literacy in people with diabetes and to determine the current instrument that is the most appropriate for applying to this population in both practice and research. A systematic review of measurement properties. MEDLINE, EMBASE and CINAHL electronic databases from their inception up to 28 March 2016. The methodological quality of each included study was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The reported results for measurement properties in the studies were assessed according to Terwee's quality criteria. Thirteen self-administered instruments measuring health literacy in people with diabetes were identified, of which six (44%) were diabetes-specific instruments. The instruments that covered the broadest contents of health literacy were the Health Literacy Scale and Health Literacy Questionnaire. The (test-retest) reliability, measurement error and responsiveness were not evaluated for any instrument, while internal consistency and hypothesis testing validity were the most frequently assessed measurement properties. With the current evidence, the Health Literacy Scale may be the most appropriate instrument for patients with diabetes in practice and research. However, the structural validity of this scale needs to be further established, particularly in other language versions. It is also recommended to use the Diabetes Numeracy Test-15 along with the Health Literacy Scale to complement the lack of numeracy measures in the Health Literacy Scale. © 2017 John Wiley & Sons Ltd.

  15. Pilot study of a self-administered stress management and exercise intervention during chemotherapy for cancer.

    PubMed

    Wilson, Rick W; Taliaferro, Lindsay A; Jacobsen, Paul B

    2006-09-01

    This pilot project explored the feasibility, safety, and effectiveness of a self-administered exercise and stress management intervention for cancer patients receiving chemotherapy. Thirty-nine of 56 eligible patients (acceptance =69%) with a variety of solid tumors volunteered for the study. Participants were advised to exercise 20-40 min at 50-75% estimated heart rate reserve 3-5 times per week. In addition, patients were provided with instruction and written materials regarding stress management techniques. Follow-up data were collected during regularly scheduled outpatient visits at the start of the second, third, and fourth chemotherapy cycles using diary entries and the same questionnaires previously administered at baseline. Twenty-four of 39 patients (62%) completed all study requirements. These participants completed 438 of the 678 exercise sessions assigned (adherence =62%). Of the stress management techniques, positive thinking most practiced most frequently (48%), followed by deep breathing (38%) and active relaxation (37%). Paired t tests, comparing baseline values with final recorded values, indicated a significant improvement over time in bodily pain (p<0.03) and mental health (p<0.04) subscale scores. Participants' evaluations of the combined intervention were favorable: 90% felt it was helpful to them and 100% would recommend it to another patient. A self-administered intervention combining aerobic exercise and stress management was acceptable and safe for cancer patients receiving chemotherapy. Preliminary data demonstrating intervention efficacy should be confirmed in subsequent randomized clinical trials.

  16. Efficacy of self-administered treatments for pathological academic worry: A randomized controlled trial.

    PubMed

    Wolitzky-Taylor, Kate B; Telch, Michael J

    2010-09-01

    Research on treatments for reducing pathological worry is limited. In particular, academic worry is a common theme in generalized anxiety disorder (GAD) samples as well as non-clinical student samples. Given the high cost of anxiety disorders to society, research is needed to examine the efficacy of self-administered treatments designed to reduce pathological worry. The primary goal of this study was to investigate the benefits of three self-administered interventions for reducing academic worry. College students (N = 113) experiencing clinically significant academic worry were randomized to either: (a) worry exposure (WE); (b) expressive writing (EW); (c) relaxation consisting of pulsed audio-photic stimulation (APS); or (d) waitlist control (WLC). Participants were instructed to practice their interventions three times per week for one month and completed home practice logs online to track treatment adherence. Academic worry, general anxiety, and perceived stress were assessed at baseline and post-treatment. Academic worry and general anxiety were also assessed at a three-month follow-up. Those assigned to the WE and APS conditions showed significant improvement relative to EW and WLC at post-treatment. All treatment conditions showed continued improvement by follow-up, with no between-group differences. Treatment and public health implications are discussed.

  17. Applications for self-administered mobile cognitive assessments in clinical research: A systematic review.

    PubMed

    Moore, Raeanne C; Swendsen, Joel; Depp, Colin A

    2017-03-31

    Frequent, brief and repeated self-administered mobile assessments of cognitive function, conducted in everyday life settings, are a promising complementary tool to traditional assessment approaches. Mobile cognitive assessments promote patient-centered care and might enhance capacity to inform individual-level outcomes over time (i.e. detecting subtle declines in cognitive function), as well as in assessing cognition and its correlates in the naturalistic environment. The goal of this systematic review was to assess the feasibility and psychometric properties of mobile cognitive assessments. Through a comprehensive search, we identified 12 articles using self-administered, mobile phone-based cognitive assessments. Studies sampled participants between 1 and 6 times per day for 1-14 days. Samples ranged in age from 14 to 83 years old and were generally healthy populations without cognitive impairment. Working memory was the most frequently-assessed cognitive domain (n = 7), followed by attention/reaction time (n = 4). Seven studies reported adherence, with mean adherence rates of 79.2%. In addition to positive evidence of feasibility, there was general support for high levels of between- and within-person reliability and construct validity. While research has only begun to explore the utility of mobile cognitive assessments, studies to-date indicate they may be a promising complementary tool to traditional assessment methods with potential to improve clinical care and research. Copyright © 2017 John Wiley & Sons, Ltd.

  18. A Population-Level Data Analytics Portal for Self-Administered Lifestyle and Mental Health Screening.

    PubMed

    Zhang, Xindi; Warren, Jim; Corter, Arden; Goodyear-Smith, Felicity

    2016-01-01

    This paper describes development of a prototype data analytics portal for analysis of accumulated screening results from eCHAT (electronic Case-finding and Help Assessment Tool). eCHAT allows individuals to conduct a self-administered lifestyle and mental health screening assessment, with usage to date chiefly in the context of primary care waiting rooms. The intention is for wide roll-out to primary care clinics, including secondary school based clinics, resulting in the accumulation of population-level data. Data from a field trial of eCHAT with sexual health questions tailored to youth were used to support design of a data analytics portal for population-level data. The design process included user personas and scenarios, screen prototyping and a simulator for generating large-scale data sets. The prototype demonstrates the promise of wide-scale self-administered screening data to support a range of users including practice managers, clinical directors and health policy analysts.

  19. Effect of self-administered daily irrigation with 0.02% SnF2 on periodontal disease activity.

    PubMed

    Boyd, R L; Leggott, P; Quinn, R; Buchanan, S; Eakle, W; Chambers, D

    1985-07-01

    To determine the effect on periodontal health of a daily self-administered irrigation with 0.02% stannous fluoride (SnF2) solution, 28 subjects who had moderate to advanced periodontitis were randomly divided into 3 groups: a control group (n = 9) which used no irrigation, a group (n = 8) which used a self-administered water irrigation device (Water Pik) daily with water (H2O group) and a group (n = 11) which used the Water Pik in a similar manner but with SnF2 solution (SnF2 group). All subjects were instructed in routine tooth brushing and flossing but received no other periodontal treatment. 4 study sites were selected from each patient which had pocket depths greater than 4 mm and bleeding upon probing. Plaque index, gingival index, bleeding tendency, pocket depth, loss of attachment, and microbiologic samples of subgingival plaque for morphologic determinations were collected from all study sites at baseline, 2, 6, and 10 weeks. A cross-over was then initiated for 2 additional monthly checks in which the H2O group changed to SnF2 and the SnF2 group was divided into 2 subgroups which either continued to use SnF2 or changed to H2O. The control group completed the study at the beginning of the crossover. The clinical data showed significantly more improvement in periodontal health during the first 10 weeks for the SnF2 group (p less than 0.01). After cross-over, the clinical data indicated the group that changed from H2O to SnF2 significantly improved their periodontal health, while the group that changed from SnF2 to H2O became worse. The microbiologic data showed trends which agreed with the clinical data during the first 10 weeks but were less significant. After cross-over, the %s of motile rods and spirochetes were too small (0-7%) to establish statistically significant changes considering the accuracy of the technique used.

  20. Review of gastroesophageal reflux disease (GERD) in the diabetic patient.

    PubMed

    Punjabi, Paawan; Hira, Angela; Prasad, Shanti; Wang, Xiangbing; Chokhavatia, Sita

    2015-09-01

    This article reviews the known pathophysiological mechanisms of comorbid gastroesophageal reflux disease (GERD) in the diabetic patient, discusses therapeutic options in care, and provides an approach to its evaluation and management. We searched for review articles published in the past 10 years through a PubMed search using the filters diabetes mellitus, GERD, pathophysiology, and management. The search only yielded a handful of articles, so we independently included relevant studies from these review articles along with related citations as suggested by PubMed. We found diabetic patients are more prone to developing GERD and may present with atypical manifestations. A number of mechanisms have been proposed to elucidate the connection between these two diseases. Studies involving treatment options for comorbid disease suggest conflicting drug-drug interactions. Currently, there are no published guidelines specifically for the evaluation and management of GERD in the diabetic patient. Although there are several proposed mechanisms for the higher prevalence of GERD in the diabetic patient, this complex interrelationship requires further research. Understanding the pathophysiology will help direct diagnostic evaluation. In our review, we propose a management algorithm for GERD in the diabetic patient. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  1. The effect of dexlansoprazole MR on nocturnal heartburn and GERD-related sleep disturbances in patients with symptomatic GERD.

    PubMed

    Fass, Ronnie; Johnson, David A; Orr, William C; Han, Cong; Mody, Reema; Stern, Kathleen N; Pilmer, Betsy L; Perez, M Claudia

    2011-03-01

    Nocturnal heartburn and related sleep disturbances are common among patients with gastroesophageal reflux disease (GERD). This study evaluated the efficacy of dexlansoprazole MR 30 mg in relieving nocturnal heartburn and GERD-related sleep disturbances, improving work productivity, and decreasing nocturnal symptom severity in patients with symptomatic GERD. Patients (N=305) with frequent, moderate-to-very severe nocturnal heartburn and associated sleep disturbances were randomized 1:1 in a double-blind fashion to receive dexlansoprazole MR or placebo once daily for 4 weeks. The primary end point was the percentage of nights without heartburn. Secondary end points were the percentage of patients with relief of nocturnal heartburn and of GERD-related sleep disturbances over the last 7 days of treatment. At baseline and week 4/final visit, patients completed questionnaires that assessed sleep quality, work productivity, and the severity and impact of nocturnal GERD symptoms. Dexlansoprazole MR 30 mg (n=152) was superior to placebo (n=153) in median percentage of nights without heartburn (73.1 vs. 35.7%, respectively; P<0.001). Dexlansoprazole MR was significantly better than placebo in percentage of patients with relief of nocturnal heartburn and GERD-related sleep disturbances (47.5 vs. 19.6%, 69.7 vs. 47.9%, respectively; P<0.001), and led to significantly greater improvements in sleep quality and work productivity and decreased nocturnal symptom severity. Adverse events were similar across treatment groups. In patients with symptomatic GERD, dexlansoprazole MR 30 mg is significantly more efficacious than placebo in providing relief from nocturnal heartburn, in reducing GERD-related sleep disturbances and the consequent impairments in work productivity, and in improving sleep quality/quality of life.

  2. Comparison of the Carlsson-Dent and GERD-Q questionnaires for gastroesophageal reflux disease symptom detection in a general population.

    PubMed

    Contreras-Omaña, R; Sánchez-Reyes, O; Ángeles-Granados, E

    Gastroesophageal reflux disease (GERD) is an extremely common pathology in the general population and one of the main reasons for consultation in gastroenterology. There are different instruments for detecting its symptoms, but few studies comparing one tool with another have been conducted in Mexico. To compare the effectiveness of the Carlsson-Dent questionnaire (CDQ) and the GERD-Q questionnaire (GQQ) in detecting GERD symptoms in a general population. A prospective, descriptive, cross-sectional study was conducted on 220 individuals in an open population within the time frame of May-June 2015. The subjects were evaluated through the self-assessment CDQ and GQQ. The positive scores from the CDQ (≥ 4) were compared with those of the GQQ (≥ 8), to determine which of the two instruments more easily detected patients with GERD symptoms. Fifty-seven percent of the patients were men and the mean patient age was 38.1 years. Fifty percent of the subjects presented with GERD symptoms with a positive score in at least one questionnaire; 45% had positive CDQ results and 23% had positive GQQ results. Fifty-seven percent of the patients with a positive CDQ score presented with overweight/obesity, as did 72% of the patients with a positive GQQ result. Finally, 20% of the individuals had positive results for reflux symptoms in both questionnaires. There was a prevalence of GERD symptoms in 50% of the individuals studied from a general population. The GQQ detected a greater number of GERD symptoms in patients that presented with overweight/obesity and the CDQ was considered easier for patients to understand and answer. It is striking that there was only 20% agreement between the two questionnaires, suggesting that they may be useful for identifying GERD symptoms in different populations. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  3. Predisposition to self-administer amphetamine: the contribution of response to novelty and prior exposure to the drug.

    PubMed

    Pierre, P J; Vezina, P

    1997-02-01

    The present experiment examined the contribution of locomotor response to novelty and prior exposure to amphetamine to rats' predisposition to self-administer a low dose of the drug. Rats were screened for their locomotor response to a novel environment and divided into high (HR) or low (LR) responders based on whether their locomotor scores were above or below the median activity level of the subject sample. Animals were then pre-exposed to nine daily injections of either saline (1 ml/kg, i.p.) or amphetamine (1.5 mg/kg, i.p.). Starting 1 week after pre-exposure, animals in the four different groups (HR pre-exposed to saline or amphetamine; LR pre-exposed to saline or amphetamine) were given the opportunity, in each of ten daily sessions, to lever press for a low dose of amphetamine (10 micrograms/kg per infusion) in a two lever (active versus inactive) continuous reinforcement operant task. Initial lever press performance revealed no difference in active versus inactive lever pressing between amphetamine and saline pre-exposed animals. However, in agreement with previous reports, with successive test sessions amphetamine pre-exposed rats maintained higher levels of active versus inactive lever pressing for drug while saline pre-exposed rats showed a progressive decrease in the pressing of either lever. Interestingly, this enhanced active lever pressing was observed in HR but not LR rats pre-exposed to amphetamine. In addition, HR saline pre-exposed animals showed initial active versus inactive lever pressing equivalent to that of HR amphetamine pretreated rats but this enhanced responding for drug diminished over days and by the last day of self-administration was indistinguishable from that of LR animals having been pre-exposed either to amphetamine or saline. These findings confirm that prior exposure to amphetamine promotes the subsequent self-administration of the drug and suggest that response to novelty may be a predictor more closely linked to an animal

  4. Heritability and genetic correlation between GERD symptoms severity, metabolic syndrome, and inflammation markers in families living in Mexico City.

    PubMed

    Reding-Bernal, Arturo; Sánchez-Pedraza, Valentin; Moreno-Macías, Hortensia; Sobrino-Cossio, Sergio; Tejero-Barrera, María Elizabeth; Burguete-García, Ana Isabel; León-Hernández, Mireya; Serratos-Canales, María Fabiola; Duggirala, Ravindranath; López-Alvarenga, Juan Carlos

    2017-01-01

    The aim of this study was to estimate the heritability (h2) and genetic correlation (ρG) between GERD symptoms severity, metabolic syndrome components, and inflammation markers in Mexican families. Cross-sectional study which included 32 extended families resident in Mexico City. GERD symptoms severity was assessed by the ReQuest in Practice questionnaire. Heritability and genetic correlation were determined using the Sequential Oligogenic Linkage Analysis Routines software. 585 subjects were included, the mean age was 42 (±16.7) years, 57% were women. The heritability of the severity of some GERD symptoms was h2 = 0.27, 0.27, 0.37, and 0.34 (p-value <1.0x10-5) for acidity complaints, lower abdominal complaints, sleep disturbances, and total ReQuest score, respectively. Heritability of metabolic syndrome components ranged from 0.40 for fasting plasma glucose to 0.61 for body mass index and diabetes mellitus. The heritability for fibrinogen and C-reactive protein was 0.64 and 0.38, respectively. Statistically significant genetic correlations were found between acidity complaints and fasting plasma glucose (ρG = 0.40); sleep disturbances and fasting plasma glucose (ρG = 0.36); acidity complaints and diabetes mellitus (ρG = 0.49) and between total ReQuest score and fasting plasma glucose (ρG = 0.43). The rest of metabolic syndrome components did not correlate with GERD symptoms. Genetic factors substantially explain the phenotypic variance of the severity of some GERD symptoms, metabolic syndrome components and inflammation markers. Observed genetic correlations suggest that these phenotypes share common genes. These findings suggest conducting further investigation, as the determination of a linkage analysis in order to identify regions of susceptibility for developing of GERD and metabolic syndrome.

  5. Self-administered written prompts to teach home accident prevention skills to adults with brain injuries.

    PubMed Central

    O'Reilly, M F; Green, G; Braunling-McMorrow, D

    1990-01-01

    This study evaluated the use of written checklists and task analyses as self-administered prompts to teach home accident prevention skills to 4 adults with brain injuries. Subsequent to baseline, participants used written checklists that identified potential in-home hazards but did not prompt behaviors necessary for hazard remediation. Written individualized task analyses, incorporating specific behavioral steps for correcting hazards that participants had failed to remediate during the checklist phase, were used to prompt appropriate responding when necessary. These were subsequently faded to transfer stimulus control to the natural conditions. A multiple probe technique across participants and settings was used. Results indicated that the checklist alone was sufficient to increase appropriate responses to many of the potential hazards. Individualized task analyses, when needed, resulted in appropriate remediation of all potential hazards. Generalization to untrained potential hazards occurred to some degree for all participants. Follow-up results showed that most skills trained were maintained over a 1-month period. PMID:2074235

  6. Disclosure of sensitive behaviors across self-administered survey modes: a meta-analysis.

    PubMed

    Gnambs, Timo; Kaspar, Kai

    2015-12-01

    In surveys, individuals tend to misreport behaviors that are in contrast to prevalent social norms or regulations. Several design features of the survey procedure have been suggested to counteract this problem; particularly, computerized surveys are supposed to elicit more truthful responding. This assumption was tested in a meta-analysis of survey experiments reporting 460 effect sizes (total N =125,672). Self-reported prevalence rates of several sensitive behaviors for which motivated misreporting has been frequently observed were compared across self-administered paper-and-pencil versus computerized surveys. The results revealed that computerized surveys led to significantly more reporting of socially undesirable behaviors than comparable surveys administered on paper. This effect was strongest for highly sensitive behaviors and surveys administered individually to respondents. Moderator analyses did not identify interviewer effects or benefits of audio-enhanced computer surveys. The meta-analysis highlighted the advantages of computerized survey modes for the assessment of sensitive topics.

  7. Self-Administered, Subcutaneous Alemtuzumab to Treat Residual Disease in Patients With Chronic Lymphocytic Leukemia

    PubMed Central

    Wierda, William G.; Kipps, Thomas J.; Keating, Michael J.; Brown, Jennifer R.; Gribben, John G.; Browning, Mary; Rassenti, Laura Z.; Greaves, Andrew W.; Neuberg, Donna; O’Brien, Susan M.

    2015-01-01

    BACKGROUND Alemtuzumab is highly effective at treating chronic lymphocytic leukemia (CLL) in bone marrow, which is the usual site of residual disease after fludarabine-based treatment. Eliminating residual disease potentially is associated with longer remission and overall survival. The authors of this report evaluated the ability of subcutaneous alemtuzumab to treat residual disease. METHODS Patients in partial remission (PR), nodular PR (nPR), or complete remission (CR) who had disease in bone marrow established by 2-color flow cytometry analysis were enrolled and received alemtuzumab 30 mg subcutaneously 3 times weekly for 4 weeks, and patients had the option to self-administer alemtuzumab. Responders were patients in PR who converted to an nPR or a CR, patients in nPR who converted to a CR, and patients in CR who had no evidence of disease on 2-color flow cytometry analysis after treatment. RESULTS There were 31 patients enrolled, of whom 29 were evaluable, and there were 23 responders (4 of 4 patients who achieved a CR, 8 of 9 patients who achieved an nPR, and 11 of 16 patients who achieved a PR. Non-responders had significantly lower plasma alemtuzumab levels at the end of treatment. Furthermore, higher plasma alemtuzumab levels at the end of treatment were correlated with a longer response duration. Compared with the results from an historic group that received intravenous alemtuzumab for residual disease, there was a trend toward a higher response rate but a shorter response duration with subcutaneous alemtuzumab. CONCLUSIONS The current results demonstrated that self-administered, subcutaneous alemtuzumab was safe and active for residual disease and that plasma alemtuzumab levels and real-time minimal residual disease evaluation are important endpoints to monitor in future alemtuzumab consolidation trials. PMID:20806349

  8. Emergency department medication history taking: current inefficiency and potential for a self-administered form.

    PubMed

    Witting, Michael D; Hayes, Bryan D; Schenkel, Stephen M; Drucker, Charles B; DeWane, Michael P; Lantry, James H; Vashi, Satyam V

    2013-07-01

    Emergency Departments (EDs) struggle with obtaining accurate medication information from patients. Our aim was to estimate the proportion of urban ED patients who are able to complete a self-administered medication form and record patient observations of the medication information process. In this cross-sectional study, we consecutively sampled ED patients during various shifts between 8 AM and 10 PM. We created a one-page medication questionnaire that included a list of 49 common medications, categorized by general indications. We asked patients to circle any medications they took and write the names of those not on the form in a dedicated area on the bottom of the page. After their visit, we asked patients to recall which providers had asked them about their medications. Research staff approached 354 patients; median age was 45 years (interquartile range 29-53 years). Two hundred and forty-nine (70%) completed a form, 61 (17%) were too ill, 19 (5%) could not read it, and 25 (7%) refused to participate. Excluding refusals, 249 of 329 (76%; 95% confidence interval 70-80%) were able to complete the form. Of 209 patients recalling their visit, 180 (86%) indicated that multiple providers took a history, including 103 in which every provider did so, and 9 (4%) indicated that no provider took a medication history. The process of ED medication information transfer often involves redundant efforts by the health care team. More than 70% of patients presenting for Emergency care were able to complete a self-administered medication information form. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Self-Administered Lidocaine Gel for Intrauterine Device Insertion in Nulliparous Women: A Randomized Controlled Trial.

    PubMed

    Rapkin, Rachel B; Achilles, Sharon L; Schwarz, E Bimla; Meyn, Leslie; Cremer, Miriam; Boraas, Christy M; Chen, Beatrice A

    2016-09-01

    To evaluate self-administration of vaginal lidocaine gel to decrease pain with intrauterine device (IUD) insertion in nulliparous women. In this randomized, double-blind, placebo-controlled trial, women self-administered 2% lidocaine or placebo vaginal gel 5 minutes before IUD insertion. The primary outcome was change in pain from baseline to IUD insertion on a 100-mm visual analog scale. We also assessed pain after speculum insertion, tenaculum placement, uterine sounding, and 5 minutes after IUD insertion. Secondary outcomes included patient acceptability, ease of IUD insertion, and need for pain medication for up to 7 days. From July 2012 to May 2013, 59 women were randomized; 30 received lidocaine gel and 29 placebo. Baseline demographics, including age, race, and body mass index, were similar. There was no difference in median change in pain during IUD insertion in women receiving lidocaine (61 mm [interquartile range 53-71]) compared with placebo (69 mm [interquartile range 63-80], P=.06). Women receiving lidocaine experienced less pain with tenaculum placement (32 mm [interquartile range 18-54]) compared with placebo (56 mm [interquartile range 26-75], P=.02). Most (76%) women were satisfied with their IUD insertion experience and 86% would probably or definitely recommend an IUD to a friend. Thirty-four percent of women required pain medication for at least 3 days after IUD insertion. For nulliparous women, self-administered vaginal lidocaine gel does not reduce pain with IUD insertion, but does decrease pain with tenaculum placement. ClinicalTrials.gov, http://clinicaltrials.gov, NCT01534520.

  10. Clinical availability of a self-administered odor questionnaire for patients with olfactory disorders.

    PubMed

    Takebayashi, Hironori; Tsuzuki, Kenzo; Oka, Hideki; Fukazawa, Keijiro; Daimon, Takashi; Sakagami, Masafumi

    2011-02-01

    This study demonstrated statistical correlations between a novel self-administered odor questionnaire (SAOQ) and other olfaction tests in patients with olfactory disorders, and the usefulness of this questionnaire was discussed. Between December 2004 and November 2009 (5 years), the SAOQ was completed by 405 healthy people without any nasal diseases (Group A) and 539 patients with an olfactory disorder (Group B) at the Department of Otolaryngology, Hyogo College of Medicine. This was a prospective study. The SAOQ proposed by the Japan Rhinology Society is a self-administered survey consisting of 20 smell-related items: "steamed rice, miso, seaweed, soy sauce, baked bread, butter, curry, garlic, orange, strawberry, green tea, coffee, chocolate, household gas, garbage, timber, stercus, sweat, flower, and perfume". The normal reference range of scores (%) of the SAOQ was calculated in Group A. To determine whether the results of the SAOQ were correlated with those of visual analogue scale (VAS) and T&T olfactometer, pre- and post-treatment results of the SAOQ and olfaction tests were analyzed. The questionnaire response rates were 99.5% (403/405 people) in Group A and 95.9% (517/539 patients) in Group B. The statistically normal reference level of the SAOQ was determined as more than 70%. In Group B, the mean pre-treatment SAOQ score (20.4%), VAS score (16.5%), and T&T recognition threshold (5.0) significantly improved to values of 46.7%, 41.1%, and 4.1 after treatments, respectively (n=249). Both pre- and post-treatment SAOQ scores (ΔQ) had statistically significant relationships with those of VAS and T&T (n=249). The utility of the SAOQ as an easy method of estimating olfaction was suggested. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Behaviour of laboratory mice in different housing conditions when allowed to self-administer an anxiolytic.

    PubMed

    Olsson, I Anna S; Sherwin, Chris M

    2006-10-01

    Standard cages prevent mice from performing several natural behaviours for which they are motivated. As a consequence, abnormal behaviours sometimes develop and mice often spend long periods inactive. To improve welfare, cages are sometimes furnished with items such as nesting material, shelters and running wheels. We have previously reported that when allowed to self-administer an anxiolytic, mice in furnished cages consume less anxiolytic than mice in standard cages. This paper presents the results of behaviour studies of the mice in the same experiment. Female C57BL/6J mice (3 per cage) were housed in Standard (n = 10), Unpredictable (n = 10) or Furnished (n = 6) cages. Unpredictable cages were identical to Standard cages, but were exposed to unpredictable events two to three times a week. Furnished cages were double the size of Standard cages and contained nesting material, nest box, tubes, chew blocks and a running wheel. During three consecutive periods, mice had access to only water (control), water or an anxiolytic solution on a daily alternating schedule (forced consumption), and finally, both water and anxiolytic (self-administration). Behaviour was analysed from video recordings taken during the dark phase. The housing type affected behaviour both under the control and the self-administration conditions. Overall, mice in Furnished cages spent less time resting and performing bar-related behaviours and more time on exploratory/locomotory behaviours. Mice in Furnished cages also performed less bar-circling stereotypies than mice in Standard cages. The Unpredictable treatment did not significantly affect behaviour compared to mice in the Standard conditions. There was an overall effect of anxiolytic availability on rest-related behaviours and on exploration-locomotion behaviours, in that mice rested more and spent less time on exploration and locomotion when they were able to self-administer the anxiolytic.

  12. The Speed of Cocaine Delivery Determines the Subsequent Motivation to Self-Administer the Drug

    PubMed Central

    Minogianis, Ellie-Anna; Lévesque, Daniel; Samaha, Anne-Noël

    2013-01-01

    The rapid delivery of drugs of abuse to the brain is associated with an increased likelihood and severity of addiction. Here we evaluated the hypothesis that rapidly delivered cocaine facilitates the addiction process by promoting the development of enhanced motivation for the drug. Rats lever-pressed for cocaine delivered intravenously over 5 or 90 s under fixed ratio (FR) during 6-h sessions. The motivation for cocaine was subsequently assessed using a progressive ratio (PR) schedule, where each successive drug injection cost an exponentially greater number of lever presses, until the cessation of responding. Throughout all self-administration sessions, all rats could only take one injection every 90 s. The 5-s groups self-administered more drug than the 90-s groups across the FR sessions. Under PR, animals that had chronically self-administered rapidly delivered cocaine took more cocaine across a range of doses and regardless of whether the drug was delivered over 5 or 90 s during PR testing. The speed of delivery also determined the long-term neurobiological impact of cocaine. Fourteen days following cocaine withdrawal, caudate-putamen D2 levels were decreased only in the 90-s rats, and quinpirole-mediated Gαi/o-protein activation was increased to a greater extent in the 90- vs 5-s rats. Thus, rapid delivery promotes the pursuit of cocaine in the face of rising costs and alters cocaine-induced changes in striatal D2 receptor number and function. As such, rapidly delivered cocaine might facilitate addiction because it more readily alters brain motivation circuits in ways that contribute to the compulsive pursuit of the drug. PMID:23921953

  13. Musical Rehabilitation in Adult Cochlear Implant Recipients With a Self-administered Software.

    PubMed

    Smith, Leah; Bartel, Lee; Joglekar, Samidha; Chen, Joseph

    2017-09-01

    The goal of this study was to determine if a self-administered computer-based rehabilitation program could improve music appreciation and speech understanding in adults who have a cochlear implant (CI). Prospective study. Tertiary adult CI program. Twenty-one postlingually deafened cochlear implant users between the ages of 27 and 79 years were recruited. A self-administered music rehabilitative software was designed to help improve the perception of musical patterns of increasing complexity, as well as pitch and timbre perception, premised on focused and divided attention. All participants completed a diagnostic music test before and after rehabilitative training, including tests of pitch and timbre perception and pattern identification with increasing levels of difficulty. Speech data in quiet and noise was also collected both pre- and post-training. Participants trained for a minimum of 3.5 hours a week, for 4 weeks. Mean changes in music perception and enjoyment as well as speech perception (IEEE sentence test in quiet and noise). Post-training diagnostic test scores, as compared with pretraining scores, indicated significant improvements in musical pattern perception. Tests of speech perception in quiet and in noise were significantly improved in a subset of this cohort. All of the training participants thought that the training helped to improve their recognition skills, and found the program to be beneficial. Despite the limitations of current CI technology, the results of this study suggest that auditory training can improve music perception skills, and possibly speech intelligibility, lending further support to rehabilitation being an integral part of the postimplantation paradigm.

  14. Distinguishing GERD from eosinophilic oesophagitis: concepts and controversies.

    PubMed

    Kia, Leila; Hirano, Ikuo

    2015-07-01

    Over the past three decades, the detection of oesophageal mucosal eosinophils has transitioned from a biomarker of GERD to a diagnostic criterion for eosinophilic oesophagitis (EoE). In GERD, oesophageal eosinophils are considered part of the chronic inflammatory response to acid reflux, whereas the marked eosinophilia in EoE is viewed as a central feature of the immune response to ingested food and/or environmental antigen stimulation. Descriptions of a considerable subset of patients with symptomatic, endoscopic and histological findings of EoE that resolve with PPI therapy has led to confusion and controversy regarding the distinction of EoE from GERD. Study findings indicate that PPI-responsive oesophageal eosinophilia (PPI-REE) more closely resembles EoE than GERD, both from a clinical and immunological aspect. Although responsiveness to PPI therapy should not be utilized to exclude EoE, PPI therapy is effective at reducing oesophageal eosinophilia in ∼40% of patients, and PPI therapy is both a safe and practical initial step in the management of patients with oesophageal eosinophilia. Ongoing studies elucidating the mechanism behind PPI-REE will improve our understanding and management of EoE. In this Review, the mechanisms and evidence that underlie the controversy in the distinction between GERD and EoE are evaluated.

  15. [Endoscopic examination including magnifying endoscopy for diagnosis of GERD].

    PubMed

    Kato, Mototsugu; Ono, Shoko; Nakagawa, Manabu; Shimizu, Yuichi; Asaka, Masahiro

    2007-05-01

    Symptoms of heartburn and regurgitation are the most important for diagnosis of gastroesophageal reflux disease (GERD) in the clinical field. Endoscopic examination is also widely used modality for Los Angeles classification of GERD according to endoscopic severity of esophageal mucosal breaks. However, about half of GERD patients reveal no abnormality under conventional endoscopy. These endoscopic negative GERD is called as non-erosive reflux disease (NERD). There is the possibility to underestimate a minute mucosal change of GERD by conventional endoscopy that has the limitation of visual ability. Magnifying endoscopic examination is able to get clear visualization of intrapapillary capillary loops(IPCL), which are usually shown as dot-like structures in esophageal mucosa by a conventional endoscopy. The changing of IPCLs is associated with inflammation and neoplasia of esophagus. Minute change of IPCLs such as a dilation and elongation with regular intervals were reported to be suggestive of inflammatory change in esophagus. Magnifying endoscopic observation of IPCLs is useful for diagnosis of NERD which cannot be visualized by conventional endoscopy.

  16. Distinguishing GERD from eosinophilic oesophagitis: concepts and controversies

    PubMed Central

    2016-01-01

    Over the past three decades, the detection of oesophageal mucosal eosinophils has transitioned from a biomarker of GERD to a diagnostic criterion for eosinophilic oesophagitis (EoE). In GERD, oesophageal eosinophils are considered part of the chronic inflammatory response to acid reflux, whereas the marked eosinophilia in EoE is viewed as a central feature of the immune response to ingested food and/or environmental antigen stimulation. Descriptions of a considerable subset of patients with symptomatic, endoscopic and histological findings of EoE that resolve with PPI therapy has led to confusion and controversy regarding the distinction of EoE from GERD. Study findings indicate that PPI-responsive oesophageal eosinophilia (PPI-REE) more closely resembles EoE than GERD, both from a clinical and immunological aspect. Although responsiveness to PPI therapy should not be utilized to exclude EoE, PPI therapy is effective at reducing oesophageal eosinophilia in ~40% of patients, and PPI therapy is both a safe and practical initial step in the management of patients with oesophageal eosinophilia. Ongoing studies elucidating the mechanism behind PPI-REE will improve our understanding and management of EoE. In this Review, the mechanisms and evidence that underlie the controversy in the distinction between GERD and EoE are evaluated. PMID:25986303

  17. Diagnostic testing in extraesophageal GERD: another case of "furor medicus"?

    PubMed

    Spiegel, Brennan

    2013-06-01

    Proton pump inhibitors (PPIs) work for most patients with gastroesophageal reflux disease (GERD). But when PPIs fail to work, or when there are atypical extra-esophageal symptoms, diagnostic and management decisions become much more difficult. Although atypical GERD is common, there are limited data about how best to approach these patients. The temptation is often to perform extensive diagnostic testing, sometimes to little avail. In this issue of The Journal, Francis et al. present a new study to help close the research gap in understanding the costs and benefits of testing in atypical GERD. The authors conclude that diagnostic testing is very expensive and real-life benefits are modest. This editorial reviews the findings, places them into clinical perspective, and concludes that diagnostic testing in atypical GERD may be another example of "furor medicus" - an old but descriptive term referring to the instinct of doctors to implore "don't just stand there, do something!" The data from Francis et al. suggest we might do the opposite in atypical GERD: "Don't just do something, stand there."

  18. Self-Administered Mind-Body Practices for Reducing Health Disparities: An Interprofessional Opinion and Call to Action

    PubMed Central

    Masho, Saba W.

    2016-01-01

    Health disparities (HD) continue to persist in the United States which underscores the importance of using low-cost, accessible, evidence-based strategies that can improve health outcomes, especially for chronic conditions that are prevalent among underserved minority populations. Complementary/integrative health modalities, particularly self-administered mind-body practices (MBP), can be extremely useful in reducing HD because they are intrinsically patient-centered and they empower patients to actively engage in self-care of health and self-management of symptoms. Interprofessional healthcare providers and patients can engage in powerful partnerships that encompass self-administered MBP to improve health. This is a call to action for interprofessional researchers to engage in high-quality research regarding efficacy and cost-effectiveness of self-administered MBP, for practitioners to engage patients in self-administered MBP for health promotion, disease prevention, and symptom management, and for healthcare institutions to integrate self-administered MBP into conventional health practices to reduce HD in their communities. PMID:27672398

  19. Cross-cultural adaptation and validation of the Portuguese version of "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire".

    PubMed

    da Rocha Lopes, Sofia Manuela; Duarte, José Alberto; Mesquita, Cristina Teresa Torrão Carvalho

    2016-04-01

    Knowledge is an important factor in patients with ankylosing spondylitis regarding the adoption of appropriate behaviours and education. The aim of this study was to culturally adapt and validate "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire" for the Portuguese population with ankylosing spondylitis. The Portuguese version of "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire" was administered to a sample of 180 subjects, from which 63 individuals responded. The adaptation process involved translation, back-translation and submission to a committee of experts in the area, culminating with a Portuguese version of the instrument. Next, the scale reliability and validity were assessed. There was a statistically significant decrease from test to retest, although the intra-class correlation coefficient between test and retest was 0.76 (95 % CI 0.61-0.86), which was considered good. From 180 individuals, 63 (35.0 %) subjects were available for the present study. The proportion of individuals that correctly answered each item ranged from 19 to 92 %, corresponding to items 8 and 13, respectively. The mean number of correct answers was 8.5 [mean (SD) = 2.4] in 12 questions. The proposed Portuguese version of the ankylosing spondylitis knowledge scale showed good reliability, reproducibility and construct validity.

  20. Self-administered acupressure for symptom management among Chinese family caregivers with caregiver stress: a randomized, wait-list controlled trial.

    PubMed

    Tiwari, Agnes; Lao, Lixing; Wang, Amy Xiao-Min; Cheung, Denise Shuk Ting; So, Mike Ka Pui; Yu, Doris Sau Fung; Lum, Terry Yat Sang; Yuk Fung, Helina Yin King; Yeung, Jerry Wing Fai; Zhang, Zhang-Jin

    2016-10-28

    Caregiving can be stressful, potentially creating physical and psychological strain. Substantial evidence has shown that family caregivers suffer from significant health problems arising from the demands of caregiving. Although there are programs supporting caregivers, there is little evidence regarding their effectiveness. Acupressure is an ancient Chinese healing method designed to restore the flow of Qi (vital energy) by applying external pressure to acupoints. A randomized, wait-list controlled trial was developed to evaluate the effectiveness of a self-administered acupressure intervention on caregiver stress (primary objective) and stress-related symptoms of fatigue, insomnia, depression, and health-related quality of life (secondary objectives) in Chinese caregivers of older family members. Two hundred Chinese participants, aged ≥ 21 years, who are the primary caregivers of an older family member and screen positive for caregiver stress and symptoms of fatigue/insomnia/depression will be recruited from a community setting in Hong Kong. Subjects will be randomized to receive either an immediate treatment condition (self-administered acupressure intervention) or a wait-list control condition. The self-administered acupressure intervention will include (i) an individual learning and practice session twice a week for 2 weeks, (ii) a home follow-up visit once a week for 2 weeks, and (iii) 15-min self-practice twice a day for 6 weeks. The wait-list control group will receive the same acupressure training after the intervention group has completed the intervention. We hypothesize that Chinese family caregivers in the intervention group will have lower levels of caregiver stress, fatigue, insomnia, depression, and higher health-related quality of life after completion of the intervention than participants in the wait-list control group. This study will provide evidence for the effectiveness of self-administered acupressure in reducing stress and improving

  1. Interviewer versus self-administered health-related quality of life questionnaires - Does it matter?

    PubMed Central

    2011-01-01

    Background Patient-reported outcomes are measured in many epidemiologic studies using self- or interviewer-administered questionnaires. While in some studies differences between these administration formats were observed, other studies did not show statistically significant differences important to patients. Since the evidence about the effect of administration format is inconsistent and mainly available from cross-sectional studies our aim was to assess the effects of different administration formats on repeated measurements of patient-reported outcomes in participants with AIDS enrolled in the Longitudinal Study of Ocular Complications of AIDS. Methods We included participants enrolled in the Longitudinal Study of Ocular Complications in AIDS (LSOCA) who completed the Medical Outcome Study [MOS] -HIV questionnaire, the EuroQol, the Feeling Thermometer and the Visual Function Questionnaire (VFQ) 25 every six months thereafter using self- or interviewer-administration. A large print questionnaire was available for participants with visual impairment. Considering all measurements over time and adjusting for patient and study site characteristics we used linear models to compare HRQL scores (all scores from 0-100) between administration formats. We defined adjusted differences of ≥0.2 standard deviations [SD]) to be quantitatively meaningful. Results We included 2,261 participants (80.6% males) with a median of 43.1 years of age at enrolment who provided data on 23,420 study visits. The self-administered MOS-HIV, Feeling Thermometer and EuroQol were used in 70% of all visits and the VFQ-25 in 80%. For eight domains of the MOS-HIV differences between the interviewer- and self- administered format were < 0.1 SD. Differences in scores were highest for the social and role function domains but the adjusted differences were still < 0.2 SD. There was no quantitatively meaningful difference between administration formats for EuroQol, Feeling Thermometer and VFQ-25 domain

  2. Reminder packaging for improving adherence to self-administered long-term medications.

    PubMed

    Heneghan, C J; Glasziou, P; Perera, R

    2006-01-25

    Current methods of improving medication adherence for health problems are mostly complex, labour-intensive, and not reliably effective. Medication 'reminder packaging' which incorporates a date or time for a medication to be taken in the packaging, can act as a reminder system to improve adherence. The objective of this review was to determine the effects of reminder packaging to enhance patient adherence with self-administered medications taken for one month or more. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library Issue 3, 2004), MEDLINE, EMBASE, CINAHL and PsycINFO from the start of the databases to 1 September 2004. We also searched the internet, contacted packaging manufacturers, and checked abstracts from the Pharm-line database and reference lists from relevant articles. We did not apply any language restrictions. We selected randomised controlled trials with at least 80% follow up, comparing a reminder packaging device with no device in participants taking self-administered medications for a minimum of one month. Two reviewers independently assessed studies for inclusion, assessed quality, and extracted data from included studies. Where considered appropriate, data were combined for meta-analysis, or were reported and discussed in a narrative. Eight studies containing data on 1,137 participants were included. Six intervention groups in four trials provided data on the percentage of pills taken. Reminder packaging showed a significant increase in the percentage of pills taken, weighted mean difference 11% (95% confidence interval (CI) 6% to 17%). Notable heterogeneity occurred among these trials I(2 )= 96.3%. Two trials provided data for the proportion of self-reported adherent patients, reporting a reduction in the intervention group which was not statistically significant, odds ratio = 0.89 (95% CI 0.56 to 1.40). No appropriate data were available for

  3. Effect of Body Weight and Esophageal Damage on the Severity of Gastroesophageal Reflux Symptoms. Mexican GERD Working Group

    PubMed Central

    Lopez-Alvarenga, Juan Carlos; Vargas, José Antonio; Lopez, Luis Humberto; Fass, Ronnie; Sobrino-Cossio, Sergio; Higgins, Paul; Comuzzie, Anthony

    2010-01-01

    Background and Aims Several studies have demonstrated overweight and obesity are strong independent risk factor of GERD symptoms and esophageal erosions. Our aim was to analyze the joint effect of BMI with the grade of esophageal damage over symptoms’ intensity of GERD. Methods We used a questionnaire with a Likert scale for severity of symptoms related to GERD. The distal portion of the esophagus was evaluated to determine the presence of mucosal injury, classified by Los Angeles criteria (LA). Results We included 917 subjects (53.76% females) with average age 36.8 ± 7 years. Males had higher BMI than females (26.8 ± 3.5 vs. 25.2 ± 4.5, p <0.001). Severe damage (C–D ulcers) was associated with overweight (BMI 25–30), severity of heartburn, retching, halitosis, regurgitation, and chest oppression. BMI >30 had high score for heartburn and retching, but low score for nausea, compared with lower weight. The model with interaction showed a non-linear association between BMI and LA. Overweight (but not obese) patients with damage scored C–D had the highest score for intensity of heartburn and retching. Conclusions BMI and LA do not have additive effects on the severity of symptoms of GERD. Those with BMI between 25 and 30 had severe symptoms score, but those with BMI >30 showed lower scores. These findings could explain controversial results found in other studies. PMID:20082872

  4. Comparison of self-administered survey questionnaire responses collected using mobile apps versus other methods.

    PubMed

    Marcano Belisario, José S; Jamsek, Jan; Huckvale, Kit; O'Donoghue, John; Morrison, Cecily P; Car, Josip

    2015-07-27

    Self-administered survey questionnaires are an important data collection tool in clinical practice, public health research and epidemiology. They are ideal for achieving a wide geographic coverage of the target population, dealing with sensitive topics and are less resource-intensive than other data collection methods. These survey questionnaires can be delivered electronically, which can maximise the scalability and speed of data collection while reducing cost. In recent years, the use of apps running on consumer smart devices (i.e., smartphones and tablets) for this purpose has received considerable attention. However, variation in the mode of delivering a survey questionnaire could affect the quality of the responses collected. To assess the impact that smartphone and tablet apps as a delivery mode have on the quality of survey questionnaire responses compared to any other alternative delivery mode: paper, laptop computer, tablet computer (manufactured before 2007), short message service (SMS) and plastic objects. We searched MEDLINE, EMBASE, PsycINFO, IEEEXplore, Web of Science, CABI: CAB Abstracts, Current Contents Connect, ACM Digital, ERIC, Sociological Abstracts, Health Management Information Consortium, the Campbell Library and CENTRAL. We also searched registers of current and ongoing clinical trials such as ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform. We also searched the grey literature in OpenGrey, Mobile Active and ProQuest Dissertation & Theses. Lastly, we searched Google Scholar and the reference lists of included studies and relevant systematic reviews. We performed all searches up to 12 and 13 April 2015. We included parallel randomised controlled trials (RCTs), crossover trials and paired repeated measures studies that compared the electronic delivery of self-administered survey questionnaires via a smartphone or tablet app with any other delivery mode. We included data obtained from

  5. Improving efficiency and safety for patients who are unable to self-administer insulin.

    PubMed

    Livingstone, Carina; Wolper, Sandra; Rogers, Tracy

    2013-10-01

    A one-day 'snapshot' study was conducted to determine the nature and extent of specific safety issues faced by community nurses who care for patients unable to self-administer insulin. Community teams from 19 NHS trusts reported 607 patients requiring support with insulin administration. In total, 15.1% of insulin administration documents had an abbreviation for the word 'units', which is a serious safety hazard where any resulting serious harm would be classed as a 'never event'. Pens or disposable devices were used for 52.9% of all administrations, with 16.7% using an insulin device without any previous device-specific training. Major differences were discovered between trusts in many aspects of practice and insulin use, and comparative data can be used to benchmark activity and drive safety and cost improvement For example, 50.9% of patients had insulin administered more than once a day, but individual trusts reported figures ranging from 25.9% to 66.7%. If it were possible for all 19 trusts to manage 60% of patients on once-daily regimens, total annual service costs could be reduced by about pounds 200,000, or by pounds 3.5 million across the U.K.s.

  6. Development of a self-administered web-based test for longitudinal cognitive assessment

    PubMed Central

    Ruano, Luis; Sousa, Andreia; Severo, Milton; Alves, Ivânia; Colunas, Márcio; Barreto, Rui; Mateus, Cátia; Moreira, Sandra; Conde, Eduardo; Bento, Virgílio; Lunet, Nuno; Pais, Joana; Tedim Cruz, Vítor

    2016-01-01

    Sequential testing with brief cognitive tools has been recommended to improve cognitive screening and monitoring, however the few available tools still depend on an external evaluator and periodic visits. We developed a self-administered computerized test intended for longitudinal cognitive testing (Brain on Track). The test can be performed from a home computer and is composed of several subtests, expected to evaluate different cognitive domains, all including random elements to minimize learning effects. An initial (A) and a refined version of the test (B) were applied to patients with mild cognitive impairment or early dementia (n = 88) and age and education-matched controls. A subsample of a population-based cohort (n = 113) performed the test at home every three months to evaluate test-retest reliability. The test’s final version Cronbach’s alpha was 0.90, test scores were significantly different between patients and controls (p = 0.001), the area under the receiver operating characteristic curve was 0.75 and the smallest real difference (43.04) was lower than the clinical relevant difference (56.82). In the test-retest reliability analysis 9/10 subtests showed two-way mixed single intraclass consistency correlation coefficient >0.70. These results imply good internal consistency, discriminative ability and reliability when performed at home, encouraging further longitudinal clinical and population-based studies. PMID:26743329

  7. Effectiveness of a self-administered intervention for criminal thinking: Taking a chance on change

    PubMed Central

    Folk, Johanna B.; Disabato, David J.; Daylor, Jordan M.; Tangney, June P.; Barboza, Sharen; Wilson, John S.; Bonieskie, Lynda; Holwager, James

    2016-01-01

    The current study tested the effectiveness of a self-administered, cognitive-behavioral intervention targeting criminal thinking for inmates in segregated housing: Taking a Chance on Change (TCC). Participants included 273 inmates in segregated housing at state correctional institutions. Reductions in criminal thinking, as assessed by the Psychological Inventory of Criminal Styles-Simplified Version, were found in the general criminal thinking score as well as the proactive and reactive composite scores. Examination of demographic predictors of change (i.e., age, years of education, length of sentence) revealed older and more educated participants decreased in criminal thinking more than younger and less educated participants. For a subset of 48 inmates, completion of TCC was associated with significant reduction of disciplinary infractions. Reductions in reactive criminal thinking predicted reductions in disciplinary infractions. Although further research is needed to determine the effectiveness of TCC in reducing recidivism, the reductions in criminal thinking and disordered conduct suggest this is a promising intervention and mode of treatment delivery. By utilizing self-directed study at an accessible reading level, the intervention is uniquely suited to a correctional setting where staff and monetary resources are limited and security and operational issues limit the feasibility of traditional cognitive-behavioral group treatment. PMID:27243111

  8. Hyperthermia therapy for warts utilizing a self-administered exothermic patch. Review of two cases.

    PubMed

    Dvoretzky, I

    1996-12-01

    Hyperthermia therapy was described previously to be effective for treating warts using a hot water technique as well as an ultrasound hyperthermia technique. Recently, two other papers described controlled localized heat therapy for cutaneous warts. A new heat-generated application system and method has been developed for treating warts using a self-administered, self-adhesive disposable exothermic patch. The objective of this study was to describe our clinical experience in using the exothermic patch to successfully treat patients with cutaneous recalcitrant warts who failed to respond to multiple antiwart therapy. Two patients with recalcitrant warts that did not respond to other therapeutic modalities were treated with the exothermic patch with complete remission of their warts. Exothermic patches were used in this study that were specially constructed to provide long-lasting, continuous, and reproducible heating of the skin surface for at least 2 hours at a temperature level of 42-43 degrees C, which will not burn or otherwise injure the skin. Warts are difficult to treat in part because there are no specific anti-Papillomavirus drugs or methods available. We describe our clinical experience in successfully treating two patients with recalcitrant warts using the exothermic patch.

  9. Development of a self-administered web-based test for longitudinal cognitive assessment.

    PubMed

    Ruano, Luis; Sousa, Andreia; Severo, Milton; Alves, Ivânia; Colunas, Márcio; Barreto, Rui; Mateus, Cátia; Moreira, Sandra; Conde, Eduardo; Bento, Virgílio; Lunet, Nuno; Pais, Joana; Tedim Cruz, Vítor

    2016-01-08

    Sequential testing with brief cognitive tools has been recommended to improve cognitive screening and monitoring, however the few available tools still depend on an external evaluator and periodic visits. We developed a self-administered computerized test intended for longitudinal cognitive testing (Brain on Track). The test can be performed from a home computer and is composed of several subtests, expected to evaluate different cognitive domains, all including random elements to minimize learning effects. An initial (A) and a refined version of the test (B) were applied to patients with mild cognitive impairment or early dementia (n = 88) and age and education-matched controls. A subsample of a population-based cohort (n = 113) performed the test at home every three months to evaluate test-retest reliability. The test's final version Cronbach's alpha was 0.90, test scores were significantly different between patients and controls (p = 0.001), the area under the receiver operating characteristic curve was 0.75 and the smallest real difference (43.04) was lower than the clinical relevant difference (56.82). In the test-retest reliability analysis 9/10 subtests showed two-way mixed single intraclass consistency correlation coefficient >0.70. These results imply good internal consistency, discriminative ability and reliability when performed at home, encouraging further longitudinal clinical and population-based studies.

  10. The METER: A Brief, Self-Administered Measure of Health Literacy

    PubMed Central

    Gunstad, John; Hughes, Joel; Spitznagel, Mary Beth; Potter, Vanessa; Waechter, Donna; Rosneck, James

    2009-01-01

    Background Given rapidly accumulating evidence that health literacy is correlated with important health-related measures, assessing patients’ health literacy level is of increasing concern for researchers and practitioners. Practical limitations for use of existing health literacy measures include length of time and practitioner involvement in administration. Objective To develop and validate a brief, self-administered measure of health literacy, the Medical Term Recognition Test (METER). Participants 155 participants were recruited from an outpatient cardiology program at an urban hospital. Measures Patients completed measures of health literacy (METER and REALM), neuropsychological function, psychosocial health, and self-report questionnaires about health behaviors. Indicators of cardiovascular health were also recorded from patients’ medical charts. Key results The measure took 2 min to complete. The internal consistency of the METER was 0.93, and it correlated highly with REALM (r = 0.74). Regarding sensitivity and specificity for identifying individuals below REALM’s cutoff for functional literacy, METER resulted in 75% correct identifications and 8% false positives. METER and REALM were both associated with various health-related measures (including significant correlations with measures of neuropsychological function and cardiovascular health). Conclusions These initial findings show that the METER is a quick and practical measure of health literacy for use in clinical settings. PMID:19885705

  11. Impact of self-administered relaxation and guided imagery techniques during final trimester and birth.

    PubMed

    Gedde-Dahl, Merete; Fors, Egil A

    2012-02-01

    The objective of this study was to test if and how self-administered practice of relaxation techniques, positive affirmation and guided imagery, in the final part of pregnancy had an impact on giving birth. Further to see if the use of a simple method, a CD with a booklet, with no previous training or specific support of the participants (neither required nor delivered), affected the birth experience. Outcome measures were monitored both during and after delivery: During delivery, pain and anxiety were measured at different stages of birth. Post-delivery Wellbeing (Edmonton Scale 0-10, where 10 is the worst possible feeling of Wellbeing), pain, anxiety, Apgar score, duration of birth, complications and anesthesia/analgesic were recorded. Those in the CD-intervention group also reported how many times they had practiced the techniques. The study employed a randomized controlled trial. Results show that the CD-intervention group had a significantly better score on total Wellbeing, as measured by the ESAS (0-10) Edmonton Scale.

  12. Effectiveness of a self-administered intervention for criminal thinking: Taking a Chance on Change.

    PubMed

    Folk, Johanna B; Disabato, David J; Daylor, Jordan M; Tangney, June P; Barboza, Sharen; Wilson, John S; Bonieskie, Lynda; Holwager, James

    2016-08-01

    The current study tested the effectiveness of a self-administered, cognitive-behavioral intervention targeting criminal thinking for inmates in segregated housing: Taking a Chance on Change (TCC). Participants included 273 inmates in segregated housing at state correctional institutions. Reductions in criminal thinking, as assessed by the Psychological Inventory of Criminal Styles-Simplified Version, were found in the general criminal thinking score as well as the proactive and reactive composite scores. Examination of demographic predictors of change (i.e., age, years of education, length of sentence) revealed older and more educated participants decreased in criminal thinking more than younger and less educated participants. For a subset of 48 inmates, completion of TCC was associated with significant reduction of disciplinary infractions. Reductions in reactive criminal thinking predicted reductions in disciplinary infractions. Although further research is needed to determine the effectiveness of TCC in reducing recidivism, the reductions in criminal thinking and disordered conduct suggest this is a promising intervention and mode of treatment delivery. By utilizing self-directed study at an accessible reading level, the intervention is uniquely suited to a correctional setting where staff and monetary resources are limited and security and operational issues limit the feasibility of traditional cognitive-behavioral group treatment. (PsycINFO Database Record

  13. Initial validation of a web-based self-administered neuropsychological test battery for older adults and seniors

    PubMed Central

    Hansen, Tor Ivar; Haferstrom, Elise Christina D.; Brunner, Jan F.; Lehn, Hanne; Håberg, Asta Kristine

    2015-01-01

    Introduction: Computerized neuropsychological tests are effective in assessing different cognitive domains, but are often limited by the need of proprietary hardware and technical staff. Web-based tests can be more accessible and flexible. We aimed to investigate validity, effects of computer familiarity, education, and age, and the feasibility of a new web-based self-administered neuropsychological test battery (Memoro) in older adults and seniors. Method: A total of 62 (37 female) participants (mean age 60.7 years) completed the Memoro web-based neuropsychological test battery and a traditional battery composed of similar tests intended to measure the same cognitive constructs. Participants were assessed on computer familiarity and how they experienced the two batteries. To properly test the factor structure of Memoro, an additional factor analysis in 218 individuals from the HUNT population was performed. Results: Comparing Memoro to traditional tests, we observed good concurrent validity (r = .49–.63). The performance on the traditional and Memoro test battery was consistent, but differences in raw scores were observed with higher scores on verbal memory and lower in spatial memory in Memoro. Factor analysis indicated two factors: verbal and spatial memory. There were no correlations between test performance and computer familiarity after adjustment for age or age and education. Subjects reported that they preferred web-based testing as it allowed them to set their own pace, and they did not feel scrutinized by an administrator. Conclusions: Memoro showed good concurrent validity compared to neuropsychological tests measuring similar cognitive constructs. Based on the current results, Memoro appears to be a tool that can be used to assess cognitive function in older and senior adults. Further work is necessary to ascertain its validity and reliability. PMID:26009791

  14. Comparability of weighed dietary records and a self-administered diet history questionnaire for estimating monetary cost of dietary energy.

    PubMed

    Murakami, Kentaro; Sasaki, Satoshi; Takahashi, Yoshiko; Okubo, Hitomi; Hirota, Naoko; Notsu, Akiko; Fukui, Mitsuru; Date, Chigusa

    2008-09-15

    An increasing number of studies have estimated monetary diet cost using various dietary assessment methods, based on databases on retail food prices, for investigating its association with dietary intake and health outcomes. However, information regarding the comparability of monetary diet cost across dietary assessment methods is absolutely lacking. This study compared monetary cost of dietary energy estimated from weighed dietary records (DRs) with that estimated from a self-administered diet history questionnaire (DHQ). The subjects were 92 Japanese women aged 31-69 years and 92 Japanese men aged 32-76 years. The DHQ (assessing diet during the preceding month) and 4-day DRs (one weekend day and three weekdays) were completed in each season over a 1-year period (DHQs1-4 and DRs1-4, respectively). An additional DHQ was completed at one year after completing DHQ1 (DHQ5). Monetary cost of dietary energy (Japanese yen/4184 kJ) was calculated using food intake information derived from each dietary assessment method, based on retail food prices. Pearson correlation between the mean of DRs1-4 and mean of DHQs1-4 was 0.64 for women and 0.69 for men. Pearson correlation between the mean of DRs1-4 and DHQ1 was 0.60 for women and 0.52 for men, while intraclass correlation between DHQ1 and DHQ5 was 0.64 for women and 0.51 for men. These data indicate reasonable comparability of monetary cost of dietary energy across DR and a DHQ as well as usefulness of a single administration of the DHQ for estimating monetary cost of dietary energy.

  15. Satisfaction with Therapist-Delivered vs. Self-Administered Online Cognitive Behavioural Treatments for Depression Symptoms in College Students

    ERIC Educational Resources Information Center

    Richards, Derek; Timulak, Ladislav

    2013-01-01

    Participants with symptoms of depression received either eight sessions of therapist-delivered email cognitive behaviour therapy (eCBT; n = 37), or eight sessions of computerised CBT self-administered treatment (cCBT; n = 43). At post-treatment participants completed a questionnaire to determine what they found satisfying about their online…

  16. Strategies and Considerations for Teaching an Adolescent with Down Syndrome and Type I Diabetes to Self-Administer Insulin.

    ERIC Educational Resources Information Center

    Bosner, Sylvia M.; Belfiore, Phillip J.

    2001-01-01

    In this study, a system of least prompts, partial participation, and parental involvement was used to successfully teach an adolescent with Down syndrome, moderate mental retardation, and Type I diabetes to self-administer an injection of insulin as part of an overall plan to increase self-determination and independence. (Contains seven…

  17. Strategies and Considerations for Teaching an Adolescent with Down Syndrome and Type I Diabetes to Self-Administer Insulin.

    ERIC Educational Resources Information Center

    Bosner, Sylvia M.; Belfiore, Phillip J.

    2001-01-01

    In this study, a system of least prompts, partial participation, and parental involvement was used to successfully teach an adolescent with Down syndrome, moderate mental retardation, and Type I diabetes to self-administer an injection of insulin as part of an overall plan to increase self-determination and independence. (Contains seven…

  18. Validation of the Portuguese self-administered computerised 24-hour dietary recall among second-, third- and fourth-grade children

    USDA-ARS?s Scientific Manuscript database

    Current methods for assessing children's dietary intake, such as interviewer-administered 24-h dietary recall (24-h DR), are time consuming and resource intensive. Self-administered instruments offer a low-cost diet assessment method for use with children. The present study assessed the validity of ...

  19. Developing a self-administered questionnaire as a guide to consultations with women treated for breast cancer.

    PubMed

    Jiwa, Moyez; Ping-Delfos, Wendy Chan She; Briffa, Kathy; Sherriff, Jill; Merriman, Gareth; Nockolds, Janice; Jardine, Liz; Musiello, Toni; Longman, Glenys

    2011-01-01

    Background. Health professionals, including general practitioners involved in followup of breast cancer patients, need to systematically assess opportunities to offer patients support with ongoing or new problems. Methods. A self-administered needs assessment questionnaire was developed with reference to a multidisciplinary team. Short, evidence-based, readable questions were emphasized, and questions were tested for face validity. The questions flowed across three domains: physical, social, and psychological. Content validity and user friendliness were assessed. Results. A final set of 30 questions was rated as easy to read and comprehend (Flesch Reading Ease score 65.8 and Flesch-Kincaid Grade Level 6.9). When piloted with twenty-one patients the self-administered questionnaire detected 121 items of unmet need encompassing all three domains. Conclusions. This self-administered questionnaire has the potential to assist in the holistic assessment of breast cancer patient after treatment. The clinical value of the self-administered questionnaire will need to be further tested before it can be widely adopted.

  20. Satisfaction with Therapist-Delivered vs. Self-Administered Online Cognitive Behavioural Treatments for Depression Symptoms in College Students

    ERIC Educational Resources Information Center

    Richards, Derek; Timulak, Ladislav

    2013-01-01

    Participants with symptoms of depression received either eight sessions of therapist-delivered email cognitive behaviour therapy (eCBT; n = 37), or eight sessions of computerised CBT self-administered treatment (cCBT; n = 43). At post-treatment participants completed a questionnaire to determine what they found satisfying about their online…

  1. Reminder packaging for improving adherence to self-administered long-term medications.

    PubMed

    Mahtani, Kamal R; Heneghan, Carl J; Glasziou, Paul P; Perera, Rafael

    2011-09-07

    Current methods of improving medication adherence for health problems are mostly complex, labour-intensive, and not reliably effective. Medication 'reminder packaging', which incorporates a date or time for a medication to be taken in the packaging, can act as a reminder to improve adherence. This review of reminder packaging is an update of our 2006 Cochrane review. The objective of this review was to determine the effects of reminder packaging aids for self-administered medication/s taken for at least one month, on adherence and other outcomes. We updated searches of the Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library Issue 9, 2010), MEDLINE, EMBASE, CINAHL and PsycINFO from the database start dates to September 2010. We searched Current Controlled Trials to identify trials in progress. We performed a cited reference search on the Science Citation Index to identify papers that had cited the original systematic review.We also searched the Internet, contacted packaging manufacturers, and checked abstracts from the Pharm-line database and reference lists from relevant articles. We did not apply any language restrictions. We selected randomised controlled trials with at least 80% follow up. We intended to do a sensitivity analysis of those studies that analysed their data on an intention-to-treat basis. Included studies compared a reminder packaging device with no device, for participants taking self-administered medications for at least one month. Three review authors independently assessed studies for inclusion, assessed quality, and extracted data from included studies. Where considered appropriate, data were combined for meta-analysis, or were reported and discussed in a narrative. We included twelve studies containing data on 2196 participants; four of these studies were newly included in this 2011 update of our 2006 Cochrane review.Six intervention groups in four trials

  2. Gastroesophageal reflux disease (GERD): is there more to the story?

    PubMed

    Vesper, Benjamin J; Altman, Kenneth W; Elseth, Kim M; Haines, G Kenneth; Pavlova, Sylvia I; Tao, Lin; Tarjan, Gabor; Radosevich, James A

    2008-04-01

    Gastroesophageal reflux disease (GERD) affects both men and women worldwide, with the most common symptom of GERD being frequent heartburn. If left untreated, more serious diseases including esophagitis and/or esophageal cancer may result. GERD has been commonly held to be the result of gastric acid refluxing into the esophagus. Recent work, however, has shown that there are acid-producing cells in the upper aerodigestive tract. In addition, acid-producing bacteria located within the upper gastrointestinal tract and oral cavity may also be a contributing factor in the onset of GERD. Proton pump inhibitors (PPIs) are commonly prescribed for treating GERD; these drugs are designed to stop the production of gastric acid by shutting down the H(+)/K(+)-ATPase enzyme located in parietal cells. PPI treatment is systemic and therefore significantly different than traditional antacids. Although a popular treatment choice, PPIs exhibit substantial interpatient variability and commonly fail to provide a complete cure to the disease. Recent studies have shown that H(+)/K(+)-ATPases are expressed in tissues outside the stomach, and the effects of PPIs in these nongastric tissues have not been fully explored. Likewise, acid-producing bacteria containing proton pumps are present in both the oral cavity and esophagus, and PPI use may also adversely affect these bacteria. The use of PPI therapy is further complicated by the two philosophical approaches to treating this disease: to treat only symptoms or to treat continuously. The latter approach frequently results in unwanted side effects which may be due to the PPIs acting on nongastric tissues or the microbes which colonize the upper aerodigestive tract.

  3. Comparison of voice quality in patients with GERD-related dysphonia or chronic cough.

    PubMed

    Domeracka-Kołodziej, Anna; Grabczak, Elżbieta M; Dąbrowska, Marta; Arcimowicz, Magdalena; Lachowska, Magdalena; Osuch-Wójcikiewicz, Ewa; Niemczyk, Kazimierz

    2014-01-01

    The aim was to compare a voice quality in patients with GERD-related dysphonia or chronic cough and to determine whether there is a relationship between the main symptom reported and voice quality. 249 consecutive patients diagnosed with GERD-related chronic cough or dysphonia were involved in this retrospective study and were divided into two main groups of men and women, and furthermore into groups of chronic cough and dysphonia. Laryngeal lesions were evaluated with videolaryngostroboscopy using Reflux Finding Score. Voice quality was assessed using GRBAS scale, sonograms, and multidimensional voice program (MDVP). All subjects were found to have vocal abnormalities both in subjective and objective voice analysis. Perceptual assessment of voice (GRBAS) did not reveal any differences between analyzed groups depending on the reported symptom. In MDVP analysis, the group of women with cough as the main symptom demonstrated significantly less abnormalities in VTI value. In men with cough as their main complaint, significantly less MDVP abnormalities were found in Jita, Jitt, RAP, PPQ, and sPPQ parameters. The comparison of voice perceptual assessment in patients with GERD-related dysphonia or chronic cough revealed no differences between analyzed groups. In objective voice analysis, the latter group presented lower degree of hoarseness in Yanagihara's scale. In objective MDVP analysis, the chronic cough group presented lower degree of abnormalities only in one of the noise related parameters in females and five frequency perturbation parameters in males. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  4. Diazepam promotes choice of abstinence in cocaine self-administering rats.

    PubMed

    Augier, Eric; Vouillac, Caroline; Ahmed, Serge H

    2012-03-01

    When facing a choice between cocaine and a potent, albeit inessential, non-drug alternative (i.e. water sweetened with saccharin), most cocaine self-administering rats abstain from cocaine in favor of the non-drug pursuit, regardless of the dose available and even after extended drug use. Only a minority continues to take the drug despite the opportunity of making a different choice and increasing stakes. This pattern of individual variation could suggest that the majority of rats are resilient to addiction, taking cocaine by default of other options. Only a minority would be vulnerable to addiction. This study tested the hypothesis that rats choose to refrain from cocaine self-administration because cocaine would be conflictual, having both rewarding and anxiogenic properties. Contrary to this hypothesis, however, we report here that diazepam-a broad-spectrum benzodiazepine anxiolytic-did not decrease, but instead, further increased cocaine abstinence. Interestingly, although diazepam decreased locomotion, rats adapted to this effect by spending more time near the lever associated with the preferred reward, a behavior that minimized the need for locomotion at the moment of choice. When responding for cocaine or saccharin was analyzed separately, we found that diazepam decreased responding for cocaine without affecting responding for saccharin. Finally, the abstinence-promoting effects of diazepam were also induced in cocaine-preferring rats treated chronically with diazepam. Overall, this study demonstrates that abstinence from cocaine cannot be explained away by the anxiogenic effects of cocaine, thereby reinforcing the notion of resilience to addiction. It also supports the use of benzodiazepines in the treatment of cocaine addiction.

  5. Self-administered semiquantitative food frequency questionnaires: patterns, predictors, and interpretation of omitted items

    PubMed Central

    Michels, Karin B.; Willett, Walter C.

    2013-01-01

    Background Food items on a self-administered food frequency questionnaire (FFQ) may be left blank because the food was not consumed, because of difficulties remembering the frequency or amount of intake, or due to an oversight. Methods We explored the predictors and frequency of consumption of omitted food items on an FFQ used in the Nurses’ Health Study II. Of 87,676 women who returned a mailed 147-item FFQ in 1999, 34% completed the entire questionnaire, whereas 66% left at least 1 food item blank. Ten or more foods were omitted by 5% of participants. Foods were more likely omitted by women who were older, more physically active, and had more children. We resurveyed 2876 participants who had left between 1 and 70 food items blank and asked them to fill in the blanks. Overall, 2485 participants provided complete responses. Results In the resurvey, 64% of the formerly omitted foods were marked as consumed never or less than once per month, 20% as 1–3 times per month, 8% as once per week, and 9% as more than once per week. Commonly consumed foods and beverages were less likely omitted because they were not consumed than rarely consumed foods. The best estimate for the true intake value of an omitted food was 0.82 times the average population intake. Conclusions When calculating nutrient intake, the assumption that items missing represent zero intake is reasonable. However, foods consumed more often in the population at large are less likely than rarely consumed foods to be left blank because they were not consumed. PMID:19106799

  6. Personal hygiene among military personnel: developing and testing a self-administered scale.

    PubMed

    Saffari, Mohsen; Koenig, Harold G; Pakpour, Amir H; Sanaeinasab, Hormoz; Jahan, Hojat Rshidi; Sehlo, Mohammad Gamal

    2014-03-01

    Good personal hygiene (PH) behavior is recommended to prevent contagious diseases, and members of military forces may be at high risk for contracting contagious diseases. The aim of this study was to develop and test a new questionnaire on PH for soldiers. Participants were all male and from different military settings throughout Iran. Using a five-stage guideline, a panel of experts in the Persian language (Farsi) developed a 21-item self-administered questionnaire. Face and content validity of the first-draft items were assessed. The questionnaire was then translated and subsequently back-translated into English, and both the Farsi and English versions were tested in pilot studies. The consistency and stability of the questionnaire were tested using Cronbach's alpha and the test-retest strategy. The final scale was administered to a sample of 502 military personnel. Explanatory and confirmatory factor analyses evaluated the structure of the scale. Both the convergent and discriminative validity of the scale were also determined. Cronbach's alpha coefficients were >0.85. Principal component analysis demonstrated a uni-dimensional structure that explained 59 % of the variance in PH behaviors. Confirmatory factor analysis indicated a good fit (goodness-of-fit index = 0.902; comparative fitness index = 0.923; root mean square error of approximation = 0.0085). The results show that this new PH scale has solid psychometric properties for testing PH behaviors among an Iranian sample of military personnel. We conclude that this scale can be a useful tool for assessing PH behaviors in military personnel. Further research is needed to determine the scale's value in other countries and cultures.

  7. Validation of self-administered nasal swabs and postage for the isolation of Staphylococcus aureus

    PubMed Central

    Gleadall, Nicholas S.; Ba, Xiaoliang; Danesh, John; Peacock, Sharon J.; Holmes, Mark

    2016-01-01

    Staphylococcus aureus carriers are at higher risk of S. aureus infection and are a reservoir for transmission to others. Detection of nasal S. aureus carriage is important for both targeted decolonization and epidemiological studies. Self-administered nasal swabbing has been reported previously, but the effects of posting swabs prior to culture on S. aureus yield have not been investigated. A longitudinal cohort study was performed in which healthy volunteers were recruited, trained in the swabbing procedure and asked to take weekly nasal swabs for 6 weeks (median: 3 weeks, range 1–6 weeks). Two swabs were taken at each sampling episode and randomly assigned for immediate processing on arrival to the laboratory (Swab A) or second class postage prior to processing (Swab B). S. aureus was isolated using standard methods. A total of 95 participants were recruited, who took 944 swabs (472 pairs) over a median of 5 weeks. Of these, 459 swabs were positive for S. aureus. We found no significant difference (P=0.25) between 472 pairs of nasal self-swabs processed immediately or following standard postage from 95 study participants (51.4 % vs. 48.6 %, respectively). We also provide further evidence that persistent carriers can be detected by two weekly swabs with high degrees of sensitivity [92.3 % (95 % CI 74.8–98.8 %)] and specificity [95.6 % (95 % CI 84.8–99.3 %)] compared with a gold standard of five weekly swabs. Self-swabbing and postage of nasal swabs prior to processing has no effect on yield of S. aureus, and could facilitate large community-based carriage studies. PMID:27902394

  8. Regulation of sigma-1 receptors and endoplasmic reticulum chaperones in the brain of methamphetamine self-administering rats.

    PubMed

    Hayashi, Teruo; Justinova, Zuzana; Hayashi, Eri; Cormaci, Gianfrancesco; Mori, Tomohisa; Tsai, Shang-Yi; Barnes, Chanel; Goldberg, Steven R; Su, Tsung-Ping

    2010-03-01

    sigma-1 Receptors are endoplasmic reticulum (ER) chaperones that are implicated in the neuroplasticity associated with psychostimulant abuse. We immunocytochemically examined the distribution of sigma-1 receptors in the brain of drug-naive rats and then examined the dynamics of sigma-1 receptors and other ER chaperones in specific brain subregions of rats that self-administered methamphetamine, received methamphetamine passively, or received only saline injections. sigma-1 Receptors were found to be expressed in moderate to high levels in the olfactory bulb, striatum, nucleus accumbens shell, olfactory tubercle, amygdala, hippocampus, red nucleus, ventral tegmental area, substantia nigra, and locus ceruleus. Methamphetamine, whether self-administered or passively received, significantly elevated ER chaperones including the sigma-1 receptor, BiP, and calreticulin in the ventral tegmental area and substantia nigra. In the olfactory bulb, however, only the sigma-1 receptor chaperone was increased, and this increase occurred only in rats that actively self-administered methamphetamine. Consistent with an increase in sigma-1 receptors, extracellular signal-regulated kinase was found to be activated and protein kinase A attenuated in the olfactory bulb of methamphetamine self-administering rats. sigma-1 Receptors in the olfactory bulb were found to be colocalized with dopamine D1 receptors. These results indicate that methamphetamine induces ER stress in the ventral tegmental area and substantia nigra in rats whether the drug is received actively or passively. However, the changes seen only in rats that actively self-administered methamphetamine suggest that D1 and sigma-1 receptors in the olfactory bulb might play an important role in the motivational conditioning/learning aspects of methamphetamine self-administration in the rat.

  9. Regulation of σ-1 Receptors and Endoplasmic Reticulum Chaperones in the Brain of Methamphetamine Self-Administering Rats

    PubMed Central

    Hayashi, Teruo; Justinova, Zuzana; Hayashi, Eri; Cormaci, Gianfrancesco; Mori, Tomohisa; Tsai, Shang-Yi; Barnes, Chanel; Goldberg, Steven R.

    2010-01-01

    σ-1 Receptors are endoplasmic reticulum (ER) chaperones that are implicated in the neuroplasticity associated with psychostimulant abuse. We immunocytochemically examined the distribution of σ-1 receptors in the brain of drug-naive rats and then examined the dynamics of σ-1 receptors and other ER chaperones in specific brain subregions of rats that self-administered methamphetamine, received methamphetamine passively, or received only saline injections. σ-1 Receptors were found to be expressed in moderate to high levels in the olfactory bulb, striatum, nucleus accumbens shell, olfactory tubercle, amygdala, hippocampus, red nucleus, ventral tegmental area, substantia nigra, and locus ceruleus. Methamphetamine, whether self-administered or passively received, significantly elevated ER chaperones including the σ-1 receptor, BiP, and calreticulin in the ventral tegmental area and substantia nigra. In the olfactory bulb, however, only the σ-1 receptor chaperone was increased, and this increase occurred only in rats that actively self-administered methamphetamine. Consistent with an increase in σ-1 receptors, extracellular signal-regulated kinase was found to be activated and protein kinase A attenuated in the olfactory bulb of methamphetamine self-administering rats. σ-1 Receptors in the olfactory bulb were found to be colocalized with dopamine D1 receptors. These results indicate that methamphetamine induces ER stress in the ventral tegmental area and substantia nigra in rats whether the drug is received actively or passively. However, the changes seen only in rats that actively self-administered methamphetamine suggest that D1 and σ-1 receptors in the olfactory bulb might play an important role in the motivational conditioning/learning aspects of methamphetamine self-administration in the rat. PMID:19940104

  10. Acid Reflux (GER and GERD) in Adults

    MedlinePlus

    ... Contacts Human Subjects Research Funding Process Research Training & Career Development Funded Grants & Grant History Research Resources Research at NIDDK Meetings & Events Technology Advancement & Transfer Health Information Diabetes Digestive Diseases Kidney Disease ...

  11. Does packaging with a calendar feature improve adherence to self-administered medication for long-term use? A systematic review.

    PubMed

    Zedler, Barbara K; Kakad, Priyanka; Colilla, Susan; Murrelle, Lenn; Shah, Nirav R

    2011-01-01

    The therapeutic benefit of self-administered medications for long-term use is limited by an average 50% nonadherence rate. Patient forgetfulness is a common factor in unintentional nonadherence. Unit-of-use packaging that incorporates a simple day-and-date feature (calendar packaging) is designed to improve adherence by prompting patients to maintain the prescribed dosing schedule. To review systematically, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, randomized controlled trial evidence of the adherence benefits and harms of calendar blister packaging (CBP) and calendar pill organizers (CPO) for self-administered, long-term medication use. Data sources included the MEDLINE and Web of Science and Cochrane Library databases from their inception to September 2010 and communication with researchers in the field. Key search terms included blister-calendar pack, blister pack, drug packaging, medication adherence, medication compliance, medication compliance devices, medication containers, medication organizers, multicompartment compliance aid, persistence, pill-box organizers, prescription refill, randomized controlled trials, and refill compliance. Selected studies had an English-language title; a randomized controlled design; medication packaged in CBP or CPO; a requirement of solid, oral medication self-administered daily for longer than 1 month in community-dwelling adults; and at least 1 quantitative outcome measure of adherence. Two reviewers extracted data independently on study design, sample size, type of intervention and control, and outcomes. Ten trials with a total of 1045 subjects met the inclusion criteria, and 9 also examined clinical outcomes (seizures, blood pressure, psychiatric symptoms) or health care resource utilization. Substantial heterogeneity among trials precluded meta-analysis. In 3 studies, calendar packaging was part of a multicomponent adherence intervention. Six of 10 trials

  12. Increased vulnerability to self-administer cocaine in mice prenatally exposed to cocaine.

    PubMed

    Rocha, Beatriz A; Mead, Andy N; Kosofsky, Barry E

    2002-09-01

    At least 40,000 infants born each year in the U.S. are estimated to have been exposed to crack cocaine and, therefore, may be at risk for increased vulnerability to cocaine addiction. The present study tested the hypothesis that prenatal exposure to cocaine significantly increased subsequent cocaine-taking behavior in mice. Swiss Webster male mice that had been exposed to cocaine in utero were tested at 5 months of age in the cocaine self-administration paradigm. They were the offspring of dams that received one of the following treatments during gestation days 8-17: cocaine (40 mg/kg or 20 mg/kg per day; COC40 and COC20 mice, respectively), saline with access to food ad libitum (SAL mice), or saline with access to food restricted to that of the COC40 dams (i.e., pair-fed; SPF40 mice). Mice were initially trained to lever press for a condensed-milk solution, were implanted with an indwelling intravenous (i.v.) catheter and, subsequently, allowed to self-administer cocaine (0.25, 0.5, 1.0, or 2.0 mg/kg per injection) under a fixed ratio (FR) 1 schedule of reinforcement. Latency for acquisition of food-reinforced responding appeared to be independent of prenatal treatment, as was acquisition of cocaine self-administration, which was found to be dose dependent. Both COC40 and SAL mice reached cocaine self-administration criteria at 1.0 mg/kg or 2.0 mg/kg per injection doses, while neither group did so at lower doses. It was also observed that, at each of the doses tested, a higher number of COC40 mice reached criteria for acquisition. A logistic regression analysis confirmed that the likelihood for acquiring cocaine self-administration was positively correlated to prenatal exposure to cocaine and the dose of cocaine tested. These data provide evidence, for the first time, that prenatal exposure to higher doses of cocaine increase the probability of acquiring cocaine self-administration at moderate doses during adulthood and modulate vulnerability to cocaine

  13. Assessment of airway inflammation by exhaled breath condensate and impedance due to gastroesophageal reflux disease (GERD).

    PubMed

    Shimizu, Yasuo; Dobashi, Kunio; Nagoshi, Atsuto; Kawamura, Osamu; Mori, Masatomo

    2009-09-01

    Avoiding oxidative stress in the airways is important for the treatment of respiratory disease associated with gastroesophageal reflux disease (GERD). It is often difficult to decide whether GERD is causing airway inflammation or whether an airway disease is complicated by GERD. Measurement of exhaled breath condensate (EBC) is performed by cooling and collecting the airway lining fluid contained in exhaled air. A decrease of pH and an increase of the 8-isoprostane concentration in EBC have been observed in patients with mild to moderate asthma accompanied by GERD. There are still problems to be overcome before EBC can be used clinically, but pH and 8-isoprostane may be promising objective markers of airway inflammation due to GERD. The disease concept and diagnosis of GERD are constantly advancing, including the development of impedance methods. It is expected that treatment will be based on the latest diagnostic knowledge of GERD associated with respiratory disease and on monitoring of airway inflammation.

  14. Do proton pump inhibitors protect against cancer progression in GERD?

    PubMed

    Miyashita, Tomoharu; Shah, Furhawn A; Harmon, John W; Marti, Guy P; Matsui, Daisuke; Okamoto, Koichi; Makino, Isamu; Hayashi, Hironori; Oyama, Katsunobu; Nakagawara, Hisatoshi; Tajima, Hidehiro; Fujita, Hideto; Takamura, Hiroyuki; Murakami, Manabu; Ninomiya, Itasu; Kitagawa, Hirohisa; Fushida, Sachio; Fujimura, Takashi; Ohta, Tetsuo

    2013-08-01

    Gastro-duodenal content reflux from gastro-esophageal reflux disease (GERD) induces the inflammation-metaplasia-dysplasia-adenocarcinoma sequence. Proton pump inhibitors (PPIs) are potent blockers of gastric acid secretion, which are widely used for treating GERD and peptic ulcer-associated acid-secreting diseases. The effect of PPI therapy on esophageal carcinogenesis remains unclear. While some studies suggest PPIs result in a significant reduction in the risk of developing dysplasia and adenocarcinoma in patients with Barrett's esophagus, others suggest that PPIs have no effect. Recent studies have revealed that PPIs can exert anti-inflammatory effects such as anti-oxidant properties and immunomodulatory effects through their interactions with neutrophils, monocytes, endothelial and epithelial cells. In addition, PPIs have the ability to prevent adhesion molecule binding in malignant cells and suppress metastasis. This article reviews the role of PPIs in esophageal carcinogenesis and their use as antitumor agents.

  15. Test Your Memory-Spanish version (TYM-S): a validation study of a self-administered cognitive screening test.

    PubMed

    Muñoz-Neira, Carlos; Henríquez Chaparro, Fernando; Delgado, Carolina; Brown, Jerry; Slachevsky, Andrea

    2014-07-01

    To develop the Test Your Memory (TYM)-Spanish version (TYM-S), a self-administered cognitive screening test, in a Chilean older sample and to estimate its psychometric properties and diagnostic accuracy. The TYM was translated into Spanish and adapted for a Chilean population to develop the TYM-S. Measures of global cognitive impairment and executive dysfunction were administered to 30 controls, 30 dementia patients, and 14 subjects with mild cognitive impairment (MCI). All participants' proxies were interviewed with assessments of dementia severity, functionality in daily living activities, and cognitive change. Convergent validity and internal consistency reliability of the TYM-S were estimated. Cut-off points, sensitivity, and specificity were determined to test its diagnostic capacity for dementia or MCI. Regarding convergent validity, the TYM-S was significantly correlated (p < 0.001) with global cognitive impairment (Mini-Mental State Examination: r = 0.902; Addenbrooke's Cognitive Examination-Revised-Chilean version: r = 0.922; Montreal Cognitive Assessment: r = 0.923), executive dysfunction (Frontal Assessment Battery: r = 0.862), dementia severity (Clinical Dementia Rating: r = -0.757), functional capacity (Technology-Activities of Daily Living Questionnaire: r = -0.864; Pfeffer Functional Activities Questionnaire: r = -0.748; Instrumental Activities of Daily Living: r = 0.769), and cognitive change (Alzheimer's Disease 8-Chilean version: r = -0.700) measures. Regarding reliability, Cronbach's α was 0.776. Optimum cut-off scores of 39 and 44 distinguished dementia cases from controls (93.1% sensitivity, 82.2% specificity) and MCI cases from controls (85.7% sensitivity, 69% specificity), respectively. The extent of assistance required in the TYM-S and cognitive impairment was correlated. The TYM-S is a valid and reliable instrument to assess cognitive impairment, showing good psychometric properties and diagnostic

  16. Design and validation of a self-administered questionnaire as an aid to detection of occupational exposure to lung carcinogens.

    PubMed

    Pélissier, C; Dutertre, V; Fournel, P; Gendre, I; Michel Vergnon, J; Kalecinski, J; Tinquaut, F; Fontana, L; Chauvin, F

    2017-02-01

    Ten to thirty percent of lung cancer is thought to be of occupational origin. Lung cancer is under-declared as an occupational disease in Europe, and most declarations of occupational disease concern asbestos. The purpose of this study was to design and validate a short, sensitive self-administered questionnaire, as an aid for physicians in detecting occupational exposure to asbestos and other lung carcinogens in order to remedy occupational lung cancer under-declaration. Cross-sectional study. A short (30-question) self-administered questionnaire was drawn up by oncologist-pneumologists and occupational physicians, covering situations of exposure to proven and probable lung carcinogens. Understanding and acceptability were assessed on 15 lung cancer patients. Validity and reliability were assessed on 70 lung cancer patients by comparison against a semi-directive questionnaire considered as gold standard. Sensitivity and specificity were assessed by comparing responses to items on the two questionnaires. Reliability was assessed by analysing the kappa concordance coefficient for items on the two questionnaires. Sensitivity was 0.85 and specificity 0.875. Concordance between responses on the two questionnaires was 85.7%, with a kappa coefficient of 0.695 [0.52-0.87]. Mean self-administration time was 3.1 min (versus 8.12 min to administer the gold-standard questionnaire). In 16 patients, the self-administered questionnaire detected lung carcinogen exposure meeting the criteria for occupational disease. The present short, easy-to-use self-administered questionnaire should facilitate detection of occupational exposure to lung carcinogens. It could be used in occupational lung cancer screening and increase the presently low rate of application for recognition of lung cancer as an occupational disease. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. The Automated Self-Administered 24-Hour Dietary Recall for Children, 2012 version, for youth aged 9 to 11 Years: A validation study

    USDA-ARS?s Scientific Manuscript database

    Our objective was to validate the 2012 version of the Automated Self-Administered 24-Hour Dietary Recall for Children (ASA24-Kids-2012), a self-administered web-based 24-hour dietary recall (24hDR) instrument, among children aged 9 to 11 years, in two sites using a quasiexperimental design. In one s...

  18. Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report.

    PubMed

    Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N

    2015-01-01

    This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability. Copyright © 2015 by the American Occupational Therapy Association, Inc.

  19. Using computer-assisted survey instruments instead of paper and pencil increased completeness of self-administered sexual behavior questionnaires.

    PubMed

    Spark, Simone; Lewis, Dyani; Vaisey, Alaina; Smyth, Eris; Wood, Anna; Temple-Smith, Meredith; Lorch, Rebecca; Guy, Rebecca; Hocking, Jane

    2015-01-01

    To compare the data quality, logistics, and cost of a self-administered sexual behavior questionnaire administered either using a computer-assisted survey instrument (CASI) or by paper and pencil in a primary care clinic. A self-administered sexual behavior questionnaire was administered to 16-29 year olds attending general practice. Questionnaires were administered by either paper and pencil (paper) or CASI. A personal digital assistant was used to self-administer the CASI. A total of 4,491 people completed the questionnaire, with 46.9% responses via CASI and 53.2% by paper. Completion of questions was greater for CASI than for paper for sexual behavior questions: number of sexual partners [odds ratio (OR), 6.85; 95% confidence interval (CI): 3.32, 14.11] and ever having had sex with a person of the same gender (OR, 2.89; 95% CI: 1.52, 5.49). The median number of questions answered was higher for CASI than for paper (17.6 vs. 17.2; P < 0.01). CASI was cheaper to run at $8.18 per questionnaire compared with $11.83 for paper. Electronic devices using CASI are a tool that can increase participants' questionnaire responses and deliver more complete data for a sexual behavior questionnaire in primary care clinics. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Dopamine decreases NMDA currents in the oval bed nucleus of the stria terminalis of cocaine self-administering rats.

    PubMed

    Krawczyk, Michal; deBacker, Julian; Mason, Xenos; Jones, Andrea A; Dumont, Eric C

    2014-06-03

    Dopamine (DA) and N-methyl-D-aspartate receptors (NMDARs) contribute in the neural processes underlying drug-driven behaviors. DA is a potent modulator of NMDAR, but few studies have investigated the functional interaction between DA and NMDAR in the context of substance abuse. We combined the rat model of cocaine self-administration with brain slice electrophysiology to study DA modulation of NMDA currents in the oval bed nucleus of the stria terminalis (ovBNST), a dense DA terminal field involved in maintenance of cocaine self-administration amongst other drug related behaviors. Long-Evans rats self-administered intravenous cocaine (0.75 mg/kg/injection) on a progressive ratio (PR) schedule of reinforcement for 15 days and whole-cell patch-clamp recordings were done on the 16th day. DA reduced NMDA currents in brain-slices from cocaine self-administering rats, but not in those of drug-naïve and sucrose self-administering, or when cocaine exposure was passive (yoked), revealing a mechanism unique to voluntary cocaine intake. DA reduced NMDA currents by activating G-protein-coupled D1- and D2-like receptors that converged on phospholipase C and protein phosphatases. Accordingly, our study reveals a mechanism that may contribute to dysfunctional synaptic plasticity associated with drug-driven behaviors during acute withdrawal.

  1. Self-administered sample collection for screening of sexually transmitted infection among reservation-based American Indian youth

    PubMed Central

    Tingey, Lauren; Strom, Rachel; Hastings, Ranelda; Parker, Anthony; Barlow, Allison; Rompalo, Anne; Gaydos, Charlotte

    2015-01-01

    Background American Indians suffer a disproportionate burden of sexually transmitted infection, particularly adolescents. Screening access barriers in rural and reservation-based communities necessitate alternatives to clinic-based options. Methods Self-administered screening for three sexually transmitted infections was piloted among 32 American Indian adolescents aged 18 to 19. Participants self-collected in a private location; specimens were processed by trained, American Indian paraprofessionals and analysis was conducted by an outside laboratory. Participants testing positive were treated by a Public Health Nurse from the Indian Health Service. Results Results suggest high overall acceptability: 69% preferred a self-administered method over clinic-based screening, 75% would encourage their friends to use this method and 100% would use it again. Conclusions A self-administered screening method has the ability to reach this and other high-risk populations that might not otherwise access screening, with added potential within the Indian Health Services system for uptake and dissemination in rural, reservation communities facing significant screening barriers. PMID:25228666

  2. The assessment of generalized anxiety disorder: psychometric validation of the Spanish version of the self-administered GAD-2 scale in daily medical practice

    PubMed Central

    2012-01-01

    Aim To psychometrically validate the Spanish version of the self-administered 2-item GAD-2 scale for screening probable patients with generalised anxiety disorder (GAD). Methods The GAD-2 was self-administered by patients diagnosed with GAD according to DSM-IV criteria and by age- and sex-matched controls who were recruited at random in mental health and primary care centres. Criteria validity was explored using ROC curve analysis, and sensitivity, specificity and positive and negative predictive values were determined for different cut-off values. Concurrent validity was also established using the HAM-A, HADS, and WHODAS II scales. Results The study sample consisted of 212 subjects (106 patients with GAD) with a mean age of 50.38 years (SD = 16.76). No items of the scale were left blank. Floor and ceiling effects were negligible. No patients with GAD had to be assisted to complete the questionnaire. Reliability (internal consistency) was high; Cronbach’s α = 0.875. A cut-off point of 3 showed adequate sensitivity (91.5%) and specificity (85.8%), with a statistically significant area under the curve (AUC = 0.937, p < 0.001), to distinguish GAD patients from controls. Concurrent validity was also high and significant with HAM-A (0.806, p < 0.001), HADS (anxiety domain, 0.825, p < 0.001) and WHO-DAS II (0.642, p < 0.001) scales. Conclusion The Spanish version of the GAD-2 scale has been shown to have appropriate psychometric properties to rapidly detect probable cases of GAD in the Spanish cultural context under routine clinical practice conditions. PMID:22992432

  3. The assessment of generalized anxiety disorder: psychometric validation of the Spanish version of the self-administered GAD-2 scale in daily medical practice.

    PubMed

    García-Campayo, Javier; Zamorano, Enric; Ruiz, Miguel A; Pérez-Páramo, María; López-Gómez, Vanessa; Rejas, Javier

    2012-09-19

    To psychometrically validate the Spanish version of the self-administered 2-item GAD-2 scale for screening probable patients with generalised anxiety disorder (GAD). The GAD-2 was self-administered by patients diagnosed with GAD according to DSM-IV criteria and by age- and sex-matched controls who were recruited at random in mental health and primary care centres. Criteria validity was explored using ROC curve analysis, and sensitivity, specificity and positive and negative predictive values were determined for different cut-off values. Concurrent validity was also established using the HAM-A, HADS, and WHODAS II scales. The study sample consisted of 212 subjects (106 patients with GAD) with a mean age of 50.38 years (SD = 16.76). No items of the scale were left blank. Floor and ceiling effects were negligible. No patients with GAD had to be assisted to complete the questionnaire. Reliability (internal consistency) was high; Cronbach's α = 0.875. A cut-off point of 3 showed adequate sensitivity (91.5%) and specificity (85.8%), with a statistically significant area under the curve (AUC = 0.937, p < 0.001), to distinguish GAD patients from controls. Concurrent validity was also high and significant with HAM-A (0.806, p < 0.001), HADS (anxiety domain, 0.825, p < 0.001) and WHO-DAS II (0.642, p < 0.001) scales. The Spanish version of the GAD-2 scale has been shown to have appropriate psychometric properties to rapidly detect probable cases of GAD in the Spanish cultural context under routine clinical practice conditions.

  4. Incidence of gastroesophageal reflux disease (GERD), active component, U.S. Armed Forces, 2005-2014.

    PubMed

    Daniele, Denise O; Oh, Gi-Taik; O'Donnell, Francis L; Clark, Leslie L

    2015-07-01

    Gastroesophageal reflux disease (GERD) is a common condition among adults that can cause symptoms such as frequent heartburn, substernal chest pain, and regurgitation of food. During 2005-2014, a total of 137,081 active component service members had an incident (first-ever) diagnosis of GERD (incidence rate: 101.3 per 10,000 person-years). Incidence rates were higher than their respective counterparts among females, black and white non-Hispanics, service members in the Coast Guard and Air Force, officers, and those in healthcare occupations. Rates increased monotonically with increasing age groups. Most GERD cases (79.2%) were uncomplicated GERD; however, 20.8% were identified as having a symptom or complication linked to their GERD diagnosis. Lifestyle changes, medication, and prevention of serious complications should be emphasized among individuals diagnosed with GERD, particularly those at risk for severe disease.

  5. Comparison of voice quality in patients with GERD-related larynx and layngopharynx disorders before and after therapy.

    PubMed

    Domeracka-Kołodziej, Anna; Grabczak, Elżbieta M; Dąbrowska, Marta; Lachowska, Magdalena

    2015-01-01

    The aim of this study was to compare voice quality in patients with GERD-related changes in the larynx and laryngopharynx before and after treatment. 249 consecutive patients diagnosed with GERD-related changes in larynx and laryngopharynx were involved in this retrospective study (166 females, 83 males). Patients completed the questionnaire RSI. The GRBAS scale was used for subjective voice evaluation. Objective voice analysis was performed with the use of KAY Elemetrics Model CSL 4300 (CSL 4305, MDVP). In women, the mean RSI score (by Belafsky) was 12.69, in men 12.6. In both analyzed groups, the laryngeal symptoms related to GERD diminished after treatment. Perceptual assessment of voice (GRBAS) revealed G2R1B0A0S1 in women and G2R2B0A0S1 in men. In both the male and female group before treatment, the dominant sonogram was type III in Remacle's scale, IInd degree of hoarseness in Yanagihara's scale, phonation time was shortened, and MDVP parameters were abnormal. After treatment there was statistically significant improvement in the following parameters: G, R, B, and S in sonogram, degree of hoarseness, some of MDVP parameters (Fhi, RAP and PPQ in females, and F0 and Flo in males), and less irregularity in tomogram. In all patients no restoration of normal voice was noted after treatment despite disappearance of the gastrological symptoms.

  6. Development and psychometric validation of a self-administered questionnaire assessing the acceptance of influenza vaccination: the Vaccinees' Perception of Injection (VAPI©) questionnaire

    PubMed Central

    Chevat, Catherine; Viala-Danten, Muriel; Dias-Barbosa, Carla; Nguyen, Van Hung

    2009-01-01

    Background Influenza is among the most common infectious diseases. The main protection against influenza is vaccination. A self-administered questionnaire was developed and validated for use in clinical trials to assess subjects' perception and acceptance of influenza vaccination and its subsequent injection site reactions (ISR). Methods The VAPI questionnaire was developed based on interviews with vaccinees. The initial version was administered to subjects in international clinical trials comparing intradermal with intramuscular influenza vaccination. Item reduction and scale construction were carried out using principal component and multitrait analyses (n = 549). Psychometric validation of the final version was conducted per country (n = 5,543) and included construct and clinical validity and internal consistency reliability. All subjects gave their written informed consent before being interviewed or included in the clinical studies. Results The final questionnaire comprised 4 dimensions ("bother from ISR"; "arm movement"; "sleep"; "acceptability") grouping 16 items, and 5 individual items (anxiety before vaccination; bother from pain during vaccination; satisfaction with injection system; willingness to be vaccinated next year; anxiety about vaccination next year). Construct validity was confirmed for all scales in most of the countries. Internal consistency reliability was good for all versions (Cronbach's alpha ranging from 0.68 to 0.94), as was clinical validity: scores were positively correlated with the severity of ISR and pain. Conclusion The VAPI questionnaire is a valid and reliable tool, assessing the acceptance of vaccine injection and reactions following vaccination. Trial registration NCT00258934, NCT00383526, NCT00383539. PMID:19261173

  7. Psychological profile and self-administered relaxation in patients with craniofacial pain: a prospective in-office study

    PubMed Central

    2013-01-01

    Introduction The objective of this study was to evaluate the psychological profile of craniofacial pain sufferers and the impact of patient subtype classification on the short-time effectiveness of a self-administered relaxation training. Methods One hundred unselected in-office patients (67% females) suffering from chronic facial pain and/or headache with the presumptive diagnose of temporo-mandibular disorder (TMD) completed a questionnaire battery comprising craniofacial pain perception, somatic complaints, irrational beliefs, and pain behavior and were classified into subtypes using cluster analysis. They underwent a self-administered progressive relaxation training and were re-evaluated for pain perception after 3 months. Results Pain was mild to moderate in the majority of patients. Symptom domains comprised parafunctional activities, temporo-mandibular pain and dysfunction, fronto-temporal headache, head/neck and neck/back pain. Three patient subtypes were identified regarding symptom/dysfunction level: (i) low burden (mild/moderate), (ii) psychosocial dysfunction (moderate/high), (iii) adaptive coping (moderate/mild). Self-rated adherence to the recommended relaxation training was moderate throughout the sample, but self-rated relief was significantly different between clusters. At follow-up, pain intensity was significantly decreased in all patients, whereas pain-related interference was improved only in dysfunctional and adaptive patients. Improvement of symptom domains varied between clusters and was most comprehensive in adaptive patients. Conclusions In conclusion, craniofacial pain sufferers can be divided in meaningful subtypes based on their pain perception, irrational beliefs, and pain behaviour. A self-administered relaxation training generally yielded positive effects on pain perception, however the benefit may be greater in patients with more marked symptom impact (both dysfunctional and adaptive). PMID:24382096

  8. Self-Administered Computer Therapy for Apraxia of Speech: Two-Period Randomized Control Trial With Crossover.

    PubMed

    Varley, Rosemary; Cowell, Patricia E; Dyson, Lucy; Inglis, Lesley; Roper, Abigail; Whiteside, Sandra P

    2016-03-01

    There is currently little evidence on effective interventions for poststroke apraxia of speech. We report outcomes of a trial of self-administered computer therapy for apraxia of speech. Effects of speech intervention on naming and repetition of treated and untreated words were compared with those of a visuospatial sham program. The study used a parallel-group, 2-period, crossover design, with participants receiving 2 interventions. Fifty participants with chronic and stable apraxia of speech were randomly allocated to 1 of 2 order conditions: speech-first condition versus sham-first condition. Period 1 design was equivalent to a randomized controlled trial. We report results for this period and profile the effect of the period 2 crossover. Period 1 results revealed significant improvement in naming and repetition only in the speech-first group. The sham-first group displayed improvement in speech production after speech intervention in period 2. Significant improvement of treated words was found in both naming and repetition, with little generalization to structurally similar and dissimilar untreated words. Speech gains were largely maintained after withdrawal of intervention. There was a significant relationship between treatment dose and response. However, average self-administered dose was modest for both groups. Future software design would benefit from incorporation of social and gaming components to boost motivation. Single-word production can be improved in chronic apraxia of speech with behavioral intervention. Self-administered computerized therapy is a promising method for delivering high-intensity speech/language rehabilitation. URL: http://orcid.org/0000-0002-1278-0601. Unique identifier: ISRCTN88245643. © 2016 American Heart Association, Inc.

  9. Rat nucleus accumbens core astrocytes modulate reward and the motivation to self-administer ethanol after abstinence.

    PubMed

    Bull, Cecilia; Freitas, Kelen C C; Zou, Shiping; Poland, Ryan S; Syed, Wahab A; Urban, Daniel J; Minter, Sabrina C; Shelton, Keith L; Hauser, Kurt F; Negus, S Stevens; Knapp, Pamela E; Bowers, M Scott

    2014-11-01

    Our understanding of the active role that astrocytes play in modulating neuronal function and behavior is rapidly expanding, but little is known about the role that astrocytes may play in drug-seeking behavior for commonly abused substances. Given that the nucleus accumbens is critically involved in substance abuse and motivation, we sought to determine whether nucleus accumbens astrocytes influence the motivation to self-administer ethanol following abstinence. We found that the packing density of astrocytes that were expressing glial fibrillary acidic protein increased in the nucleus accumbens core (NAcore) during abstinence from EtOH self-administration. No change was observed in the nucleus accumbens shell. This increased NAcore astrocyte density positively correlated with the motivation for ethanol. Astrocytes can communicate with one another and influence neuronal activity through gap-junction hemichannels. Because of this, the effect of blocking gap-junction hemichannels on the motivation for ethanol was examined. The motivation to self-administer ethanol after 3 weeks abstinence was increased following microinjection of gap-junction hemichannel blockers into the NAcore at doses that block both neuronal and astrocytic channels. In contrast, no effect was observed following microinjection of doses that are not thought to block astrocytic channels or following microinjection of either dose into the nucleus accumbens shell. Additionally, the motivation for sucrose after 3 weeks abstinence was unaffected by NAcore gap-junction hemichannel blockers. Next, Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) were selectively expressed in NAcore astrocytes to test the effect of astrocyte stimulation. DREADD activation increased cytosolic calcium in primary astrocytes, facilitated responding for rewarding brain stimulation, and reduced the motivation for ethanol after 3 weeks abstinence. This is the first work to modulate drug-seeking behavior with

  10. Smartphone-Based, Self-Administered Intervention System for Alcohol Use Disorders: Theory and Empirical Evidence Basis

    PubMed Central

    Dulin, Patrick L.; Gonzalez, Vivian M.; King, Diane K.; Giroux, Danielle; Bacon, Samantha

    2013-01-01

    Advances in mobile technology provide an opportunity to deliver in-the-moment interventions to individuals with alcohol use disorders, yet availability of effective “apps” that deliver evidence-based interventions is scarce. We developed an immediately available, portable, smartphone-based intervention system whose purpose is to provide stand-alone, self-administered assessment and intervention. In this paper, we describe how theory and empirical evidence, combined with smartphone functionality contributed to the construction of a user-friendly, engaging alcohol intervention. With translation in mind, we discuss how we selected appropriate intervention components including assessments, feedback and tools, that work together to produce the hypothesized outcomes. PMID:24347811

  11. Parent Use and Efficacy of a Self-Administered, Tablet-Based Parent Training Intervention: A Randomized Controlled Trial

    PubMed Central

    Fogg, Louis; Ocampo, Edith V; Acosta, Diana I

    2016-01-01

    Background Parent training programs are traditionally delivered in face-to-face formats and require trained facilitators and weekly parent attendance. Implementing face-to-face sessions is challenging in busy primary care settings and many barriers exist for parents to attend these sessions. Tablet-based delivery of parent training offers an alternative to face-to-face delivery to make parent training programs easier to deliver in primary care settings and more convenient and accessible to parents. We adapted the group-based Chicago Parent Program (CPP) to be delivered as a self-administered, tablet-based program called the ez Parentprogram. Objective The purpose of this study was to (1) assess the feasibility of the ez Parentprogram by examining parent satisfaction with the program and the percent of modules completed, (2) test the efficacy of the ez Parentprogram by examining the effects compared with a control condition for improving parenting and child behavior in a sample of low-income ethnic minority parents of young children recruited from a primary care setting, and (3) compare program completion and efficacy with prior studies of the group-based CPP. Methods The study used a two-group randomized controlled trial (RCT) design with repeated measures follow up. Subjects (n=79) were randomly assigned to an intervention or attention control condition. Data collection was at baseline and 12 and 24 weeks post baseline. Parents were recruited from a large, urban, primary care pediatric clinic. ez Parentmodule completion was calculated as the percentage of the six modules completed by the intervention group parents. Attendance in the group-based CPP was calculated as the percentage of attendance at sessions 1 through 10. Satisfaction data were summarized using item frequencies. Parent and child data were analyzed using a repeated measures analysis of variance (RM-ANOVA) with simple contrasts to determine if there were significant intervention effects on the outcome

  12. Use of electrostatic dust cloth for self-administered home allergen collection

    EPA Science Inventory

    Abstract Most epidemiologic studies employ a vacuum cleaner used by a trained technician to collect household allergens. This approach is labor intensive, equipment dependent, and impractical if study subjects reside over a wide geographic area. We examined the feasibility of a s...

  13. Comprehensive Comparison of Self-Administered Questionnaires for Measuring Quantitative Autistic Traits in Adults

    ERIC Educational Resources Information Center

    Nishiyama, Takeshi; Suzuki, Masako; Adachi, Katsunori; Sumi, Satoshi; Okada, Kensuke; Kishino, Hirohisa; Sakai, Saeko; Kamio, Yoko; Kojima, Masayo; Suzuki, Sadao; Kanne, Stephen M.

    2014-01-01

    We comprehensively compared all available questionnaires for measuring quantitative autistic traits (QATs) in terms of reliability and construct validity in 3,147 non-clinical and 60 clinical subjects with normal intelligence. We examined four full-length forms, the Subthreshold Autism Trait Questionnaire (SATQ), the Broader Autism Phenotype…

  14. Comprehensive Comparison of Self-Administered Questionnaires for Measuring Quantitative Autistic Traits in Adults

    ERIC Educational Resources Information Center

    Nishiyama, Takeshi; Suzuki, Masako; Adachi, Katsunori; Sumi, Satoshi; Okada, Kensuke; Kishino, Hirohisa; Sakai, Saeko; Kamio, Yoko; Kojima, Masayo; Suzuki, Sadao; Kanne, Stephen M.

    2014-01-01

    We comprehensively compared all available questionnaires for measuring quantitative autistic traits (QATs) in terms of reliability and construct validity in 3,147 non-clinical and 60 clinical subjects with normal intelligence. We examined four full-length forms, the Subthreshold Autism Trait Questionnaire (SATQ), the Broader Autism Phenotype…

  15. Use of electrostatic dust cloth for self-administered home allergen collection

    EPA Science Inventory

    Abstract Most epidemiologic studies employ a vacuum cleaner used by a trained technician to collect household allergens. This approach is labor intensive, equipment dependent, and impractical if study subjects reside over a wide geographic area. We examined the feasibility of a s...

  16. The Effect of Nonrespondents on a Self-Administered Mail Survey.

    ERIC Educational Resources Information Center

    Krushat, W. Mark; Molnar, John I.

    1993-01-01

    After a mailed questionnaire and two follow-ups, hard-core survey nonrespondents were contacted to ask why they had not responded and what they would have answered had they responded. Results from 28 subjects indicate that efforts to pursue nonrespondents may be unnecessary, because bias resulting from nonresponse appeared minimal. (SLD)

  17. Self-administered C1 esterase inhibitor concentrates for the management of hereditary angioedema: usability and patient acceptance

    PubMed Central

    Li, Huamin Henry

    2016-01-01

    Hereditary angioedema (HAE) is a rare genetic disease characterized by episodic subcutaneous or submucosal swelling. The primary cause for the most common form of HAE is a deficiency in functional C1 esterase inhibitor (C1-INH). The swelling caused by HAE can be painful, disfiguring, and life-threatening. It reduces daily function and compromises the quality of life of affected individuals and their caregivers. Among different treatment strategies, replacement with C1-INH concentrates is employed for on-demand treatment of acute attacks and long-term prophylaxis. Three human plasma-derived C1-INH preparations are approved for HAE treatment in the US, the European Union, or both regions: Cinryze®, Berinert®, and Cetor®; however, only Cinryze is approved for long-term prophylaxis. Postmarketing studies have shown that home therapy (self-administered or administered by a caregiver) is a convenient and safe option preferred by many HAE patients. In this review, we summarize the role of self-administered plasma-derived C1-INH concentrate therapy with Cinryze at home in the prophylaxis of HAE. PMID:27660422

  18. Successful treatment of acute hereditary angioedema attacks with self-administered icatibant in patients with venous access problems.

    PubMed

    Wiednig, Michaela

    2013-04-25

    Hereditary angioedema is a rare and potentially fatal autosomal dominant disorder characterised by unpredictable skin, gastrointestinal tract or respiratory tract oedema. Plasma-derived C1-esterase inhibitors are effective in the prophylaxis or treatment of hereditary angioedema type I and II attacks, but must be administered intravenously. This may be problematic in patients with venous access difficulties. Icatibant, a bradykinin B2-receptor antagonist, is administered subcutaneously. In July 2008 icatibant received approval for healthcare professional-administered treatment of hereditary angioedema attacks in adults. In 2011 it received European Medicines Agency and US Food and Drug Administration licences for patient-administered treatment of hereditary angioedema attacks. Given these approvals, and with the appropriate training, icatibant could provide the opportunity for patients to self-administer treatment. This is one of the first long-term follow-up reports of patients with hereditary angioedema using self-administered icatibant. During follow-up, icatibant remained effective and patient satisfaction was high.

  19. Attitudes and factors affecting acceptability of self-administered cervicovaginal sampling for human papillomavirus (HPV) genotyping as an alternative to Pap testing among multiethnic Malaysian women

    PubMed Central

    Ma'som, Mahirah; Bhoo-Pathy, Nirmala; Nasir, Nazrila Hairizan; Bellinson, Jerome; Subramaniam, Shridevi; Ma, Yuntong; Yap, Siew-Hwei; Goh, Pik-Pin; Gravitt, Patti; Woo, Yin Ling

    2016-01-01

    Objective The objective of this study was to determine the attitudes and acceptability of self-administered cervicovaginal sampling compared with conventional physician-acquired Papanicolaou (Pap) smear among multiethnic Malaysian women. Method A cross-sectional study was carried out via interviewer-administered surveys from August 2013 through August 2015 at five government-run, urban health clinics in the state of Selangor. Subjects were participants from an ongoing community-based human papillomavirus (HPV) prevalence study who answered a standard questionnaire before and after self-sampling. The cervicovaginal self-sampling for HPV genotyping was performed using a simple brush (‘Just for Me’; Preventive Oncology International, Hong Kong). Detailed data on sociodemographics, previous Pap smear experience, and attitudes towards self-administered cervicovaginal sampling were collected and analysed. Acceptability was inferred using a five-item Likert scale that included six different subjective descriptives: experience, difficulty, convenience, embarrassment, discomfort or pain, and confidence in collecting one's own sample. Results Of the 839 participants, 47.9% were Malays, followed by 30.8% Indians, 18.8% Chinese and 2.5% from other ethnicities. The median age of the participants was 38 years (IQR 30–48). Some 68.2% of participants indicated a preference for self-sampling over the Pap test, with 95% indicating willingness to follow-up a positive result at the hospital. Age, ethnicity and previous Pap test experience were significant independent factors associated with preference for self-sampling. The older the individual, the less likely they were to prefer self-sampling (adjusted OR 0.94, 95% CI 0.90 to 0.98). The Chinese were less likely to prefer self-sampling (72.6%) than the Malays (85.1%) (adjusted OR 0.57, 95% CI 0.33 to 0.98, p=0.004). Participants who had never undergone a Pap smear were also more likely to prefer self-sampling (88.5%) than

  20. Attitudes and factors affecting acceptability of self-administered cervicovaginal sampling for human papillomavirus (HPV) genotyping as an alternative to Pap testing among multiethnic Malaysian women.

    PubMed

    Ma'som, Mahirah; Bhoo-Pathy, Nirmala; Nasir, Nazrila Hairizan; Bellinson, Jerome; Subramaniam, Shridevi; Ma, Yuntong; Yap, Siew-Hwei; Goh, Pik-Pin; Gravitt, Patti; Woo, Yin Ling

    2016-08-04

    The objective of this study was to determine the attitudes and acceptability of self-administered cervicovaginal sampling compared with conventional physician-acquired Papanicolaou (Pap) smear among multiethnic Malaysian women. A cross-sectional study was carried out via interviewer-administered surveys from August 2013 through August 2015 at five government-run, urban health clinics in the state of Selangor. Subjects were participants from an ongoing community-based human papillomavirus (HPV) prevalence study who answered a standard questionnaire before and after self-sampling. The cervicovaginal self-sampling for HPV genotyping was performed using a simple brush ('Just for Me'; Preventive Oncology International, Hong Kong). Detailed data on sociodemographics, previous Pap smear experience, and attitudes towards self-administered cervicovaginal sampling were collected and analysed. Acceptability was inferred using a five-item Likert scale that included six different subjective descriptives: experience, difficulty, convenience, embarrassment, discomfort or pain, and confidence in collecting one's own sample. Of the 839 participants, 47.9% were Malays, followed by 30.8% Indians, 18.8% Chinese and 2.5% from other ethnicities. The median age of the participants was 38 years (IQR 30-48). Some 68.2% of participants indicated a preference for self-sampling over the Pap test, with 95% indicating willingness to follow-up a positive result at the hospital. Age, ethnicity and previous Pap test experience were significant independent factors associated with preference for self-sampling. The older the individual, the less likely they were to prefer self-sampling (adjusted OR 0.94, 95% CI 0.90 to 0.98). The Chinese were less likely to prefer self-sampling (72.6%) than the Malays (85.1%) (adjusted OR 0.57, 95% CI 0.33 to 0.98, p=0.004). Participants who had never undergone a Pap smear were also more likely to prefer self-sampling (88.5%) than women who had undergone a previous

  1. Getting ready for an emotion: specific premotor brain activities for self-administered emotional pictures

    PubMed Central

    Perri, Rinaldo L.; Berchicci, Marika; Lucci, Giuliana; Cimmino, Rocco L.; Bello, Annalisa; Di Russo, Francesco

    2014-01-01

    Emotional perception has been extensively studied, but only a few studies have investigated the brain activity preceding exposure to emotional stimuli, especially when they are triggered by the subject himself. Here, we sought to investigate the emotional expectancy by means of movement related cortical potentials (MRCPs) in a self-paced task, in which the subjects begin the affective experience by pressing a key. In this experiment, participants had to alternatively press two keys to concomitantly display positive, negative, neutral, and scrambled images extracted from the International Affective Pictures System (IAPS). Each key press corresponded to a specific emotional category, and the experimenter communicated the coupling before each trial so that the subjects always knew the valence of the forthcoming picture. The main results of the present study included a bilateral positive activity in prefrontal areas during expectancy of more arousing pictures (positive and negative) and an early and sustained positivity over occipital areas, especially during negative expectancy. In addition, we observed more pronounced and anteriorly distributed Late Positive Potential (LPPs) components in the emotional conditions. In conclusion, these results show that emotional expectancy can influence brain activity in both motor preparation and stimulus perception, suggesting enhanced pre-processing in the to-be-stimulated areas. We propose that before a predictable emotional stimulus, both appetitive and defensive motivational systems act to facilitate the forthcoming processing of survival-relevant contents by means of an enhancement of attention toward more arousing pictures. PMID:24904344

  2. Self-Administered Questionnaire Is a Reliable Measure of Coffee Consumption

    PubMed Central

    Sääksjärvi, Katri; Knekt, Paul; Männistö, Satu; Heliövaara, Markku

    2010-01-01

    Background The objective of this study was to assess the agreement and repeatability of 2 methods of measuring habitual coffee consumption, and to examine their homogeneity with respect to socioeconomic and lifestyle factors. Methods Data on coffee consumption were collected from 4254 subjects by means of a health questionnaire (HQ) and a 1-year dietary history interview (DHI), the latter of which was used as the reference method during the Finnish Mobile Clinic Health Examination Survey conducted in 1973–1976. Short-term repeatability of the methods was assessed using data from 286 and 93 subjects who repeated the HQ and the DHI, respectively, after an interval of 4 to 8 months. The strength of agreement between the 2 methods and between the repeated measurements was estimated using intraclass correlation coefficients (ICCs). Results The ICC was 0.86 for the agreement between the HQ and the DHI, and 0.77 and 0.85 for the repeatability of the HQ and the DHI, respectively. There were no statistically significant systematic differences in mean intake values between the 2 methods or between repeated measurements. In subgroup analysis of background variables, there were only minor differences in agreement and repeatability, with somewhat higher ICC values among subjects with a healthier lifestyle and higher education. Conclusions The high reliability and homogeneity of the health questionnaire make it a useful tool for measuring habitual coffee consumption for the purposes of epidemiological research. PMID:20671374

  3. Extraesophageal gastroesophageal reflux disease (GERD) symptoms are not more frequently associated with proximal esophageal reflux than typical GERD symptoms.

    PubMed

    Roberts, J R; Aravapalli, A; Pohl, D; Freeman, J; Castell, D O

    2012-01-01

    Extraesophageal (EE) symptoms such as cough and throat clearing are common in patients referred for reflux testing, but are less commonly associated with gastroesophageal reflux disease (GERD). Patients with reflux associated EE symptoms often lack typical GERD symptoms of heartburn and regurgitation. Our aim was to compare the frequency of proximal esophageal reflux between esophageal (typical) symptoms and EE (atypical) symptoms. Combined multichannel intraluminal impedance-pH (MII-pH) tracings were blinded by an investigator so that symptom markers were relabeled with a number without disclosure of symptom type. We selected 40 patients with at least five reflux-related symptom events for one of four symptoms (heartburn, regurgitation, cough, or throat clearing). A blinded investigator analyzed all 200 reflux episodes, reporting the proximal esophageal extent of the reflux for all symptoms. The percentage of symptom-related reflux extending proximally to 17 cm above the LES was similar among all four symptom types. At least 50% of all symptoms were associated with proximal esophageal reflux to 17 cm, with regurgitation having the highest frequency at 60%. Our data indicate that EE symptoms are not more frequently associated with proximal esophageal reflux than typical esophageal symptoms. © 2012 Copyright the Authors. Journal compilation © 2012, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  4. An alginate-antacid formulation (Gaviscon Double Action Liquid) can eliminate or displace the postprandial 'acid pocket' in symptomatic GERD patients.

    PubMed

    Kwiatek, M A; Roman, S; Fareeduddin, A; Pandolfino, J E; Kahrilas, P J

    2011-07-01

    Recently, an 'acid pocket' has been described in the proximal stomach, particularly evident postprandially in GERD patients, when heartburn is common. By creating a low density gel 'raft' that floats on top of gastric contents, alginate-antacid formulations may neutralise the 'acid pocket'. To assess the ability of a commercial high-concentration alginate-antacid formulation to neutralize and/or displace the acid pocket in GERD patients. The 'acid pocket' was studied in ten symptomatic GERD patients. Measurements were made using concurrent stepwise pH pull-throughs, high resolution manometry and fluoroscopy in a semi-recumbent posture. Each subject was studied in three conditions: fasted, 20 min after consuming a high-fat meal and 20 min later after a 20 mL oral dose of an alginate-antacid formulation (Gaviscon Double Action Liquid, Reckitt Benckiser Healthcare, Hull, UK). The relative position of pH transition points (pH >4) to the EGJ high-pressure zone was analysed. Most patients (8/10) exhibited an acidified segment extending from the proximal stomach into the EGJ when fasted that persisted postprandially. Gaviscon neutralised the acidified segment in six of the eight subjects shifting the pH transition point significantly away from the EGJ. The length and pressure of the EGJ high-pressure zone were minimally affected. Gaviscon can eliminate or displace the 'acid pocket' in GERD patients. Considering that EGJ length was unchanged throughout, this effect was likely attributable to the alginate 'raft' displacing gastric contents away from the EGJ. These findings suggest the alginate-antacid formulation to be an appropriately targeted postprandial GERD therapy. © 2011 Blackwell Publishing Ltd.

  5. GERD and obesity: is the autonomic nervous system the missing link?

    PubMed

    Devendran, Neranjani; Chauhan, Nita; Armstrong, David; Upton, Adrian R M; Kamath, Markad V

    2014-01-01

    Gastroesophageal reflux disease (GERD) is a common chronic condition that not only impairs the quality of life of those who are affected by it but also poses a significant economic burden. It encompasses a wide spectrum of symptoms as a result of gastric content moving into the esophagus. The most common cause of GERD, other than a hiatus hernia, is considered to be transient lower esophageal sphincter relaxation. The lower esophageal sphincter (LES) normally has a higher resting tone than the stomach, thus preventing the reflux of gastric contents into the esophagus. The greater prevalence of GERD and GERD symptoms in obese individuals has generated significant interest in understanding the association between these 2 conditions and the underlying physiological mechanisms. The potential relationship between GERD and obesity and the exact mechanism by which obesity may cause reflux, however, remains uncertain. It has been proposed that patients with GERD have altered autonomic nervous function and, more specifically, have reduced parasympathetic activity. Obese individuals also have shown diminished parasympathetic activity, which may be reversed after weight reduction through exercise, diet control, and bariatric surgery. Given that contraction and relaxation of the LES are vagally mediated, the question that arises is whether the autonomic nervous system is, in fact, the missing link between obesity and GERD. In this article we examine the current evidence and hypothesize that the potential imbalance in sympathovagal stimulation to the LES is a key contributing factor to the increased prevalence of GERD symptoms in obese individuals.

  6. Can a self-administered questionnaire identify workers with chronic or recurring low back pain?

    PubMed

    Takekawa, Karina Satiko; Gonçalves, Josiane Sotrate; Moriguchi, Cristiane Shinohara; Coury, Helenice Jane Cote Gil; Sato, Tatiana de Oliveira

    2015-01-01

    To verify if the Nordic Musculoskeletal Questionnaire (NMQ), Visual Analogue Scale (VAS), Roland-Morris Disability Questionnaire (RDQ) and physical examination of the lumbar spine can identify workers with chronic or recurring low back pain, using health history for reference. Fifty office workers of both sexes, aged between 19 and 55 yr, were evaluated using a standardized physical examination and the NMQ, VAS and RDQ. Discriminant analysis was performed to determine the discriminant properties of these instruments. A higher success rate (94%) was observed in the model including only the NMQ and in the model including the NMQ and the physical examination. The lowest success rate (82%) was observed in the model including the NMQ, RDQ and VAS. The NMQ was able to detect subjects with chronic or recurring low back pain with 100% sensitivity and 88% specificity. The NMQ appears to be the best instrument for identifying subjects with chronic or recurring low back pain. Thus, this self-reported questionnaire is suitable for screening workers for chronic or recurring low back pain in occupational settings.

  7. Can a self-administered questionnaire identify workers with chronic or recurring low back pain?

    PubMed Central

    TAKEKAWA, Karina Satiko; GONÇALVES, Josiane Sotrate; MORIGUCHI, Cristiane Shinohara; COURY, Helenice Jane Cote Gil; SATO, Tatiana de Oliveira

    2015-01-01

    To verify if the Nordic Musculoskeletal Questionnaire (NMQ), Visual Analogue Scale (VAS), Roland-Morris Disability Questionnaire (RDQ) and physical examination of the lumbar spine can identify workers with chronic or recurring low back pain, using health history for reference. Fifty office workers of both sexes, aged between 19 and 55 yr, were evaluated using a standardized physical examination and the NMQ, VAS and RDQ. Discriminant analysis was performed to determine the discriminant properties of these instruments. A higher success rate (94%) was observed in the model including only the NMQ and in the model including the NMQ and the physical examination. The lowest success rate (82%) was observed in the model including the NMQ, RDQ and VAS. The NMQ was able to detect subjects with chronic or recurring low back pain with 100% sensitivity and 88% specificity. The NMQ appears to be the best instrument for identifying subjects with chronic or recurring low back pain. Thus, this self-reported questionnaire is suitable for screening workers for chronic or recurring low back pain in occupational settings. PMID:25810448

  8. Comprehensive comparison of self-administered questionnaires for measuring quantitative autistic traits in adults.

    PubMed

    Nishiyama, Takeshi; Suzuki, Masako; Adachi, Katsunori; Sumi, Satoshi; Okada, Kensuke; Kishino, Hirohisa; Sakai, Saeko; Kamio, Yoko; Kojima, Masayo; Suzuki, Sadao; Kanne, Stephen M

    2014-05-01

    We comprehensively compared all available questionnaires for measuring quantitative autistic traits (QATs) in terms of reliability and construct validity in 3,147 non-clinical and 60 clinical subjects with normal intelligence. We examined four full-length forms, the Subthreshold Autism Trait Questionnaire (SATQ), the Broader Autism Phenotype Questionnaire, the Social Responsiveness Scale2-Adult Self report (SRS2-AS), and the Autism-Spectrum Quotient (AQ). The SRS2-AS and the AQ each had several short forms that we also examined, bringing the total to 11 forms. Though all QAT questionnaires showed acceptable levels of test-retest reliability, the AQ and SRS2-AS, including their short forms, exhibited poor internal consistency and discriminant validity, respectively. The SATQ excelled in terms of classical test theory and due to its short length.

  9. Agreement between a self-administered questionnaire on musculoskeletal disorders of the neck-shoulder region and a physical examination.

    PubMed

    Perreault, Nathalie; Brisson, Chantal; Dionne, Clermont E; Montreuil, Sylvie; Punnett, Laura

    2008-03-17

    In epidemiological studies on neck-shoulder disorders, physical examination by health professionals, although more expensive, is usually considered a better method of data collection than self-administered questionnaires on symptoms. However, little is known on the comparison of these two methods of data collection. The agreement between self-administered questionnaires and the physical examination on the presence of neck-shoulders disorders was assessed in the present study. This study was conducted among clerical workers using video display units. Prevalent cases were workers for whom neck-shoulder symptoms were present for at least 3 days during the previous 7 days and for whom pain intensity was greater than 50 mm on a 100 mm visual analogue scale. All 85 workers meeting this definition and a random sample of 102 workers who did not meet this definition were selected. Physical examination included measures of active range of motion and musculoskeletal strength. Cohen's kappa and global percent agreement were calculated to compare the two methods of data collection. The effect on the agreement of different question and physical examination definitions and the importance of the time interval elapsed between the administrations of the tests were also evaluated. Kappa coefficients ranged from 0.19 to 0.54 depending on the definitions used to ascertain disorders. The agreement was highest when the two instruments were administered 21 days apart or less (Kappa = 0.54, global agreement = 77%). It was not substantially improved by the addition of criteria related to functional limitations or when comparisons were made with alternative physical examination definitions. Pain intensity recorded during physical examination maneuvers was an important element of the agreement between questionnaire and physical examination findings. These results suggest a fair to good agreement between the presence of musculoskeletal disorders ascertained by self-administered questionnaire

  10. [Usefulness of a multidimensional self-administered questionnaire for the clinical management of a pain treatment unit].

    PubMed

    Busquets, C; Ojeda, A; Torres, F; Faulí, A; Moreno, L A; Bogdanovich, A; Giménez-Milà, M; Hernández-Cera, C; Fàbregas, N; Videla, S

    2014-01-01

    To study the feasibility of a multidimensional self-administered questionnaire before the patient is seen at the first visit in a clinical Pain Treatment Unit (PTU) of a tertiary hospital, and its impact on the management of patients in the first visit. Cross-sectional study. Self-administered questionnaire that gathered: socio-demographic data, medical history of pain, pain perception (intensity and characteristics), comorbidity of pain and patient expectations of analgesic treatment ("What do you expect from our treatment? If we cannot resolve your pain, what level of pain would you be willing to live with?). A descriptive analysis was performed. A total of 293 consecutive patients (31% men, 69% women), mean age (SD) 62 (16) years-old, were included in 2011. All patients completed and returned the questionnaire before the first visit to the PTU. The questionnaire was completed fully and correctly by 80% (234, 95% CI: 75-84) of the patients, and the rest completed the questionnaire with some points unanswered. About 24% (70/293, 95% CI: 19-29) of the patients should not have been referred to the PTU [20% were not attended]. A small percentage (9%,26/293, 95% CI: 6-13) were evaluated as «urgent'» and visited over the following 7 days, with 19% (56/293, 95%CI: 15-24) being «preferential» (visited before 15 days) and 52% (152/293, 95% CI: 46-58) as «non-urgent/non-preferential» (visited before 60 days). Almost one third (30%, 87/293, 95% CI: 25-35) did not need a second visit to the PTU. Patient expectations: 21% expected complete pain relief and 64% would accept a lower pain intensity score of 4. The use of a multidimensional self-administered questionnaire before the first visit to a clinical Pain Treatment Unit of a tertiary hospital was a practicable and useful tool for the management of patients on the first visit. Likewise, the questionnaire provided information on the patient's perception of pain and the expectations concerning the analgesic treatment

  11. Agreement between a self-administered questionnaire on musculoskeletal disorders of the neck-shoulder region and a physical examination

    PubMed Central

    Perreault, Nathalie; Brisson, Chantal; Dionne, Clermont E; Montreuil, Sylvie; Punnett, Laura

    2008-01-01

    Background In epidemiological studies on neck-shoulder disorders, physical examination by health professionals, although more expensive, is usually considered a better method of data collection than self-administered questionnaires on symptoms. However, little is known on the comparison of these two methods of data collection. The agreement between self-administered questionnaires and the physical examination on the presence of neck-shoulders disorders was assessed in the present study. Methods This study was conducted among clerical workers using video display units. Prevalent cases were workers for whom neck-shoulder symptoms were present for at least 3 days during the previous 7 days and for whom pain intensity was greater than 50 mm on a 100 mm visual analogue scale. All 85 workers meeting this definition and a random sample of 102 workers who did not meet this definition were selected. Physical examination included measures of active range of motion and musculoskeletal strength. Cohen's kappa and global percent agreement were calculated to compare the two methods of data collection. The effect on the agreement of different question and physical examination definitions and the importance of the time interval elapsed between the administrations of the tests were also evaluated. Results Kappa coefficients ranged from 0.19 to 0.54 depending on the definitions used to ascertain disorders. The agreement was highest when the two instruments were administered 21 days apart or less (Kappa = 0.54, global agreement = 77%). It was not substantially improved by the addition of criteria related to functional limitations or when comparisons were made with alternative physical examination definitions. Pain intensity recorded during physical examination maneuvers was an important element of the agreement between questionnaire and physical examination findings. Conclusion These results suggest a fair to good agreement between the presence of musculoskeletal disorders

  12. Determining the general utilization and characteristics of orthopedic complementary and alternative medicine using a self-administered online questionnaire in Japan.

    PubMed

    Watanabe, Hideaki; Horiguchi, Istuko; Hayasaka, Shinya; Hagiwara, Kayo; Sugawara, Ryo; Inoue, Hirokazu; Takeshita, Katsushi; Marui, Eiji; Kikkawa, Ichiro

    2015-05-01

    Acupuncture and moxibustion, massage, bone-setting, manual therapy, and chiropractic treatments are representative components of orthopedic complementary and alternative medicine (OCAM) in Japan. However, the state of their utilization and characteristics are unclear, and have yet to be thoroughly surveyed. The objective of this study was to survey the utilization and characteristics of OCAM in the general public. In January 2011, we conducted a self-administered online questionnaire survey with 10,400 members of the general public, who were registered as consumer reviewers at the internet survey company. Survey topics were the use of OCAM within one month prior to the survey, the objective of using OCAM, and the presence or absence of consultation with and recommendation or referral by a physician. The subjects were divided into those who used and did not use OCAM as user and non-user groups, respectively, and the age, sex, and prevalence of past treatment for orthopedic diseases at medical institutions were compared between the groups. Data of 3,211 subjects (1,611 males and 1,600 females, mean age: 44.7 years old) were analyzed. Four hundred and thirty-eight subjects (13.6%) used OCAM within one month prior to the survey. The subjects in their forties used OCAM most frequently, followed by those in their twenties. The most frequent objective of OCAM usage was treatment, accounting for 63% (275 subjects) of the subjects. Fifty-three subjects (12.1%) consulted a physician, and 48 (11%) were recommended or referred by a physician. Upon logistic regression analysis, significant differences were detected in age, sex, and prevalence of treatment at a medical institution in the user group. A decreasing trend in the odds ratio correlated with subjects having received previous treatment at a medical institution, female subjects, and subjects of a younger age (p = 0.01; odds ratio = 4.33, 1.43, and 1.01, respectively), and these factors were independent. It was determined

  13. Development of a menu of performance tests self-administered on a portable microcomputer

    NASA Technical Reports Server (NTRS)

    Wilkes, Robert L.; Kuntz, Lois-Ann; Kennedy, Robert S.

    1987-01-01

    Eighteen cognitive, motor, and information processing performance subtests were screened for self-administration over 10 trials by 16 subjects. When altered presentation forms of the same test were collectively considered, the battery composition was reduced to 10 distinctly different measures. A fully automated microbased testing system was employed in presenting the battery of subtests. Successful self-administration of the battery provided for the field testing of the automated system and facilitated convenient data collection. Total test administration time was 47.2 minutes for each session. Results indicated that nine of the tests stabilized, but for a short battery of tests only five are recommended for use in repeated-measures research. The five recommended tests include: the Tapping series, Number Comparison, Short-term Memory, Grammatical Reasoning, and 4-Choice Reaction Time. These tests can be expected to reveal three factors: (1) cognition, (2) processing quickness, and (3) motor. All the tests stabilized in 24 minutes, or approximately two 12-minute sessions.

  14. The Medicine and GERD of Immanuel Kant (1724-1804).

    PubMed

    Figueiredo Filho, Gilberto Vilela

    2009-01-01

    We can place Kant as one of the pillars of contemporary medicine. Firstly, as an Illuminist, his work subordinates the collection of empirical data, which in medical science is constitutional to reason. This was the basis of a rational medical science. Secondly, he is the father of medical regulation, having set the philosophical control ground stone for physicians by the State. His work "Critique of Practical Reason" drafts all the future codes of ethics and bioethics. We will hereby study his relationship with medicine based on the text "The Conflict with the Faculty of Medicine" and other auxiliary texts.We can find in Kant's works the description of a series of symptoms that were related to a nonspecific dyspeptic syndrome that nowadays would be diagnosed as a strong indication that he suffered from gastroesophageal reflux disease (GERD).

  15. The endogenous cannabinoid anandamide and its synthetic analog R(+)-methanandamide are intravenously self-administered by squirrel monkeys.

    PubMed

    Justinova, Zuzana; Solinas, Marcello; Tanda, Gianluigi; Redhi, Godfrey H; Goldberg, Steven R

    2005-06-08

    Anandamide, an endogenous ligand for brain cannabinoid CB(1) receptors, produces many behavioral effects similar to those of Delta(9)-tetrahydrocannabinol (THC), the main psychoactive ingredient in marijuana. Reinforcing effects of THC have been demonstrated in experimental animals, but there is only indirect evidence that endogenous cannabinoids such as anandamide participate in brain reward processes. We now show that anandamide serves as an effective reinforcer of drug-taking behavior when self-administered intravenously by squirrel monkeys. We also show that methanandamide, a synthetic long-lasting anandamide analog, similarly serves as a reinforcer of drug-taking behavior. Finally, we show that the reinforcing effects of both anandamide and methanandamide are blocked by pretreatment with the cannabinoid CB(1) receptor antagonist rimonabant (SR141716). These findings strongly suggest that release of endogenous cannabinoids is involved in brain reward processes and that activation of cannabinoid CB(1) receptors by anandamide could be part of the signaling of natural rewarding events.

  16. Validation of a self-administered questionnaire to screen for prenatal alcohol use in Northern Plains Indian women.

    PubMed

    Bull, L B; Kvigne, V L; Leonardson, G R; Lacina, L; Welty, T K

    1999-04-01

    This study among American Indian prenatal patients was conducted to validate a self-administered questionnaire (SAQ) designed to (1) identify women who had consumed alcohol during pregnancy, (2) identify women who may be at risk of drinking during pregnancy, and (3) determine the quantity and frequency of alcohol and other substance use just before and during pregnancy. The validation involved three components: (1) review of the SAQ responses by a public health nurse; (2) structured patient interview with the research nurse; and (3) medical record abstraction postpartum. Compared to extensive interview and medical record data, the SAQ is sensitive (76.6%) and specific (92.8%) in detecting pregnant women who had consumed alcohol during pregnancy. The SAQ is a useful screening tool for alcohol use in this population.

  17. Methoxyflurane and Nitrous Oxide as Obstetric Analgesics. II.—A Comparison by Self-administered Intermittent Inhalation

    PubMed Central

    Jones, Peter L.; Rosen, M.; Mushin, W. W.; Jones, E. V.

    1969-01-01

    Methoxyflurane (0·35%) in air and nitrous oxide/oxygen (50%/50%) self-administered intermittently in the usual way have been compared as analgesics for labour. There were 25 patients in each group. Objective assessment by an anaesthetist showed that methoxyflurane is the more effective analgesic, and this was supported by the opinion of the multiparae. Nausea and vomiting were significantly less with methoxyflurane. Fifty per cent. nitrous oxide in oxygen given intermittently does not appear to be the best analgesic concentration. Nevertheless, since a considerable variation in sensitivity exists, it would probably be unwise to consider the introduction of higher concentrations for use by unsupervised midwives. This trial confirms the predictions made by us using a method for screening inhalational analgesics, in which methoxyflurane and nitrous oxide were given continuously. PMID:4895339

  18. The motivation to self-administer is increased after a history of spiking brain levels of cocaine.

    PubMed

    Zimmer, Benjamin A; Oleson, Erik B; Roberts, David Cs

    2012-07-01

    Recent attempts to model the addiction process in rodents have focused on cocaine self-administration procedures that provide extended daily access. Such procedures produce a characteristic loading phase during which blood levels rapidly rise and then are maintained within an elevated range for the duration of the session. The present experiments tested the hypothesis that multiple fast-rising spikes in cocaine levels contribute to the addiction process more robustly than constant, maintained drug levels. Here, we compared the effects of various cocaine self-administration procedures that produced very different patterns of drug intake and drug dynamics on Pmax, a behavioral economic measure of the motivation to self-administer drug. Two groups received intermittent access (IntA) to cocaine during daily 6-h sessions. Access was limited to twelve 5-min trials that alternated with 25-min timeout periods, using either a hold-down procedure or a fixed ratio 1 (FR1). Cocaine levels could not be maintained with this procedure; instead the animals experienced 12 fast-rising spikes in cocaine levels each day. The IntA groups were compared with groups given 6-h FR1 long access and 2-h short access sessions and two other control groups. Here, we report that cocaine self-administration procedures resulting in repeatedly spiking drug levels produce more robust increases in Pmax than procedures resulting in maintained high levels of cocaine. These results suggest that rapid spiking of brain-cocaine levels is sufficient to increase the motivation to self-administer cocaine.

  19. Validation of a self-administered instrument to measure adherence to anticholinergic drugs in women with overactive bladder

    PubMed Central

    Andy, UU; Harvie, HS; Smith, AL; Propert, KJ; Bogner, HR; Arya, LA

    2015-01-01

    Aim To validate a self-administered instrument, the Medication Adherence Self-Report Inventory (MASRI) for measuring adherence to anti-cholinergic medication for overactive bladder (OAB). Methods Prospective study in 131 women with OAB treated with fesoterodine. Adherence was measured at 8 and 12 weeks using an interviewer administered Brief Medication Questionnaire (BMQ) that assesses barriers to adherence (criterion standard), the MASRI, and pill count. Construct, concurrent and discriminant validity of the MASRI was assessed. We hypothesized that women who were non-adherent as measured by the MASRI would be more likely to have a belief barrier than women who were adherent to medication. Results Women diagnosed as non-adherent by the MASRI were more likely to report a belief barrier to taking medication as compared to adherent women at 8weeks (80 v 38%, p<0.001) and at 12 weeks (70% v. 40%, p=0.003). Significant correlations were noted between adherence rates measured by the MASRI and the BMQ at 8 weeks (r=0.87, p<0.001) and 12 weeks (r=0.90, p<0.001). Moderate correlation was noted between the adherence rate as measured by the MASRI and pill count at 8 weeks (r=0.49, p=0.02) but not at 12 weeks (r=0.05, p=0.87). The MASRI correctly identified 93% and 96% of non-adherent women at 8 and 12 weeks, respectively. Sensitivity, specificity and positive likelihood ratio of the MASRI for predicting non-adherence was 91%, 82%, and 5.1 at 8 weeks and 90%, 85% and 6.1 at 12 weeks. Conclusions The MASRI is a valid self-administered tool for measuring adherence to anti-cholinergic medication in women with OAB. PMID:24719232

  20. Validation of a self-administered instrument to measure adherence to anticholinergic drugs in women with overactive bladder.

    PubMed

    Andy, Uduak U; Harvie, Heidi S; Smith, Ariana L; Propert, Kathleen J; Bogner, Hillary R; Arya, Lily A

    2015-06-01

    To validate a self-administered instrument, the Medication Adherence Self-Report Inventory (MASRI) for measuring adherence to anti-cholinergic medication for overactive bladder (OAB). Prospective study in 131 women with OAB treated with fesoterodine. Adherence was measured at 8 and 12 weeks using an interviewer administered brief medication questionnaire (BMQ) that assesses barriers to adherence (criterion standard), the MASRI, and pill count. Construct, concurrent and discriminant validity of the MASRI was assessed. We hypothesized that women who were non-adherent as measured by the MASRI would be more likely to have a belief barrier than women who were adherent to medication. Women diagnosed as non-adherent by the MASRI were more likely to report a belief barrier to taking medication as compared to adherent women at 8 weeks (80% vs. 38%, P < 0.001) and at 12 weeks (70% vs. 40%, P = 0.003). Significant correlations were noted between adherence rates measured by the MASRI and the BMQ at 8 weeks (r = 0.87, P < 0.001) and 12 weeks (r = 0.90, P < 0.001). Moderate correlation was noted between the adherence rate as measured by the MASRI and pill count at 8 weeks (r = 0.49, P = 0.02) but not at 12 weeks (r = 0.05, P = 0.87). The MASRI correctly identified 93% and 96% of non-adherent women at 8 and 12 weeks, respectively. Sensitivity, specificity, and positive likelihood ratio of the MASRI for predicting non-adherence was 91%, 82%, and 5.1 at 8 weeks and 90%, 85% and 6.1 at 12 weeks. The MASRI is a valid self-administered tool for measuring adherence to anti-cholinergic medication in women with OAB. © 2014 Wiley Periodicals, Inc.

  1. Feasibility of a self-administered survey to identify primary care patients at risk of medication-related problems.

    PubMed

    Makowsky, Mark J; Cave, Andrew J; Simpson, Scot H

    2014-01-01

    Pharmacists working in primary care clinics are well positioned to help optimize medication management of community-dwelling patients who are at high risk of experiencing medication-related problems. However, it is often difficult to identify these patients. Our objective was to test the feasibility of a self-administered patient survey, to facilitate identification of patients at high risk of medication-related problems in a family medicine clinic. We conducted a cross-sectional, paper-based survey at the University of Alberta Hospital Family Medicine Clinic in Edmonton, Alberta, which serves approximately 7,000 patients, with 25,000 consultations per year. Adult patients attending the clinic were invited to complete a ten-item questionnaire, adapted from previously validated surveys, while waiting to be seen by the physician. Outcomes of interest included: time to complete the questionnaire, staff feedback regarding impact on workflow, and the proportion of patients who reported three or more risk factors for medication-related problems. The questionnaire took less than 5 minutes to complete, according to the patient's report on the last page of the questionnaire. The median age (and interquartile range) of respondents was 57 (45-69) years; 59% were women; 47% reported being in very good or excellent health; 43 respondents of 100 had three or more risk factors, and met the definition for being at high risk of a medication-related problem. Distribution of a self-administered questionnaire did not disrupt patients, or the clinic workflow, and identified an important proportion of patients at high risk of medication-related problems.

  2. Both comprehensive and brief self-administered diet history questionnaires satisfactorily rank nutrient intakes in Japanese adults.

    PubMed

    Kobayashi, Satomi; Honda, Satoru; Murakami, Kentaro; Sasaki, Satoshi; Okubo, Hitomi; Hirota, Naoko; Notsu, Akiko; Fukui, Mitsuru; Date, Chigusa

    2012-01-01

    A comprehensive self-administered diet history questionnaire (DHQ: 150-item semi-quantitative questionnaire) and a brief self-administered DHQ (BDHQ: 58-item fixed-portion-type questionnaire) were developed for assessing Japanese diets. We compared the relative validity of nutrient intake derived from DHQ with that from the BDHQ, using semi-weighed 16-day dietary records (DRs) as reference. Ninety-two Japanese women aged 31 to 69 years and 92 Japanese men aged 32 to 76 years completed a 4-nonconsecutive-day DR, a DHQ, and a BDHQ 4 times each (once per season) in 3 areas of Japan (Osaka, Nagano, and Tottori). No significant differences were seen in estimates of energy-adjusted intakes of 42 selected nutrients (based on the residual method) between the 16-day DRs and the first DHQ (DHQ1) or between the DR and the first BDHQ (BDHQ1) for 18 (43%) and 14 (33%) nutrients, respectively, among women and for 4 (10%) and 21 (50%) nutrients among men. The median (interquartile range) Pearson correlation coefficients with the DR for energy-adjusted intakes of the 42 nutrients were 0.57 (0.50 to 0.64) for the DHQ1 and 0.54 (0.45 to 0.61) for the BDHQ1 in women; in men, the respective values were 0.50 (0.42 to 0.59) and 0.56 (0.41 to 0.63). Similar results were observed for the means of the 4 DHQs and BDHQs. The DHQ and BDHQ had satisfactory ranking ability for the energy-adjusted intakes of many nutrients among the present Japanese population, although these instruments were satisfactory in estimating mean values for only a small number of nutrients.

  3. Cognitive training in the elderly: a randomized trial to evaluate the efficacy of a self-administered cognitive training program.

    PubMed

    Rizkalla, Mireille N

    2015-12-08

    To evaluate the efficacy of a self-administered cognitive training program for improving cognition in normal elderly persons. A multisite, randomized control, double-blind trial was conducted with 28 experimental participants (Mage = 70.7 ± 8.89) and 28 active controls (Mage = 74.4 ± 9.39). Treatment conditions: experimental intervention (EI) consisted of three modules: (1) executive functioning, (2) memory, and (3) emotion training. Active control (AC) consisted of word searches, reading short stories, and answering multiple-choice questions. Treatments were self-administered one hour/five days a week for four weeks. Pre-and post-training neuropsychological outcome measures were utilized as determinants of program success. Compared to the AC group, the EI group displayed significant gains on targeted executive (p = .002) and memory (p < .001) composites, but not the emotion (p = .105) composite. Training-induced benefits were also observed for the EI group on untrained items within global cognition (BCRS, p = .002) and functional abilities (DAD, p < .001; FRS, p = .042). The percentage of participants who showed reliable performance improvements was greater for the EI than AC on executive (55.5% vs. 12.5%), memory (55% vs. 19.5%) and functional (41% vs. 7.5%) ability. Participant recruitment and compliance rates were enhanced by the involvement of a physician. Results support the efficacy of self-directed cognitive training in reliably improving cognitive and functional abilities in normal older adults. While physicians are critical in enhancing the delivery of regimented treatment, the present study illustrates the potential for self-directed prophylactic training in deterring the development of cognitive decline.

  4. Self-administered and noncontingent nicotine enhance reinforced operant responding in rats: impact of nicotine dose and reinforcement schedule.

    PubMed

    Chaudhri, Nadia; Caggiula, Anthony R; Donny, Eric C; Booth, Sheri; Gharib, Maysa; Craven, Laure; Palmatier, Matthew I; Liu, Xiu; Sved, Alan F

    2007-02-01

    Nicotine infusions that are self-administered (contingent) or response-independent (noncontingent) increase lever pressing for a reinforcing nonpharmacological stimulus in rats, suggesting that in addition to primary reinforcement, nicotine self-administration may result from nicotine enhancing the reinforcement derived from nonnicotine stimuli. Based on our previous research, in this study, we tested the hypothesis that contingent and noncontingent nicotine would equally elevate responding for a moderately reinforcing visual stimulus, across a range of nicotine doses on both fixed ratio and progressive ratio reinforcement schedules. The rats lever pressed for a visual stimulus with contingent nicotine, noncontingent nicotine, or contingent saline. Separate groups responded for saline or nicotine without the visual stimulus. Three doses of nicotine (0.01, 0.03, and 0.09 mg/kg per infusion, free base) were tested in a between-groups design. After responding on an escalating fixed ratio reinforcement schedule, the rats were tested on a progressive ratio schedule. Compared to responding for the visual stimulus with saline, both contingent and noncontingent nicotine equally elevated lever pressing for the stimulus at each dose on fixed and progressive ratio schedules. In the absence of the stimulus, only the highest nicotine dose sustained self-administration. The ability of noncontingent nicotine to elevate responding for a moderately reinforcing visual stimulus occurs across a range of doses, and both self-administered and noncontingent nicotine equally increase motivation to obtain the stimulus, as reflected by performance on a progressive ratio schedule. In the absence of a contingent stimulus, primary reinforcement from nicotine only supports self-administration at high nicotine doses in rats.

  5. Self-administered and noncontingent nicotine enhance reinforced operant responding in rats: impact of nicotine dose and reinforcement schedule

    PubMed Central

    Caggiula, Anthony R.; Donny, Eric C.; Booth, Sheri; Gharib, Maysa; Craven, Laure; Palmatier, Matthew I.; Liu, Xiu; Sved, Alan F.

    2010-01-01

    Rationale Nicotine infusions that are self-administered (contingent) or response-independent (noncontingent) increase lever pressing for a reinforcing nonpharmacological stimulus in rats, suggesting that in addition to primary reinforcement, nicotine self-administration may result from nicotine enhancing the reinforcement derived from nonnicotine stimuli. Objectives Based on our previous research, in this study, we tested the hypothesis that contingent and noncontingent nicotine would equally elevate responding for a moderately reinforcing visual stimulus, across a range of nicotine doses on both fixed ratio and progressive ratio reinforcement schedules. Materials and methods The rats lever pressed for a visual stimulus with contingent nicotine, noncontingent nicotine, or contingent saline. Separate groups responded for saline or nicotine without the visual stimulus. Three doses of nicotine (0.01, 0.03, and 0.09 mg/kg per infusion, free base) were tested in a between-groups design. After responding on an escalating fixed ratio reinforcement schedule, the rats were tested on a progressive ratio schedule. Results Compared to responding for the visual stimulus with saline, both contingent and noncontingent nicotine equally elevated lever pressing for the stimulus at each dose on fixed and progressive ratio schedules. In the absence of the stimulus, only the highest nicotine dose sustained self-administration. Conclusions The ability of noncontingent nicotine to elevate responding for a moderately reinforcing visual stimulus occurs across a range of doses, and both self-administered and noncontingent nicotine equally increase motivation to obtain the stimulus, as reflected by performance on a progressive ratio schedule. In the absence of a contingent stimulus, primary reinforcement from nicotine only supports self-administration at high nicotine doses in rats. PMID:16847680

  6. Functional Heartburn Overlaps With Irritable Bowel Syndrome More Often than GERD.

    PubMed

    de Bortoli, Nicola; Frazzoni, Leonardo; Savarino, Edoardo V; Frazzoni, Marzio; Martinucci, Irene; Jania, Aleksandra; Tolone, Salvatore; Scagliarini, Michele; Bellini, Massimo; Marabotto, Elisa; Furnari, Manuele; Bodini, Giorgia; Russo, Salvatore; Bertani, Lorenzo; Natali, Veronica; Fuccio, Lorenzo; Savarino, Vincenzo; Blandizzi, Corrado; Marchi, Santino

    2016-12-01

    We aimed to evaluate the prevalence of irritable bowel syndrome (IBS) in patients with typical reflux symptoms as distinguished into gastroesophageal reflux disease (GERD), hypersensitive esophagus (HE), and functional heartburn (FH) by means of endoscopy and multichannel intraluminal impedance (MII)-pH monitoring. The secondary aim was to detect pathophysiological and clinical differences between different sub-groups of patients with heartburn. Patients underwent a structured interview based on questionnaires for GERD, IBS, anxiety, and depression. Off-therapy upper-gastrointestinal (GI) endoscopy and 24 h MII-pH monitoring were performed in all cases. In patients with IBS, fecal calprotectin was measured and colonoscopy was scheduled for values >100 mg/kg to exclude organic disease. Multivariate logistic regression analysis was performed to identify independent risk factors for FH. Of the 697 consecutive heartburn patients who entered the study, 454 (65%) had reflux-related heartburn (GERD+HE), whereas 243 (35%) had FH. IBS was found in 147/454 (33%) GERD/HE but in 187/243 (77%) FH patients (P<0.001). At multivariate analysis, IBS and anxiety were independent risk factors for FH in comparison with reflux-related heartburn (GERD+HE). IBS overlaps more frequently with FH than with GERD and HE, suggesting common pathways and treatment. HE showed intermediate characteristic between GERD and FH.

  7. Expert consensus document: Advances in the physiological assessment and diagnosis of GERD.

    PubMed

    Savarino, Edoardo; Bredenoord, Albert J; Fox, Mark; Pandolfino, John E; Roman, Sabine; Gyawali, C Prakash

    2017-09-27

    GERD is a common condition worldwide. Key mechanisms of disease include abnormal oesophagogastric junction structure and function, and impaired oesophageal clearance. A therapeutic trial of acid-suppressive PPI therapy is often the initial management, with endoscopy performed in the setting of alarm symptoms and to exclude other conditions. If symptoms persist and endoscopy does not reveal evidence of GERD, oesophageal function tests are performed, including oesophageal manometry and ambulatory reflux monitoring. However, reflux episodes can be physiological, and some findings on endoscopy and manometry can be encountered in asymptomatic individuals without GERD symptoms. The diagnosis of GERD on the basis of functional oesophageal testing has been previously reported, but no updated expert recommendations on indications and the interpretation of oesophageal function testing in GERD has been made since the Porto consensus over a decade ago. In this Consensus Statement, we aim to describe modern oesophageal physiological tests and their analysis with an emphasis on establishing indications and consensus on interpretation parameters of oesophageal function testing for the evaluation of GERD in clinical practice. This document reflects the collective conclusions of the international GERD working group, incorporating existing data with expert consensus opinion.

  8. Baseline impedance measured during high-resolution esophageal impedance manometry reliably discriminates GERD patients.

    PubMed

    Ravi, K; Geno, D M; Vela, M F; Crowell, M D; Katzka, D A

    2017-05-01

    Baseline impedance measured with ambulatory impedance pH monitoring (MII-pH) and a mucosal impedance catheter detects gastroesophageal reflux disease (GERD). However, these tools are limited by cost or patient tolerance. We investigated whether baseline impedance measured during high-resolution impedance manometry (HRIM) distinguishes GERD patients from controls. Consecutive patients with clinical HRIM and MII-pH testing were identified. Gastroesophageal reflux disease was defined by esophageal pH <4 for ≥5% of both the supine and total study time, whereas controls had an esophageal pH <4 for ≤3% of the study performed off PPI. Baseline impedance was measured over 15 seconds during the landmark period of HRIM and over three 10 minute intervals during the overnight period of MII-pH. Among 29 GERD patients and 26 controls, GERD patients had a mean esophageal acid exposure time of 22.7% compared to 1.2% in controls (P<.0001). Mean baseline impedance during HRIM was lower in GERD (1061 Ω) than controls (2814 Ω) (P<.0001). Baseline mucosal impedance measured during HRIM and MII-pH correlated (r=0.59, P<.0001). High-resolution esophageal manometry baseline impedance had high diagnostic accuracy for GERD, with an area under the curve (AUC) of 0.931 on receiver operating characteristics (ROC) analysis. A HRIM baseline impedance threshold of 1582 Ω had a sensitivity of 86.2% and specificity of 88.5% for GERD, with a positive predictive value of 89.3% and negative predictive value of 85.2%. Baseline impedance measured during HRIM can reliably discriminate GERD patients with at least moderate esophageal acid exposure from controls. This diagnostic tool may represent an accurate, cost-effective, and less invasive test for GERD. © 2016 John Wiley & Sons Ltd.

  9. Validity of a self-administered diet history questionnaire for assessment of sodium and potassium: comparison with single 24-hour urinary excretion.

    PubMed

    Sasaki, S; Yanagibori, R; Amano, K

    1998-06-01

    We developed a self-administered diet history questionnaire (DHQ) for use in prevention and control of cardiovascular diseases and cancer, and validated it by comparison with single 24-h urinary excretion of sodium (Na) and potassium (K). The subjects were 154 male and 69 female freshmen university students. Mean intakes (mmol/day) assessed by DHQ and the urinary excretion of Na were 196 and 165 respectively for men and 179 and 136 respectively for women. Those of K were 61.5 and 43.9 respectively for men and 56.8 and 41.6 respectively for women. The ratios of urinary excretion to dietary intake of Na were 0.97 in men and 0.84 in women. Those of K were 0.78 in men and 0.80 in women. The results for both Na and K were reasonable, except for Na in men. When Pearson correlation was examined between dietary and urinary Na and K, no significant correlations for Na in men (r=0.14) or women (r=0.23, p=0.06), or significant correlations for K in men (r=0.34, p<0.001) or women (r=0.40, p<0.001) were observed. The results suggest a reasonable ability to estimate a subject mean for Na in women, K in both sexes, and individual level for K for both sexes. The validity for individual level for Na intake is not conclusive because the duration of urine collection was too short.

  10. Adolescent substance use screening in primary care: validity of computer self-administered vs. clinician-administered screening

    PubMed Central

    Harris, Sion Kim; Knight, John R; Van Hook, Shari; Sherritt, Lon; Brooks, Traci; Kulig, John W; Nordt, Christina; Saitz, Richard

    2015-01-01

    Background Computer self-administration may help busy pediatricians’ offices increase adolescent substance use screening rates efficiently and effectively, if proven to yield valid responses. The CRAFFT screening protocol for adolescents has demonstrated validity as an interview, but a computer self-entry approach needs validity testing. The aim of this study was to evaluate the criterion validity and time efficiency of a computerized adolescent substance use screening protocol implemented by self-administration or clinician-administration. Methods 12- to 17-year-old patients coming for routine care at three primary care clinics completed the computerized screen by both self-administration and clinician-administration during their visit. To account for order effects, we randomly assigned participants to self-administer the screen either before or after seeing their clinician. Both were conducted using a tablet computer and included identical items (any past-12-month use of tobacco, alcohol, drugs; past-3-months frequency of each; and six CRAFFT items). The criterion measure for substance use was the Timeline Follow-Back, and for alcohol/drug use disorder, the Adolescent Diagnostic Interview, both conducted by confidential research assistant-interview after the visit. Tobacco dependence risk was assessed with the self-administered Hooked on Nicotine Checklist (HONC). Analyses accounted for the multi-site cluster sampling design. Results Among 136 participants, mean age was 15.0±1.5 yrs, 54% were girls, 53% were Black or Hispanic, and 67% had ≥3 prior visits with their clinician. Twenty-seven percent reported any substance use (including tobacco) in the past 12 months, 7% met criteria for an alcohol or cannabis use disorder, and 4% were HONC-positive. Sensitivity/specificity of the screener were high for detecting past-12-month use or disorder and did not differ between computer and clinician. Mean completion time was 49 seconds (95%CI 44-54) for computer and 74

  11. Validation of FLARE-RA, a Self-Administered Tool to Detect Recent or Current Rheumatoid Arthritis Flare.

    PubMed

    Fautrel, Bruno; Morel, Jacques; Berthelot, Jean-Marie; Constantin, Arnaud; De Bandt, Michel; Gaudin, Philippe; Maillefert, Jean-Francis; Meyer, Olivier; Pham, Thao; Saraux, Alain; Solau-Gervais, Elisabeth; Vittecoq, Olivier; Wendling, Daniel; Erpelding, Marie-Line; Guillemin, Francis

    2017-02-01

    To validate the measurement properties and the detection performance of the FLARE-RA questionnaire in a longitudinal prospective study. To validate the FLARE-RA self-administered questionnaire, we conducted a prospective trial in rheumatoid arthritis (RA) patients to document: 1) content and construct validity by factor analysis, convergent validity by Pearson's correlation with routine assessment of patient index data (Routine Assessment of Patient Index Data 3 [RAPID-3] questionnaire), RA Impact of Disease (RAID) score, Disease Activity Score in 28 joints (DAS28), and Health Assessment Questionnaire (HAQ), 2) reliability (intraclass correlation coefficient [ICC] and Bland-Altman plot), and 3) feasibility of use. Patients were examined and questionnaires were collected at baseline and 3 months, and every week in between for RAPID-3. We recruited 138 patients from 13 centers: 81.9% women, mean age 57.4 years, mean DAS28 2.9, mean C-reactive protein level 6.2 mg/liter, 84.4% rheumatoid factor positive, 78.0% anti-citrullinated protein antibody positive, and 78.8% with erosive disease. At baseline, the mean ± SD FLARE-RA score was 2.3 ± 2.3. The content and construct validity of FLARE-RA was good. A substantial floor effect, but no ceiling effect, was observed. Principal components analysis revealed 1 domain disentangled in 2 subdomains: physical and emotional. The FLARE-RA total score was correlated with the DAS28 (r = 0.63, P < 0.001), RAID (r = 0.80, P < 0.001), RAPID-3 (r = 0.77, P < 0.001), and HAQ (r = 0.53, P < 0.001). The ICC for reliability was 0.94 (95% confidence interval 0.92-0.96). The FLARE-RA self-administered questionnaire represents a valid and valuable instrument to detect RA flare between visits to the physician. © 2016, American College of Rheumatology.

  12. Ultrasonic vocalization in rats self-administering heroin and cocaine in different settings: evidence of substance-specific interactions between drug and setting.

    PubMed

    Avvisati, Riccardo; Contu, Laura; Stendardo, Emiliana; Michetti, Caterina; Montanari, Christian; Scattoni, Maria Luisa; Badiani, Aldo

    2016-04-01

    Clinical and preclinical evidence indicates that the setting of drug use affects drug reward in a substance-specific manner. Heroin and cocaine co-abusers, for example, indicated distinct settings for the two drugs: heroin being used preferentially at home and cocaine preferentially outside the home. Similar results were obtained in rats that were given the opportunity to self-administer intravenously both heroin and cocaine. The goal of the present study was to investigate the possibility that the positive affective state induced by cocaine is enhanced when the drug is taken at home relative to a non-home environment, and vice versa for heroin. To test this hypothesis, we trained male rats to self-administer both heroin and cocaine on alternate days and simultaneously recorded the emission of ultrasonic vocalizations (USVs), as it has been reported that rats emit 50-kHz USVs when exposed to rewarding stimuli, suggesting that these USVs reflect positive affective states. We found that Non-Resident rats emitted more 50-kHz USVs when they self-administered cocaine than when self-administered heroin whereas Resident rats emitted more 50-kHz USVs when self-administering heroin than when self-administering cocaine. Differences in USVs in Non-Resident rats were more pronounced during the first self-administration (SA) session, when the SA chambers were completely novel to them. In contrast, the differences in USVs in Resident rats were more pronounced during the last SA sessions. These findings indicate that the setting of drug taking exerts a substance-specific influence on the ability of drugs to induce positive affective states.

  13. A self-administered Timeline Followback to measure variations in underage drinkers' alcohol intake and binge drinking.

    PubMed

    Collins, R Lorraine; Kashdan, Todd B; Koutsky, James R; Morsheimer, Elizabeth T; Vetter, Charlene J

    2008-01-01

    Underage drinkers typically have not developed regular patterns of drinking and so are likely to exhibit situational variation in alcohol intake, including binge drinking. Information about such variation is not well captured by quantity/frequency (QF) measures, which require that drinkers blend information over time to derive a representative estimate of "typical" drinking. The Timeline Followback (TLFB) method is designed to retrospectively capture situational variations in drinking during a specific period of time. We compared our newly-developed Self-administered TLFB (STLFB) measure to a QF measure for reporting alcohol intake. Our sample of 429 (men=204; women=225) underage (i.e., age 18-20 years) drinkers completed the two drinking measures and reported on alcohol problems. The STLFB and QF measures converged in assessing typical daily intake, but the STLFB provided more information about situational variations in alcohol use and better identification of regular versus intermittent binge drinkers. Regular binge drinkers reported more alcohol problems. The STLFB is an easy-to-administer measure of variations in alcohol intake, which can be useful for understanding drinking behavior.

  14. Evaluation of Sexual Function and Its Contributing Factors in Men With Spinal Cord Injury Using a Self-Administered Questionnaire.

    PubMed

    Khak, Mohammad; Hassanijirdehi, Marzieh; Afshari-Mirak, Sohrab; Holakouie-Naieni, Kourosh; Saadat, Soheil; Taheri, Taher; Rahimi-Movaghar, Vafa

    2016-01-01

    Sexual activity is an important aspect of life in patients with spinal cord injury (SCI), rated as one of the top priorities for recovery of function. This study was conducted to establish an understanding of the severity of erectile dysfunction (ED), a major component of male sexual activity, and its correlates in patients with SCI in our community. In a cross-sectional study, 37 male veterans with SCI admitted for regular follow-up at our center were recruited. Demographic and SCI-related descriptive information was gathered through a self-administered questionnaire. Sexual Health Inventory for Men was used to assess the presence and severity of ED. Euro Quality of Life questionnaire and General Health Questionnaire (GHQ-12) were also administered. The mean age of the participants was 45.7 ± 6.5 years with injury duration of 24.7 ± 6.2 years. Mean GHQ-12 score of 3.65 ± 3.38 and mean Sexual Health Inventory for Men score of 11.57 ± 5.28 were measured. All participants had ED, and 27% were suffering from severe ED. Sleep deprivation, worse GHQ-12 score, and hypertension were significantly associated with higher risk of much severe ED (p < .05). In conclusion, ED is a common problem in veterans with SCI and is inversely associated with their general health status.

  15. Self-administered chest physiotherapy in cystic fibrosis: a comparative study of high-pressure PEP and autogenic drainage.

    PubMed

    Pfleger, A; Theissl, B; Oberwaldner, B; Zach, M S

    1992-01-01

    Fourteen patients with cystic fibrosis were trained in 2 self-administered chest physiotherapy (PT) techniques: high-pressure PEP-mask physiotherapy (PEP), and autogenic drainage (AD). They then visited the clinic on 5 consecutive days, and, in a random order, performed 1 of the following: PEP, AD, PEP followed by AD (PEP-AD), AD followed by PEP (AD-PEP), and, no PT except for spontaneous coughing. Lung function was measured repeatedly before, during, and after PT; time needed for and sputum produced by each form of PT was recorded. PEP produced the highest amount of sputum, followed by PEP-AD, AD-PEP, and AD; all 4 forms of PT produced significantly more sputum than coughing. Lung function improved significantly after PEP, AD, and PEP-AD, but PEP-induced changes did not exceed those after AD. Within the investigated group, the PEP-induced lung function improvement per milliliter of sputum produced was significantly lower for those patients with airway hyperreactivity. The fact that the highest sputum yield with PEP was not reflected in higher PEP-effected lung function changes might thus be explained by PEP-induced bronchospasm in patients with airway hyperreactivity. PEP clears more sputum than AD or combined techniques; patients with airway hyperreactivity, however, should either prefer AD or should take a bronchodilator premedication before PEP.

  16. Therapist-assisted, self-administered bibliotherapy to enhance parental competence: short- and long-term effects.

    PubMed

    Hahlweg, Kurt; Heinrichs, Nina; Kuschel, Annett; Feldmann, Marit

    2008-09-01

    The efficacy of bibliotherapy has primarily been investigated in anxiety disorders, depression, or substance dependence. The efficacy of self-help books to increase parenting competence was only investigated in a few studies despite their broad dissemination in public. The aims of the study were to investigate the short- and long-term efficacy of a therapist assisted version of the Triple P self-help booklet (Sanders, Markie-Dadds, & Turner, 2003) for families with preschool-age children in Germany. Sixty-nine families were randomly assigned to either a therapist-assisted self-administered parent training (SDPT+T) or to a waitlist control group (WL). Parents in the SDPT+T received the 10 chapter self-help book and an accompanying video. A Triple P facilitator offered seven telephone consultations which aimed to support parents in skill implementation. After the post test, the WL parents were also offered the intervention. A follow-up assessment was conducted six months after post. Compared to waitlist controls, SDPT+T mothers reported significant short- and long-term reductions in child behavior problems as well as in dysfunctional parenting practices. Fathers reported only marginal changes. The study adds further empirical support of parenting self-help materials.

  17. Impulse-Control Disorders in a College Sample: Results From the Self-Administered Minnesota Impulse Disorders Interview (MIDI)

    PubMed Central

    Grant, Jon E.

    2010-01-01

    Objective: This study sought to examine the prevalence rates of and gender differences among impulse-control disorders in a college sample. Method: During the fall semester of 2006, 791 college students from 2 private colleges in the Midwest completed a self-administered, modified version of the Minnesota Impulse Disorders Interview to assess lifetime rates of DSM-IV-TR–diagnosed impulse-control disorders. Participation was voluntary and anonymous. Results: The mean age of the sample was 20.0 ± 1.25 years, with females comprising 67.9% of the respondents. Of the individuals, 10.4% (n = 82) met criteria for at least 1 lifetime impulse-control disorder. The most common disorders were trichotillomania (3.91%) and compulsive sexual behavior (3.66%). Kleptomania was the least common (0.38%). Males were significantly more likely to screen positive for pathological gambling (P = .003) and compulsive sexual behavior (P = .002). Females were more likely to have compulsive buying (P = .033). Conclusions: Impulse-control disorders appear to be common among college students. The high rates indicate that these disorders may be incipient during late adolescence and early adulthood and should be addressed prior to onset of clinical versions of the impulse-control disorder. PMID:20694115

  18. Carotenoid, tocopherol, and fatty acid biomarkers and dietary intake estimated by using a brief self-administered diet history questionnaire for older Japanese children and adolescents.

    PubMed

    Okuda, Masayuki; Sasaki, Satoshi; Bando, Noriko; Hashimoto, Michio; Kunitsugu, Ichiro; Sugiyama, Shinichi; Terao, Junji; Hobara, Tatsuya

    2009-06-01

    We investigated the association between nutrient biomarkers and dietary intake estimated using a brief self-administered dietary history questionnaire (BDHQ) for Japanese children and adolescents. Blood samples were collected from 398 subjects (5th graders of elementary school aged 10-11 y, and 2nd graders of secondary schools aged 13-14 y) randomly selected from among students in Shunan City, Japan, who were then required to answer two questionnaires. Spearman correlations were calculated between dietary intake and the corresponding biomarkers (serum carotenoids, tocopherols, and erythrocyte fatty acids). Correlations with beta-carotene and beta-cryptoxanthin were significant in the 13- and 14-y age group (r=0.220-0.333, p<0.030) and the 10- and 11-y age subgroup who answered the questionnaire with assistance (r=0.295-0.299, respectively, p=0.006). Consumption of green-yellow vegetables and fruits was significantly correlated with beta-carotene and beta-cryptoxanthin levels (r=0.205-0.341, p<0.047). In the 13- and 14-y age group, correlations with eicosapentaenoic and docosahexaenoic acids were between 0.215 and 0.473 (p<0.040). Total seafood intake was significantly correlated with marine n-3 polyunsaturated fatty acids (PUFAs; r=0.239-0.420, p<0.023). In the 10- and 11-y age subgroup who completed the questionnaire with assistance, seafood intake was significantly correlated with marine n-3 PUFAs (r=0.239-0.243, p<0.032). In conclusion, dietary intake assessed using the BDHQ reflects the corresponding biomarkers for 13- and 14-y-olds; however, when used for elementary school children, caution is necessary in interpreting the results.

  19. Validity and reproducibility of folate and vitamin B(12) intakes estimated from a self-administered diet history questionnaire in Japanese pregnant women.

    PubMed

    Shiraishi, Mie; Haruna, Megumi; Matsuzaki, Masayo; Murayama, Ryoko; Sasaki, Satoshi; Murashima, Sachiyo

    2012-03-15

    No validated dietary questionnaire for assessing folate and vitamin B(12) intakes during pregnancy is available in Japan. We evaluated the validity and reproducibility of intakes of folate and vitamin B(12) estimated from a self-administered diet history questionnaire (DHQ) in Japanese pregnant women. A sample of 167 healthy subjects with singleton pregnancies in the second trimester was recruited at a private obstetric hospital in metropolitan Tokyo from June to October 2008 (n = 76), and at a university hospital in Tokyo from June 2010 to June 2011 (n = 91). The dietary intakes of folate and vitamin B(12) were assessed using the DHQ. The serum concentrations of folate and vitamin B(12) were measured as reference values in the validation study. To assess the reproducibility of the results, 58 pregnant women completed the DHQ twice within 4-5 week interval. Significantly positive correlations were found between energy-adjusted intakes and serum concentrations of folate and vitamin B(12) (r = 0.286, p < 0.001 and r = 0.222, p = 0.004, respectively). After excluding the participants with nausea (n = 121), the correlation coefficient for vitamin B(12) increased to 0.313 (p = 0.001). When participants were classified into quintiles based on intakes and serum concentrations of folate and vitamin B(12), approximately 60% were classified in the same or adjacent quintile. The intraclass correlation coefficients of the two-time DHQ were 0.725 for folate and 0.512 for vitamin B(12). The present study indicated that the DHQ had acceptable validity and reproducibility for assessing folate and vitamin B(12) intakes in Japanese pregnant women.

  20. An alginate-antacid formulation (Gaviscon Double Action Liquid®) can eliminate the postprandial “acid pocket” in symptomatic GERD patients

    PubMed Central

    Kwiatek, Monika A.; Roman, Sabine; Fareeduddin, Anita; Pandolfino, John E.; Kahrilas, Peter J.

    2013-01-01

    SUMMARY BACKGROUND Recently, an “acid pocket” has been described in the proximal stomach, particularly evident postprandially in GERD patients, when heartburn is common. By creating a low density gel “raft” that floats on top of gastric contents, alginate-antacid formulations may neutralize the “acid pocket”. AIM We hypothesized that the postprandial “acid pocket” can be displaced distal to the esophagogastric junction (EGJ) by an alginate-antacid formulation. METHODS The “acid pocket” was studied in ten symptomatic GERD patients. Measurements were made using concurrent stepwise pH pull-throughs, high resolution manometry, and fluoroscopy in a semi-recumbent posture. Each subject was studied in three conditions: fasted, 20 min after consuming a high-fat meal and 20 min later after a 20 ml oral dose of an alginate-antacid formulation (Gaviscon Double Action Liquid®). The relative position of pH transition points (pH > 4) to the EGJ high-pressure zone was analyzed. RESULTS Most patients (8/10) exhibited an acidified segment extending from the proximal stomach into the EGJ when fasted that persisted postprandially. Gaviscon neutralized the acidified segment in 6 of the 8 subjects shifting the pH transition point significantly away from the EGJ. The length and pressure of the EGJ high-pressure zone were minimally affected. CONCLUSIONS Gaviscon can eliminate the “acid pocket” in GERD patients. Considering that EGJ length was unchanged throughout, this effect was likely attributable to the alginate “raft” displacing gastric contents away from the EGJ. These findings suggest the alginate-antacid formulation to be a well-targeted postprandial GERD therapy. PMID:21535446

  1. Validation of the automated self-administered 24-hour dietary recall for children (ASA24-Kids) among 9- to 11-year-old youth

    USDA-ARS?s Scientific Manuscript database

    Our purpose was to validate ASA24-Kids-2012, a self-administered web-based 24-hour dietary recall (24hDR) among 9- to 11-year-old children. Sixty-nine children in two sites participated in the study. In one site, trained staff observed and recorded types and portions of foods and drinks consumed by ...

  2. Self-Administered Cued Naming Therapy: A Single-Participant Investigation of a Computer-Based Therapy Program Replicated in Four Cases

    ERIC Educational Resources Information Center

    Ramsberger, Gail; Marie, Basem

    2007-01-01

    Purpose: This study examined the benefits of a self-administered, clinician-guided, computer-based, cued naming therapy. Results of intense and nonintense treatment schedules were compared. Method: A single-participant design with multiple baselines across behaviors and varied treatment intensity for 2 trained lists was replicated over 4…

  3. Alpha7 Nicotinic Acetylcholine Receptors Modulate Motivation to Self-Administer Nicotine: Implications for Smoking and Schizophrenia

    PubMed Central

    Brunzell, Darlene H; McIntosh, J Michael

    2012-01-01

    Individuals diagnosed with schizophrenia have an exceptionally high risk for tobacco dependence. Postmortem studies show that these individuals have significant reductions in α7 nicotinic acetylcholine receptors (nAChRs) in several brain areas. Decreased α7-mediated function might not only be linked to schizophrenia but also to increased tobacco consumption. The purpose of this study was to determine whether pharmacological blockade of α7 nAChRs would increase motivation of rats to intravenously self-administer nicotine (NIC) during a progressive ratio schedule of reinforcement (PR). Before PR, rats received local infusions of 0, 10, or 20 pmol of a selective α7 nAChR antagonist, α-conotoxin ArIB [V11L,V16D] (ArIB) into the nucleus accumbens (NAc) shell or the anterior cingulate cortex, brain areas that contribute to motivation for drug reward. We additionally sought to determine whether local infusion of 0, 10, or 40 nmol of a selective α7 nAChR agonist, PNU 282987, into these brain areas would decrease motivation for NIC use. Infusion of ArIB into the NAc shell and anterior cingulate cortex resulted in a significant increase in active lever pressing, breakpoints, and NIC intake, suggesting that a decrease in α7 nAChR function increases motivation to work for NIC. In contrast, PNU 282987 infusion resulted in reductions in these measures when administered into the NAc shell, but had no effect after administration into the anterior cingulate cortex. These data identify reduction of α7 nAChR function as a potential mechanism for elevated tobacco use in schizophrenia and also identify activation of α7 nAChRs as a potential strategy for tobacco cessation therapy. PMID:22169946

  4. Design of a self-administered online food frequency questionnaire (FFQ) to assess dietary intake among university population.

    PubMed

    González Carrascosa, R; Bayo Montó, J L; Meneu Barreira, T; García Segovia, P; Martínez-Monzó, J

    2011-01-01

    To introduce and describe a new tool called UPV-FFQ to evaluate dietary intake of the university population. The new tool consists principally in a self-administered online food frequency questionnaire (FFQ). The tool UPV-FFQ has been developed by means of web pages applying the technology ASP.NET 2.0 and using the database SQL Server 2005 as support. To develop the FFQ has been used as model the paper and pencil FFQ called "Dieta, salud y antropometría en la población universitaria". The tool has three parts: (1) a homepage, (2) a general questionnaire and (3) a FFQ. The FFQ has a closed list of 84 food items commonly consumed in Valencia region. The respondents has to indicate the food items that they consume (2 possible options), the frequency of consumption (9 response options) and the quantity consumed (7 response options). The UPV-FFQ has approximately 250 color photographs that represents to three portion sizes. The photographs are useful to help the respondents to choose the portion sizes that more adjusts to their habitual portions. The new tool provides quantitative information of the habitual intake of 31 nutritional parameters and provides qualitative information of the general questionnaire. A pilot study was done for a total of 57 respondents. The media time spend to fill in was 15 minutes. The pilot study concluded that the questionnaire was ease-of-use, low cost and time-effectiveness questionnaire. The format and the sequence of the questions were easily understood.

  5. Assessing medication adherence in inflammatory bowel diseases. A comparison between a self-administered scale and a pharmacy refill index.

    PubMed

    de Castro, María Luisa; Sanromán, Luciano; Martín, Alicia; Figueira, Montserrat; Martínez, Noemi; Hernández, Vicent; Del Campo, Victor; Pineda, Juan R; Martínez-Cadilla, Jesús; Pereira, Santos; Rodríguez Prada, José Ignacio

    2017-08-01

    Medication non-adherence in inflammatory bowel disease (IBD) has a negative impact on disease outcome. Different tools have been proposed to assess non-adherence. We aimed to compare a self-administered scale and a pharmacy refill index as a reliable measure of medication adherence and to determine what factors are related to adherence. Consecutive non-active IBD outpatients were asked to fill in the self-reported Morisky Medication Adherence Scale (MMAS-8) and the Beliefs about Medication Questionnaire (BMQ). Pharmacy refill data were reviewed from the previous three or six months and the medication possession ratio (MPR) was calculated. Non-adherence was defined as MMAS-8 scores < 6 or MPR < 0.8. Two-hundred and three patients were enrolled (60% ulcerative colitis, 40% Crohn's disease); 51% were men, and the mean age was 46.3 (14) years. Seventy-four per cent of patients were on monotherapy and 26% on combination therapy; altogether, 65% received mesalazine, 46% thiopurines and 16% anti-tumor necrosis factor alfa. Non-adherence rate assessed by MPR was 37% and 22.4% by MMAS-8. Receiver operator curve analysis using a MMAS-8 cut-off of six gave an area under the curve of 0.6 (95% CI 0.5-0.7), p = 0.001. This score had an 85% sensitivity and 34% specificity to predict medication non-adherence, with negative and positive predictive values of 57% and 70% respectively. High scores in the BMQ potential for harm of medication were significantly associated with MPR non-adherence (p = 0.01). The accuracy of MMAS-8 to identify medication non-adherence in inactive IBD outpatients in our setting is poor due to a low specificity and a negative predictive value. Psychosocial factors such as beliefs about medication seem to be related to IBD non-adherence.

  6. Development of the IBD Disk: A Visual Self-administered Tool for Assessing Disability in Inflammatory Bowel Diseases

    PubMed Central

    Louis, Edouard; Beaugerie, Laurent; Bossuyt, Peter; Bouguen, Guillaume; Bourreille, Arnaud; Ferrante, Marc; Franchimont, Denis; Frost, Karen; Hebuterne, Xavier; Marshall, John K.; O'Shea, Ciara; Rosenfeld, Greg; Williams, Chadwick; Peyrin-Biroulet, Laurent

    2017-01-01

    Background: The Inflammatory bowel disease (IBD) Disability Index is a validated tool that evaluates functional status; however, it is used mainly in the clinical trial setting. We describe the use of an iterative Delphi consensus process to develop the IBD Disk—a shortened, self-administered adaption of the validated IBD Disability Index—to give immediate visual representation of patient-reported IBD-related disability. Methods: In the preparatory phase, the IBD CONNECT group (30 health care professionals) ranked IBD Disability Index items in the perceived order of importance. The Steering Committee then selected 10 items from the IBD Disability Index to take forward for inclusion in the IBD Disk. In the consensus phase, the items were refined and agreed by the IBD Disk Working Group (14 gastroenterologists) using an online iterative Delphi consensus process. Members could also suggest new element(s) or recommend changes to included elements. The final items for the IBD Disk were agreed in February 2016. Results: After 4 rounds of voting, the following 10 items were agreed for inclusion in the IBD Disk: abdominal pain, body image, education and work, emotions, energy, interpersonal interactions, joint pain, regulating defecation, sexual functions, and sleep. All elements, except sexual functions, were included in the validated IBD Disability Index. Conclusions: The IBD Disk has the potential to be a valuable tool for use at a clinical visit. It can facilitate assessment of inflammatory bowel disease-related disability relevant to both patients and physicians, discussion on specific disability-related issues, and tracking changes in disease burden over time. PMID:28146002

  7. Validity and Reliability of a Self-administered Food Frequency Questionnaire to Assess Vitamin K Intake in Korean Adults

    PubMed Central

    Kim, Eunsu; Kim, Misung

    2016-01-01

    This study was conducted to validate a food frequency questionnaire (FFQ) to assess vitamin K intake in clinical and research settings based on data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). We collected a subset of data on informative food items using the 24-hour recall method from adults aged 19 to 64 years from KNHANES V. The cumulative percent contribution and cumulative multiple regression coefficients for vitamin K intake from each food were computed. Twenty-five foods items were selected for the FFQ to assess vitamin K intake. The FFQ was validated against intakes derived from a 5-day food record (5DR) (n = 48). To assess the reliability of the FFQ, participants completed the self-administered FFQ (FFQ1) and a second FFQ (FFQ2) after a 6-month period (n = 54). Data were analyzed using Pearson's correlation coefficients, the cross-classification method, and Bland-Altman plots. Mean intakes were similar for vitamin K between the FFQ and dietary records, with significant correlations observed (r = 0.652), and cross-classification analyses demonstrated no major misclassification of participants into intake quartiles. Bland-Altman plots showed no serious systematic bias between the administrations of the two dietary assessment methods over the range of mean intakes. FFQ reliability was high, with a Pearson's correlation coefficient of 0.560. This pilot study shows promising validation and reliability evidence for the use of this FFQ, which is focused on vitamin K intake in adults, as an efficient screening tool in clinical and research settings. PMID:27482519

  8. Reliability and validity of a self-administered tool for online neuropsychological testing: The Amsterdam Cognition Scan.

    PubMed

    Feenstra, Heleen E M; Murre, Jaap M J; Vermeulen, Ivar E; Kieffer, Jacobien M; Schagen, Sanne B

    2017-07-03

    To facilitate large-scale assessment of a variety of cognitive abilities in clinical studies, we developed a self-administered online neuropsychological test battery: the Amsterdam Cognition Scan (ACS). The current studies evaluate in a group of adult cancer patients: test-retest reliability of the ACS and the influence of test setting (home or hospital), and the relationship between our online and a traditional test battery (concurrent validity). Test-retest reliability was studied in 96 cancer patients (57 female; Mage = 51.8 years) who completed the ACS twice. Intraclass correlation coefficients (ICCs) were used to assess consistency over time. The test setting was counterbalanced between home and hospital; influence on test performance was assessed by repeated measures analyses of variance. Concurrent validity was studied in 201 cancer patients (112 female; Mage = 53.5 years) who completed both the online and an equivalent traditional neuropsychological test battery. Spearman or Pearson correlations were used to assess consistency between online and traditional tests. ICCs of the online tests ranged from .29 to .76, with an ICC of .78 for the ACS total score. These correlations are generally comparable with the test-retest correlations of the traditional tests as reported in the literature. Correlating online and traditional test scores, we observed medium to large concurrent validity (r/ρ = .42 to .70; total score r = .78), except for a visuospatial memory test (ρ = .36). Correlations were affected-as expected-by design differences between online tests and their offline counterparts. Although development and optimization of the ACS is an ongoing process, and reliability can be optimized for several tests, our results indicate that it is a highly usable tool to obtain (online) measures of various cognitive abilities. The ACS is expected to facilitate efficient gathering of data on cognitive functioning in the near future.

  9. Self-Administered Lidocaine Gel for Pain Control With First-Trimester Surgical Abortion: A Randomized Controlled Trial.

    PubMed

    Conti, Jennifer A; Lerma, Klaira; Shaw, Kate A; Blumenthal, Paul D

    2016-08-01

    To compare pain control at various time points during first-trimester surgical abortion using a patient-administered lidocaine gel compared with a traditional lidocaine paracervical block. We conducted a randomized controlled trial of women undergoing surgical abortion at less than 12 weeks of gestation in an outpatient setting. The primary outcome was pain at cervical dilation as measured on a 100-mm visual analog scale. A sample size of 142 participants was planned to detect a 15-mm or greater difference on the 100-mm visual analog scale with 90% power and a significance level of .025, adding 10% for participant dropout and protocol violations. Participants received either 12 mL of a 1% lidocaine paracervical block or 20 mL of a self-administered, 2% lidocaine gel 20-30 minutes before procedure initiation. Secondary outcomes included anticipated pain, baseline pain, pain with speculum and tenaculum placement, pain after suction aspiration, and pain 30-45 minutes postoperatively. From April to October 2015, a total of 142 women were enrolled (68 in the paracervical block group, 69 in the gel group, and five not analyzed as a result of participant withdrawal). Sociodemographic characteristics were similar between groups. The mean pain score with cervical dilation was 60 mm (95% confidence interval [CI] 54-66) in the paracervical block group and 64 mm (95% CI 59-69) in the gel group (P=.3). There was no significant difference between mean pain scores at any time points measured. Self-administration of lidocaine gel before first-trimester surgical abortion is noninferior to a traditional paracervical lidocaine block and should be considered as an alternative, noninvasive approach to pain control for first-trimester surgical abortion. ClinicalTrials.gov, https://clinicaltrials.gov, NCT02447029.

  10. Self-administered outpatient parenteral antimicrobial therapy (S-OPAT) for infective endocarditis: a safe and effective model.

    PubMed

    Pajarón, Marcos; Fernández-Miera, Manuel F; Allende, Iciar; Arnaiz, Ana M; Gutiérrez-Cuadra, Manuel; Cobo-Belaustegui, Manuel; Armiñanzas, Carlos; de Berrazueta, Jose R; Fariñas, Maria C; Sanroma, Pedro

    2015-03-01

    The safety and efficacy of treatment of infectious endocarditis (IE) was evaluated within a program of hospital-in-home (HIH) based on self-administered outpatient parenteral antimicrobial therapy (S-OPAT). IE episodes (n=48 in 45 patients; 71% middle-aged males) were recruited into the HIH program between 1998 and 2012. Following treatment stabilization at the hospital they returned home for HIH in which a physician and/or a nurse supervised the S-OPAT. Safety and efficacy were evaluated as mortality, re-occurrence, and unexpected re-admission to hospital. Of the episodes of IE, 83.3% had comorbidities with a mean score of 2.3 on the Charlson index and 1.5 on the Profund index; 60.4% had pre-existing valve disease (58.6% having had surgical intervention); 8.3% of patients had suffered a previous IE episode; 62.5% of all episodes affected a native valve; 45.8% being mitral; 70.8% of infection derived from the community. In 75% of the episodes there was micro-organism growth, of which 83.3% were Gram positive. Overall duration of antibiotic treatment was 4.8 weeks; 60.4% of this time corresponding to HIH. Re-admission occurred in 12.5% of episodes of which 33.3% returned to HIH to complete the S-OPAT. No deaths occurred during HIH. One year after discharge, 2 patients had recurrence and 5 patients died, in 2 of whom previous IE as cause-of-death could not be excluded. In conclusion, the S-OPAT schedule of hospital-in-home is safe and efficacious in selected patients with IE.

  11. Role Preferences of People with Multiple Sclerosis: Image-Revised, Computerized Self-Administered Version of the Control Preference Scale

    PubMed Central

    Solari, Alessandra; Giordano, Andrea; Kasper, Jurgen; Drulovic, Jelena; van Nunen, An; Vahter, Liina; Viala, Frederique; Pietrolongo, Erika; Pugliatti, Maura; Antozzi, Carlo; Radice, Davide; Köpke, Sascha; Heesen, Christoph

    2013-01-01

    Background The Control Preference Scale (CPS) is the most frequently used measure of patients’ preferred roles in treatment decisions. We revised the original CPS and developed a new computerized patient self-administered version (eCPS). We used the eCPS to assess role preferences, and their determinants, in Italian and German people with multiple sclerosis (MS). Methods New cartoons were produced, based on MS health professional and patient input/feedback and previous findings, and pilot tested on 26 Italian and German MS patients. eCPS acceptability and reliability (weighted kappa statistic, wK) in comparison to the original tool, was determined in 92 MS patients who received both CPS versions in random order. Results The new cartoons were well accepted and easily interpreted by patients, who reported they based their choices mainly on the text and considered the images of secondary importance. eCPS reliability was moderate (wK 0.53, 95% confidence interval [CI] 0.40–0.65) and similar to the test-retest reliability of face-to-face administration assessed in a previous publication (wK 0.65, 95% CI 0.45–0.81). Higher education (odds ratio [OR] 3.74, 95% CI 1.00–14.05) and German nationality (OR 10.30, 95% CI 3.10–34.15) were associated with preference for an active role in the logistic model. Conclusions The newly devised eCPS was well received and considered easy to use by MS patients. Reliability was in line with that of the original version. Role preference appears affected by cultural characteristics and (borderline statistical significance) education. PMID:23823627

  12. Does a deadline improve men's participation in self-administered health surveys? A randomized controlled trial in general practice.

    PubMed

    Gattellari, M; Ward, J E

    2004-12-01

    Self-administered questionnaires are commonly used in experimental studies to elicit quality of life or other outcomes. Hence, achieving an acceptable level of follow-up from patients is critical to minimizing bias. Many methods for maximizing follow-up remain untested. It is also unclear what level of follow-up is required to prevent bias being introduced. We recruited 246 men from general practice surgeries in Sydney, Australia. These 246 men were randomized to receive a covering letter with their follow-up questionnaire either advising of a deadline to reply (Deadline, n = 126) or a standard letter without a deadline (No Deadline, n = 120). Four standardized reminder prompts subsequently were administered. We calculated interim response rates and the final proportion of follow-up questionnaires received according to group. We also compared scores on two main outcomes, namely, knowledge and decisional conflict at each time when reminder prompts were administered. One hundred and twelve (88.9%) men in the Deadline group returned their follow-up questionnaires compared with 102 (85.0%) men in the No Deadline group. This difference was not statistically significant [odds ratio = 1.41, 95% confidence interval (CI) = 0.67-2.99; p = 0.36]. Time to response also was not significantly affected by cover letter received (hazard ratio = 0.96; 95% CI = 0.73-1.25; p = 0.76). Results of the original RCT were similar in terms of direction and effect size at all times irrespective of when reminder prompts were administered. The addition of a deadline adds no further impact in improving response rates from male patients compared with an unspecified letter. Despite the accepted wisdom that higher response protects against bias, differences in outcomes were consistent throughout the post-test data collection period.

  13. Ethanol Is Self-Administered Into the Nucleus Accumbens Shell, But Not the Core: Evidence of Genetic Sensitivity

    PubMed Central

    Engleman, Eric A.; Ding, Zheng-Ming; Oster, Scott M.; Toalston, Jamie E.; Bell, Richard L.; Murphy, James M.; McBride, William J.; Rodd, Zachary A.

    2010-01-01

    Background A previous study indicated that selectively bred alcohol-preferring (P) rats self-administered ethanol (EtOH) directly into the posterior ventral tegmental area at lower concentrations than Wistar rats. The present study was undertaken to determine involvement of the nucleus accumbens (Acb) with EtOH reinforcement, and a relationship between genetic selection for high alcohol preference and sensitivity of the Acb to the reinforcing effects of EtOH. Methods Adult P and Wistar rats were assigned to groups that self-infused 0 to 300 mg% EtOH into the Acb shell (AcbSh) or Acb Core (AcbC). Rats were placed into 2-lever (active and inactive) operant chambers and given EtOH for the first 4 sessions (acquisition), artificial cerebro-spinal fluid (aCSF) for sessions 5 and 6 (extinction), and EtOH again in session 7 (reinstatement). Responding on the active lever produced a 100-nl injection of the infusate. Results Alcohol-preferring rats self-infused 75 to 300 mg% EtOH, whereas Wistar rats reliably self-infused 100 and 300 mg% EtOH into the AcbSh. Both P and Wistar rats reduced responding on the active lever when aCSF was substituted for EtOH, and reinstated responding in session 7 when EtOH was restored. EtOH was not self-infused into the AcbC by P or Wistar rats. Conclusions The present results indicate that the AcbSh, but not AcbC, is a neuroanatomical structure that mediates the reinforcing actions of EtOH. The data also suggest that, compared to Wistar rats, the AcbSh of P rats is more sensitive to the reinforcing effects of EtOH. PMID:19764930

  14. A Self-Administered Method of Acute Pressure Block of Sciatic Nerves for Short-Term Relief of Dental Pain: A Randomized Study

    PubMed Central

    Wang, Xiaolin; Zhao, Wanghong; Wang, Ye; Hu, Jiao; Chen, Qiu; Yu, Juncai; Wu, Bin; Huang, Rong; Gao, Jie; He, Jiman

    2014-01-01

    Objectives While stimulation of the peripheral nerves increases the pain threshold, chronic pressure stimulation of the sciatic nerve is associated with sciatica. We recently found that acute pressure block of the sciatic nerve inhibits pain. Therefore, we propose that, the pain pathology-causing pressure is chronic, not acute. Here, we report a novel self-administered method: acute pressure block of the sciatic nerves is applied by the patients themselves for short-term relief of pain from dental diseases. Design This was a randomized, single-blind study. Setting Hospital patients. Patients Patients aged 16–60 years with acute pulpitis, acute apical periodontitis, or pericoronitis of the third molar of the mandible experiencing pain ≥3 on the 11-point numerical pain rating scale. Interventions Three-minute pressure to sciatic nerves was applied by using the hands (hand pressure method) or by having the patients squat to force the thigh and shin as tightly as possible on the sandwiched sciatic nerve bundles (self-administered method). Outcomes The primary efficacy variable was the mean difference in pain scores from the baseline. Results One hundred seventy-two dental patients were randomized. The self-administered method produced significant relief from pain associated with dental diseases (P ≤ 0.001). The analgesic effect of the self-administered method was similar to that of the hand pressure method. Conclusions The self-administered method is easy to learn and can be applied at any time for pain relief. We believe that patients will benefit from this method. PMID:24400593

  15. The diagnostic value of gastroesophageal reflux disease (GERD) symptoms and detection of pepsin and bile acids in bronchoalveolar lavage fluid and exhaled breath condensate for identifying lung transplantation patients with GERD-induced aspiration.

    PubMed

    Reder, Nicholas P; Davis, Christopher S; Kovacs, Elizabeth J; Fisichella, P Marco

    2014-06-01

    Gastroesophageal reflux disease (GERD) is thought to lead to aspiration and bronchiolitis obliterans syndrome after lung transplantation. Unfortunately, the identification of patients with GERD who aspirate still lacks clear diagnostic indicators. The authors hypothesized that symptoms of GERD and detection of pepsin and bile acids in the bronchoalveolar lavage fluid (BAL) and exhaled breath condensate (EBC) are effective for identifying lung transplantation patients with GERD-induced aspiration. From November 2009 to November 2010, 85 lung transplantation patients undergoing surveillance bronchoscopy were prospectively enrolled. For these patients, self-reported symptoms of GERD were correlated with levels of pepsin and bile acids in BAL and EBC and with GERD status assessed by 24-h pH monitoring. The sensitivity and specificity of pepsin and bile acids in BAL and EBC also were compared with the presence of GERD in 24-h pH monitoring. The typical symptoms of GERD (heartburn and regurgitation) had modest sensitivity and specificity for detecting GERD and aspiration. The atypical symptoms of GERD (aspiration and bronchitis) showed better identification of aspiration as measured by detection of pepsin and bile acids in BAL. The sensitivity and specificity of pepsin in BAL compared with GERD by 24-h pH monitoring were respectively 60 and 45 %, whereas the sensitivity and specificity of bile acids in BAL were 67 and 80 %. These data indicate that the measurement of pepsin and bile acids in BAL can provide additional data for identifying lung transplantation patients at risk for GERD-induced aspiration compared with symptoms or 24-h pH monitoring alone. These results support a diagnostic role for detecting markers of aspiration in BAL, but this must be validated in larger studies.

  16. Hill procedure for recurrent GERD post-Roux-en-Y gastric bypass.

    PubMed

    Pescarus, Radu; Sharata, Ahmed M; Dunst, Christy M; Shlomovitz, Eran; Swanström, Lee L; Reavis, Kevin M

    2016-05-01

    Roux-en-Y gastric bypass (RYGB) is considered to be an optimal surgical treatment option for GERD in the morbidly obese patient. Nevertheless, a subgroup of patients suffer from recurrent or persistent GERD after their gastric bypass. Unfortunately, limited treatment options are available in these patients. Fundoplication via mobilization of the remnant stomach and radiofrequency treatment of the lower esophageal sphincter have been described with some success. Our objective is to illustrate a safe and durable surgical option in the treatment of patients with medically refractory GERD post-RYGB. After placing five trocars in the usual position for a foregut laparoscopic surgery, a lysis of adhesions and standard dissection of the hiatus is performed. The anterior and posterior vagal nerves associated phrenoesophageal tissue bundles are identified. A primary crural repair with interrupted nonabsorbable sutures is performed. Four full-length nonabsorbable sutures are placed sequentially through the anterior and posterior phrenoesophageal bundle, posterior fundus and finally through the pre-aortic fascia. The repair is calibrated on a 44 French bougie. The sutures are tied from medial to lateral in the order of their placement under endoscopic guidance. No peri-procedural complications were encountered. Standard post-antireflux surgery clinical follow-up with the patient completing a validated GERD clinical questionnaire at 1 and 6 months after the surgery demonstrated excellent GERD symptom control without any dysphagia. A pH study and EGD performed at 6 months post-Hill procedure show the absence of pathological reflux with an intact Hill mechanism. The Hill procedure is a valid treatment for the post-bariatric surgical patient with GERD in which the gastric fundus is absent or inaccessible thus eliminating standard fundoplication as a reasonable option. This also represents a safe and durable treatment of GERD in this uniquely challenging patient population.

  17. Weak peristalsis with large breaks is associated with higher acid exposure and delayed reflux clearance in the supine position in GERD patients.

    PubMed

    Ribolsi, Mentore; Balestrieri, Paola; Emerenziani, Sara; Guarino, Michele Pier Luca; Cicala, Michele

    2014-01-01

    Ineffective esophageal motility is frequently observed in gastroesophageal reflux disease (GERD) patients but its clinical relevance remains controversial. In healthy subjects and in patients with nonobstructive dysphagia, it has been demonstrated, by means of high-resolution manometry (HRM), that long breaks of esophageal peristalsis predict delayed bolus clearance. HRM and 24-h multichannel impedance-pH (MI-pH) monitoring were performed in 40 GERD patients with no evidence of hiatal hernia. Total bolus clearing time (BCT) in upright and supine position and acid exposure time (AET) were calculated. Of the 40 patients, 23 showed a pathological AET and 15 erosive reflux disease (ERD). Patients with a pathological number of large breaks were characterized by a significantly lower BCT value in the supine position and higher AET. In all, 10/15 ERD patients (67%) and 5/25 nonerosive reflux disease patients (20%) were characterized by an abnormal number of small or large breaks (P<0.05). ERD patients were characterized by significantly higher AET and BCT in the supine position. GERD patients with a pathological number of large breaks, assessed by HRM, are characterized by a significantly prolonged reflux clearance in the supine position and higher AET. ERD patients display a higher number of esophageal breaks that might explain the development of erosions.

  18. Esophageal motor dysfunction plays a key role in GERD with globus sensation--analysis of factors promoting resistance to PPI therapy.

    PubMed

    Tsutsui, Hideaki; Manabe, Noriaki; Uno, Masako; Imamura, Hiroshi; Kamada, Tomoari; Kusunoki, Hiroaki; Shiotani, Akiko; Hata, Jiro; Harada, Tamotsu; Haruma, Ken

    2012-09-01

    Patients with gastroesophageal reflux disease (GERD) also have various extra-esophageal symptoms. Laryngopharyngeal reflux disease (LPRD) is a subtype of GERD associated with globus sensation, but proton pump inhibitor (PPI) therapy achieves disappointing results. This study investigated esophageal motility in GERD patients with globus sensation who were resistant to PPI therapy. The subjects were 350 patients with globus sensation. All patients underwent both laryngoscopy and upper gastrointestinal endoscopy to exclude organic disease. After 4 weeks of treatment with rabeprazole sodium (20 mg daily), the patients were divided into PPI-responsive and PPI-resistant groups. Then we investigated esophageal motility in the PPI-resistant group by a multichannel intraluminal impedance and manometry study. A total of 119 patients (55.6%) were resistant to PPI therapy, among whom 57 patients (47.9%) had abnormal esophageal motility. They included 36 patients (66.4%) with ineffective esophageal motility, 9 patients (14.4%) with achalasia, 6 patients (9.6%) with diffuse esophageal spasm, 5 patients (8%) with nutcracker esophagus, and 1 patient (1.6%) with hypertensive lower esophageal sphincter. There were significant differences of upper esophageal sphincter pressure and esophageal body peristalsis between the patients with PPI-resistant LPRD and healthy controls matched for age and sex. Among patients with PPI-resistant LPRD, 47.9% had abnormal esophageal motility.

  19. Paper and pencil vs online self-administered food frequency questionnaire (FFQ) applied to university population: a pilot study.

    PubMed

    González Carrascosa, R; García Segovia, P; Martínez Monzó, J

    2011-01-01

    To test the reliability of dietary intake data measured with an online food frequency questionnaires (FFQ) applied to a university population by comparing the results with those from a paper and pencil version. A total of 50 students were recruited from the second-year Food Technology course at the Universitat Politècnica de València (Comunidad Valenciana, Spain) in the academic year 2008-2009. The students were between the ages of 20-32. The participants completed both presentation modes of the FFQ (paper and pencil and online) in a cross-over study with a time interval of 3-week. To study the effect of ordering of the questionnaires, participants were randomly assigned to group A (paper and pencil FFQ first) and group B (online FFQ first). Both self-administered semi-quantitative presentations of the FFQ included 84 food items divided into six groups (dairy products; eggs, meat and fish; vegetables, legumes and fruits; bread, cereals and similar; oils, fats and sweets; beverages and pre-cooked). Participants were asked how frequently and how much each food item they had consumed in the previous year. The response rate was 78% (39 students, 23% men and 77% women). For the total sample, the median dietary intakes were higher for the paper and pencil FFQ than the online version for energy (2,077 vs. 1,635 kcal/day), proteins (96 vs. 88 g/day), carbohydrates (272 vs. 211 g/day), and fat (70 vs. 58 g/day), respectively. These differences were statistically significant. However, there were not significant differences between the two presentations when the consumption by groups of food was calculated, except for "beverages and pre-cooked" group. The pilot testing showed that this online FFQ is a useful tool for estimating the intake of food groups in this university population. On the other hand, the differences found in the results of the absolute quantities of energy and nutrients intakes were not clear. These differences could be due to the problems that the

  20. Self-Administered Domiciliary tDCS Treatment for Tinnitus: A Double-Blind Sham-Controlled Study.

    PubMed

    Hyvärinen, Petteri; Mäkitie, Antti; Aarnisalo, Antti A

    2016-01-01

    Transcranial direct current stimulation (tDCS) has shown potential for providing tinnitus relief, although positive effects have usually been observed only during a short time period after treatment. In recent studies the focus has turned from one-session experiments towards multi-session treatment studies investigating long-term outcomes with double-blinded and sham-controlled study designs. Traditionally, tDCS has been administered in a clinical setting by a healthcare professional but in studies involving multiple treatment sessions, often a trade-off has to be made between sample size and the amount of labor needed to run the trial. Also, as the number of required visits to the clinic increases, the dropout rate is likely to rise proportionally.The aim of the current study was to find out if tDCS treatment for tinnitus could be patient-administered in a domiciliary setting and whether the results would be comparable to those from in-hospital treatment studies. Forty-three patients with chronic (> 6 months) tinnitus were involved in the study, and data on 35 out of these patients were included in final analysis. Patients received 20 minutes of left temporal area anodal (LTA) or bifrontal tDCS stimulation (2 mA) or sham stimulation (0.3 mA) for ten consecutive days. An overall reduction in the main outcome measure, Tinnitus Handicap Inventory (THI), was found (mean change -5.0 points, p < 0.05), but there was no significant difference between active and sham treatment outcomes. Patients found the tDCS treatment easy to administer and they all tolerated it well. In conclusion, self-administered domiciliary tDCS treatment for tinnitus was found safe and feasible and gave outcome results similar to recent randomized controlled long-term treatment trials. The results suggest better overall treatment response-as measured by THI-with domiciliary treatment than with in-hospital treatment, but this advantage is not related to the tDCS variant. The study protocol

  1. The construction of a new evaluative GERD questionnaire - methods and state of the art.

    PubMed

    Armstrong, David; Mönnikes, Hubert; Bardhan, Karna Dev; Stanghellini, Vincenzo

    2004-01-01

    Gastroesophageal reflux disease (GERD) is one of the most prevalent diseases worldwide, and it is becoming increasingly important to monitor the effect of various interventions on GERD symptoms. There can be rapid temporal changes in the severity and frequency of patients' symptoms as well as their health status and well-being, all of which could, theoretically, be monitored using diaries or questionnaires. However, current GERD monitoring instruments are not appropriate because they do not assess symptoms daily, they are not sufficiently responsive to short-term changes in health status or they are not adequately validated. To address these problems, the conceptual and psychometric requirements for a GERD symptom assessment questionnaire were identified. A dimension-based scale was designed to reduce the number of symptoms monitored on a daily basis, and the validation process was defined to produce parallel long and short forms of a scale for patients' self-assessment of their GERD symptom response to therapy. These basic principles which underlie the successful development of a new, self-assessed symptomatic reflux questionnaire (ReQuest(TM)) are also applicable to the development of validated questionnaires for daily symptom self-assessment in other disease areas. Copyright 2004 S. Karger AG, Basel.

  2. Differences between clinician- and self-administered shoulder sustained mobilization on scapular and shoulder muscle activity during shoulder abduction: A repeated-measures study on asymptomatic individuals.

    PubMed

    Ribeiro, Daniel Cury; Sole, Gisela; Venkat, Ramu; Shemmell, Jonathan

    2017-08-01

    Sustained glenohumeral postero-lateral glide administered by a clinician is commonly used in the management of patients with shoulder pain. This technique reduced shoulder muscle activity in asymptomatic individuals, but it is unknown whether a self-administered version of the mobilization leads to similar neuromuscular response. This study compared the effect of sustained shoulder mobilizations (performed by a physiotherapist) with self-administered mobilization (with a belt) on activity levels of scapular and glenohumeral shoulder muscles. Twenty-two individuals participated in this study, which had a cross-over, repeated measures design. Seven shoulder muscles (upper and lower trapezius, supraspinatus, infraspinatus, posterior deltoid, middle deltoid, and serratus anterior) were monitored using surface electromyography (SEMG) during shoulder abduction performed with a clinician-administered sustained mobilization, and with self-administered sustained mobilization. Muscle activity levels were measured prior, during and after the sustained glide was applied to the shoulder. Mixed-effect models for repeated measures were used for within- and between-condition comparisons. There was no carry-over effect. Within-condition comparisons suggest that both interventions lead to changes in scapular and shoulder muscle activity levels. No differences between clinician-administered and self-administered mobilizations at intervention and follow-up were found for the monitored muscles, with the exception of upper trapezius. In young, asymptomatic individuals, self- or clinician-administered sustained mobilizations reduced activity levels of most scapular and shoulder muscles during shoulder abduction. This effect was observed only while the sustained glides were applied to the shoulder. At the immediate follow-up, muscle activity levels were similar to baseline measurements. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. [Handling of the gastroesophageal reflux disease (GERD) during pregnancy--a review].

    PubMed

    Fill, S; Malfertheiner, M; Costa, S-D; Mönkemüller, K

    2007-12-01

    Gastroesophageal reflux disease (GERD) is common during pregnancy. The pathogenesis is a decrease in lower oesophageal sphincter pressure caused by female sex hormones, especially progesterone. The most common symptom of GERD is heartburn. Nevertheless, serious reflux complications during pregnancy are rare. In contrast to non-pregnant patients, GERD during pregnancy should be managed with a step-up algorithm beginning with lifestyle modifications and dietary changes. Antacids or sucralfate are considered the first-line on-demand drug therapy. If symptoms persist, any of the histamine-2-receptor antagonists can be used. Proton pump inhibitors are reserved for women with intractable symptoms or complicated reflux disease. Usually, heartburn during pregnancy resolves soon after delivery but little is known about the late sequelae or, respectively, an influence on subsequent pregnancies. Accordingly a prospective study (longitudinal cohort analysis) is currently underway.

  4. Development, implementation, and evaluation of a computerized self-administered diet history questionnaire for use in studies of American Indian and Alaskan native people.

    PubMed

    Slattery, Martha L; Murtaugh, Maureen A; Schumacher, Mary Catherine; Johnson, Jennifer; Edwards, Sandra; Edwards, Roger; Benson, Joan; Tom-Orme, Lillian; Lanier, Anne P

    2008-01-01

    Collection of dietary intake in epidemiologic studies involves using methods that are comprehensive yet appropriate for the population being studied. Here we describe a diet history questionnaire (DHQ) that was developed using an audio self-administered computer-assisted interview technique. The DHQ was developed for use in a cohort of American Indians and Alaskan Natives with tribal input and area-specific modules to incorporate local food availability. The DHQ includes 54 main food group questions, specific food items within the main food group, and food preparation and general eating practice questions. The questionnaire was programmed to be self-administered using a computer with a touch screen. The average time for the first 6,604 participants to complete the questionnaire was 36 minutes. Almost 100% of participants had complete DHQ data and the average number of food items selected was 70. The methods developed for collection of dietary data appear to be appropriate for the targeted population and may have usefulness for other populations where collecting dietary data in a self-administered format is desirable.

  5. Development, Implementation, and Evaluation of a Computerized Self-Administered Diet History Questionnaire for Use in Studies of American Indian and Alaskan Native People

    PubMed Central

    Slattery, Martha L.; Murtaugh, Maureen A.; Schumacher, Mary Catherine; Johnson, Jennifer; Edwards, Sandra; Edwards, Roger; Benson, Joan; Tom-Orme, Lillian; Lanier, Anne P.

    2008-01-01

    Collection of dietary intake in epidemiologic studies involves using methods that are comprehensive yet appropriate for the population being studied. Here we describe a diet history questionnaire (DHQ) that was developed using an audio self-administered computer-assisted interview technique. The DHQ was developed for use in a cohort of American Indians and Alaskan Natives with tribal input and area-specific modules to incorporate local food availability. The DHQ includes 54 main food group questions, specific food items within the main food group, and food preparation and general eating practice questions. The questionnaire was programmed to be self-administered using a computer with a touch screen. The average time for the first 6,604 participants to complete the questionnaire was 36 minutes. Almost 100% of participants had complete DHQ data and the average number of food items selected was 70. The methods developed for collection of dietary data appear to be appropriate for the targeted population and may have usefulness for other populations where collecting dietary data in a self-administered format is desirable. PMID:18155994

  6. Tailored therapy for the refractory GERD patients by combined multichannel intraluminal impedance-pH monitoring.

    PubMed

    Xiao, Yinglian; Liang, Mengya; Peng, Sui; Zhang, Ning; Chen, Minhu

    2016-02-01

    About 30% of patients with gastroesophageal reflux disease (GERD) are refractory to proton pump inhibitor (PPI). The reason for the PPI failure in Asian GERD patients has rarely been studied, and the therapy remained unclear. The aims were to explore the possible reasons for PPI failure and to treat these patients with the guidance of 24-h multichannel intraluminal impedance-pH (MII-pH) monitoring. Thirty-nine consecutive patients with refractory GERD were enrolled; 24-h MII-pH monitoring was performed on PPI. The refractory GERD patients were grouped into acid overexposure, non-acid reflux, and functional heartburn after the MII-pH monitoring. Double dose of either PPI or paroxetine was administered to refractory GERD patients within different groups. The number of patients in groups of acid overexposure, non-acid reflux, and functional heartburn was 6, 12, and 21, respectively. The acid overexposure group had the most acid reflux events. Among the acid overexposure group, five (5/6) patients accomplish symptom relief with double dose of esomeprazole. For the patients in non-acid reflux group, double dose of esomeprazole made half (6/12) of the patients obtain symptom relief. For the patients in functional heartburn group, the paroxetine had relieved the symptoms in 14 patients among all the 21 patients. In total, with the guidance of MII-pH monitoring, 64.1% (25/39) of refractory GERD patients accomplished symptom relief. Acid overexposure, non-acid reflux, and functional heartburn were the common reasons for persistent reflux symptoms despite PPI. With the guidance of MII-pH, a tailored therapy could resolve the persistent reflux symptoms among two-third of patients. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  7. Financial risk relationships and adoption of management strategies in physician groups for self-administered injectable drugs.

    PubMed

    Agnew, Jonathan D; Stebbins, Marilyn R; Hickman, David E; Lipton, Helene Levins

    2003-01-01

    To consider the extent, nature, and range of risk arrangements between physician groups and health maintenance organizations (HMOs) for self-administered injectable (SAI) drugs; to examine types and frequencies of SAI drug-use management strategies adopted by physician groups; and to explore the relationship between locus and level of financial risk for SAIs and physician group strategy adoption. We used a multiple case-study design to select physician groups and their health maintenance organization (HMO) contractual partners in 4 markets in the United States (Northwest, Northeast, Midwest, Southwest). Physician groups in these markets were chosen based on size (e50 physicians) and experience with drug risk (e1 year). Physician groups were asked to identify their 3 major HMO contractual partners in each market. Telephone interviews were conducted from January 2000 to June 2001, with the resulting purposive sample of 37 individuals representing 20 physician groups. We found that the level and locus of SAI financial risk were related to the adoption of management strategies. Physician groups with higher financial risk for SAIs adopted more strategies than lower-risk groups. Groups with SAI financial risk in the medical services capitation (MSC) adopted 9.2 strategies per group. In contrast, groups with SAI financial risk in the pharmacy-risk budget (PRB) averaged 1.5 strategies per group. Groups with SAI financial risk in both the MSC and PRB fell in-between, averaging 4.5 strategies per group. The most frequently adopted strategy was designing evidenced-based therapeutic guidelines, i.e., protocols based on evidence from the peer-reviewed literature used to guide physicians in the treatment of typically chronic conditions (9 groups, 45% of sample). The second most common strategy involved adapting the existing utilization management system to process SAIs (7 groups, 35%) and the establishment of office procedures for internal authorization (5 groups, 25%). The

  8. Exploring Electronic Medical Record and Self-Administered Medication Risk Screening Tools in a Primary Care Clinic.

    PubMed

    Makowsky, Mark J; Cor, Ken; Wong, Tat

    2017-05-01

    Electronic medical record (EMR) screening for indicators of medication risk could improve efficiency in identifying primary care clinic patients in need of clinical pharmacist care compared with patient self-reporting. To (a) compare the performance of an EMR medication risk assessment questionnaire (MRAQ) with a self-administered (SA) MRAQ and (b) explore each tool's ability to predict indicators of health behavior, health status, and health care utilization. A prospective cohort study was conducted with 143 adults who attended an academic family medicine center and were taking ≥ 2 medications. All participants completed the 10-item SA-MRAQ, Morisky Medication Adherence Scale, Chew's health literacy screener, Stanford Health Distress Scale, and SF-36 overall rating of health. A blinded investigator completed the EMR-MRAQ and a chart review to ascertain 6 months of health care utilization. Outcome measures included the following: (a) scores from the 5- and 10-item SA-MRAQs and 5-item EMR-MRAQ; (b) sensitivity and specificity to determine the accuracy of the 5-item EMR versus the 5-item SA risk scores; (c) correlations between risk assessments and health behavior/status scales; and (d) area under the receiver operator curve to determine how well a high-risk score predicted health care utilization. The 5-item SA-MRAQ, the 5-item EMR-MRAQ, and the 10-item SA-MRAQ categorized 52.9% (55/104), 69.2% (99/143), and 17.6% (18/102) of participants as high risk, respectively. For the 104 participants who completed both 5-item MRAQ tools, the EMR-MRAQ had a sensitivity of 81.8% and specificity of 49.0% in detecting a high-risk SA-MRAQ score. Both 5-item risk assessments showed weak correlations with health distress and overall health, while the 10-item SA-MRAQ additionally showed weak correlations with medication adherence. The EMR-MRAQ was most effective in predicting all-cause emergency room visits/hospitalization (c-statistic = 0.69; 95% CI=0.57-0.81) and high clinic

  9. GERD and acid reduction medication use following gastric bypass and sleeve gastrectomy.

    PubMed

    Barr, Alex C; Frelich, Matthew J; Bosler, Matthew E; Goldblatt, Matthew I; Gould, Jon C

    2017-01-01

    Gastroesophageal reflux disease is a common comorbid medical condition of obesity. Laparoscopic sleeve gastrectomy has been associated with de novo and worsening GERD following surgery. For this reason, patients who suffer from GERD and are considering bariatric surgery are often counseled to undergo gastric bypass. Given this practice, we sought to determine acid reduction medication (ARM) utilization in bariatric surgical patients who undergo one of these procedures prior to surgery and at 1 year following surgery. A retrospective review of prospectively maintained data on patients to undergo gastric bypass or sleeve gastrectomy between November 2012 and December 2014 was conducted after IRB approval. ARM utilization and Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) scores [range 0 (no symptoms)-50 (severe GERD)] were compared prior to surgery and at 1 year postoperatively. 334 patients underwent an eligible procedure in the study interval. 147 patients (44 %) had data on both preoperative and 1 year postoperative ARM use (93 gastric bypass and 54 sleeve gastrectomy). ARM utilization prior to surgery in gastric bypass patients did not reach statistical significance when compared to sleeve gastrectomy (40.9 vs. 26 %, p = 0.07). GERD-HRQL scores were greater prior to surgery in gastric bypass patients (GERD-HRQL 8.2 vs. 1.9; p < 0.01). At 12 months postoperatively, sleeve gastrectomy patients had a significantly higher rate of overall ARM use (48.1 vs. 16.1 %, p < 0.01), new ARM use (35 vs. 7.3 %, p < 0.01), and persistent ARM use (78.6 vs. 21.9 %, p < 0.01) when compared to gastric bypass patients. GERD-HRQL scores were similar overall at 12 months postoperatively (4.4 bypass vs. 4.8 sleeve; p = 0.72). Laparoscopic sleeve gastrectomy is associated with a significantly increased likelihood that acid reduction medications will be necessary for GERD symptom control 12 months postoperatively when compared to gastric

  10. Choice in HIV testing: the acceptability and anticipated use of a self-administered at-home oral HIV test among South Africans.

    PubMed

    Kelvin, Elizabeth A; Cheruvillil, Sonia; Christian, Stephanie; Mantell, Joanne E; Milford, Cecilia; Rambally-Greener, Letitia; Mosery, Nzwakie; Greener, Ross; Smit, Jennifer A

    2016-07-01

    Combination HIV prevention is being widely promoted by funders. This strategy aims to offer HIV prevention choices that can be selected and combined to decrease HIV risk in ways that fit with each individual's situation. Treatment as prevention and pre-exposure prophylaxis are two new evidence-based strategies to decrease HIV incidence, both of which require high HIV testing rates to be effective, and the Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a goal of 90% of HIV-positive individuals knowing their status by 2030. However, HIV testing rates in many countries remain suboptimal. Just as no single HIV prevention method is ideal for all people in all situations, no single HIV testing modality is likely to be acceptable to everyone. By offering HIV testing choices, we may be able to increase testing rates. However, many low-resourced countries have been slow to take up new HIV testing options such as the self-administered at-home oral HIV test that is currently available in the United States. In this paper, we present findings from 20 in-depth interviews, conducted in 2010, documenting opinions about self-administered at-home oral HIV testing, a testing modality still largely unavailable in Africa. Participants were clients of three primary healthcare clinics in South Africa. Self-testing was seen as enabling confidentiality/privacy, saving time, and facilitating testing together with partners. However, concerns were raised about psychological distress when testing at home without a counsellor. Some suggested this concern could be minimised by having experienced clinic-based HIV testing and counselling before getting self-testing kits for home use. Thus, self-administered HIV testing could be an option added to the current testing modalities to address some important barriers to testing.

  11. Relationship between Self-Administered Cues and Rehabilitation Outcomes in Individuals with Aphasia: Understanding Individual Responsiveness to a Technology-Based Rehabilitation Program

    PubMed Central

    Des Roches, Carrie A.; Mitko, Annette; Kiran, Swathi

    2017-01-01

    An advantage of rehabilitation administered on computers or tablets is that the tasks can be self-administered and the cueing required to complete the tasks can be monitored. Though there are many types of cueing, few studies have examined how participants’ response to rehabilitation is influenced by self-administered cueing, which is cueing that is always available but the individual decides when and which cue to administer. In this study, participants received a tablet-based rehabilitation where the tasks were selfpaced and remotely monitored by a clinician. The results of the effectiveness of this study were published previously (Des Roches et al., 2015). The current study looks at the effect of cues on accuracy and rehabilitation outcomes. Fifty-one individuals with aphasia completed a 10-week program using Constant Therapy on an iPad targeted at improving language and cognitive deficits. Three questions were examined. The first examined the effect of cues on accuracy collapsed across time. Results showed a trend where the greater the cue use, the lower the accuracy, although some participants showed the opposite effect. This analysis divided participants into profiles based on cue use and accuracy. The second question examined how each profile differed in percent cue use and on standardized measures at baseline. Results showed that the four profiles were significantly different in frequency of cues and scores on WAB-R, CLQT, BNT, and ASHA-FACS, indicating that participants with lower scores on the standardized tests used a higher percentage of cues, which were not beneficial, while participants with higher scores on the standardized tests used a lower frequency of cues, which were beneficial. The third question examined how the relationship between cues and accuracy was affected by the course of treatment. Results showed that both more and less severe participants showed a decrease in cue use and an increase in accuracy over time, though more severe

  12. An internet-based self-administered intervention for promoting healthy habits and weight loss in hypertensive people who are overweight or obese: a randomized controlled trial.

    PubMed

    Banos, Rosa M; Mensorio, Marinna S; Cebolla, Ausias; Rodilla, Enrique; Palomar, Gonzalo; Lisón, JuanFrancisco; Botella, Cristina

    2015-08-04

    The prevalence of overweight and obesity is on the rise worldwide with severe physical and psychosocial consequences. One of the most dangerous is hypertension. Lifestyle changes related to eating behaviour and physical activity are the critical components in the prevention and treatment of hypertension and obesity. Data indicates that the usual procedures to promote these healthy habits in health services are either insufficient or not efficient enough. Internet has been shown to be an effective tool for the implementation of lifestyle interventions based on this type of problem. This study aims to assess the efficacy of a totally self-administered online intervention programme versus the usual medical care for obese and overweight participants with hypertension (from the Spanish public health care system) to promote healthy lifestyles (eating behaviour and physical activity). A randomized controlled trial will be conducted with 100 patients recruited from the hypertension unit of a public hospital. Participants will be randomly assigned to one of two conditions: a) SII: a self-administered Internet-based intervention protocol; and b) MUC-medical usual care. The online intervention is an Internet-delivered, multimedia, interactive, self-administered programme, composed of nine modules designed to promote healthy eating habits and increase physical activity. The first five modules will be activated at a rate of one per week, and access for modules 5 to 9 will open every two weeks. Patients will be assessed at four points: before the intervention, after the intervention (3 months), and at 6 and 12 months (follow-up). The outcome variables will include blood pressure, and Body Mass Index, as primary outcome measures, and quality of life and other lifestyle and anthropometrical variables as secondary outcome measures. The literature highlights the need for more studies on the benefits of using the Internet to promote lifestyle interventions. This study aims to

  13. Relationship between Self-Administered Cues and Rehabilitation Outcomes in Individuals with Aphasia: Understanding Individual Responsiveness to a Technology-Based Rehabilitation Program.

    PubMed

    Des Roches, Carrie A; Mitko, Annette; Kiran, Swathi

    2017-01-01

    An advantage of rehabilitation administered on computers or tablets is that the tasks can be self-administered and the cueing required to complete the tasks can be monitored. Though there are many types of cueing, few studies have examined how participants' response to rehabilitation is influenced by self-administered cueing, which is cueing that is always available but the individual decides when and which cue to administer. In this study, participants received a tablet-based rehabilitation where the tasks were selfpaced and remotely monitored by a clinician. The results of the effectiveness of this study were published previously (Des Roches et al., 2015). The current study looks at the effect of cues on accuracy and rehabilitation outcomes. Fifty-one individuals with aphasia completed a 10-week program using Constant Therapy on an iPad targeted at improving language and cognitive deficits. Three questions were examined. The first examined the effect of cues on accuracy collapsed across time. Results showed a trend where the greater the cue use, the lower the accuracy, although some participants showed the opposite effect. This analysis divided participants into profiles based on cue use and accuracy. The second question examined how each profile differed in percent cue use and on standardized measures at baseline. Results showed that the four profiles were significantly different in frequency of cues and scores on WAB-R, CLQT, BNT, and ASHA-FACS, indicating that participants with lower scores on the standardized tests used a higher percentage of cues, which were not beneficial, while participants with higher scores on the standardized tests used a lower frequency of cues, which were beneficial. The third question examined how the relationship between cues and accuracy was affected by the course of treatment. Results showed that both more and less severe participants showed a decrease in cue use and an increase in accuracy over time, though more severe

  14. [Construction and validation of an evaluation tool of sexual health using self-administered questionnaires for an application to metabolic diseases].

    PubMed

    Petit, F; Hubert-Buron, A; Mollet-Boudjemline, A; Sechepine, A; Milcent, K; Guyonnet, C; Labrune, P

    2013-03-01

    To elaborate and validate in general population a survey built with self-administered questionnaires in French about evaluation of sexual health for an application to men and women with metabolic disease. Study built with four questionnaires (socio-familial environment [MSPSS scale], self-esteem [Rosenberg scale], anxiety and depression scale [Sigmund and Snaith scale], and male [BISF-M] or female [BISF-W] sexuality) translated in French and distributed to 232 men and 260 women. Hundred and eleven men aged 18 to 56 years and 142 women aged 20 to 60 years answered the self-administered questionnaire. Analysis showed several links between self-esteem, anxiety and depression and the different domains of male sexuality, justifying their association. Comparison between men and women confirmed the differences of sexual approach between the two sexes. Results in our population were concordant with those already reported in literature, indicating the validity and the reliability of our questionnaire and its multiparametric approach. Data obtained in this population will allow to use this multiparametric tool with patients affected by a metabolic disease. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  15. Endoscopic appearance of GERD: putative role of cell proliferation.

    PubMed

    Calabrese, C; Trerè, D; Fabbri, A; Cenacchi, G; Vici, M; Derenzini, M; Di Febo, G

    2007-08-01

    Erosive esophagitis is a frequent endoscopic feature in patients with gastro-oesophageal reflux disease. However, most of patients with heartburn/regurgitation have a non-erosive reflux disease. The reason for this heterogeneous impact of gastro-oesophageal reflux disease on oesophageal mucosa is unknown to date. To evaluate the cell proliferation status of oesophageal epithelium in both healthy normal subjects and patients with gastro-oesophageal reflux disease with or without erosions. All the subjects underwent endoscopy and biopsies were taken at 5 cm from the squamo-columnar junction. Specimens were analysed both at histology and at transmission electron microscopy. Cell proliferation was evaluated by MIB1 immunostaining. Of the 85 subjects were studied, 10 were healthy controls with normal pH-testing and macroscopical, histological and ultrastructural patterns; 37 were patients with erosive esophagitis, and 38 patients with non-erosive reflux disease. At histology, of the 37 patients affected by erosive esophagitis, 30 had normal mucosa and 7 showed mild oesophagitis. One patient with non-erosive reflux disease showed signs of oesophagitis at histology. At TEM, all patients with gastro-oesophageal reflux disease had ultrastructural patterns of damage i.e. dilations of intercellular spaces (DIS), and all controls had a normal ultrastructural pattern. The mean (+/-SD) MIB1-LI values of normal subjects and non-erosive reflux disease and erosive oesophagitis patients were 62.2% (+/-9.1), 29.7% (+/-7.2) and 16.2% (+/-5.2), respectively; there were significant differences among the three groups (p<0.001). Oesophageal mucosa of patients with reflux symptoms presents a decrease in MIB1 immunostaining of 50% and 25% in non-erosive reflux disease and erosive esophagitis patients with respect to normal subjects.

  16. Mobile applications and patient education: Are currently available GERD mobile apps sufficient?

    PubMed

    Bobian, Michael; Kandinov, Aron; El-Kashlan, Nour; Svider, Peter F; Folbe, Adam J; Mayerhoff, Ross; Eloy, Jean Anderson; Raza, S Naweed

    2017-08-01

    Despite the increasing role of mobile applications (apps) in patient education, there has been little inquiry evaluating the quality of these resources. Because poor health literacy has been associated with inferior health outcomes, evaluating the quality of patient education materials takes on great importance. Our objective was to employ validated readability tools for the evaluation of gastroesophageal reflux (GERD) mobile apps. GERD-specific apps found in the Apple App Store (Apple Inc., Cupertino CA) were evaluated using the Readability Studio Professional Version 2015 for Windows (Oleander Software, Ltd, Vandalia, OH). All text was evaluated using nine validated algorithms measuring readability including Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook grading, Gunning Fog index, Coleman-Liau, New Fog Count formula, Raygor Readability Estimate, FORCAST, Fry graph, and Flesch Reading Ease score. Average reading grade levels for individual GERD apps ranged from 9.6 to 12.9 (interquartile range 10.3-12). The average reading grade level for all apps analyzed was 11.1 ± 0.2 standard error of the mean (SEM), with an average Flesch Reading Ease score for all mobile apps analyzed of 51 ± 2.05 (SEM), falling into the "fairly difficult" category given by this measure. Raygor Readability estimates that most mobile apps have a reading grade level between 10 and 12, with the majority of this outcome due to long words. This analysis demonstrates the feasibility of assessing readability of mobile health apps. Our findings suggest significant gaps in potential comprehension between the apps analyzed and the average reader, diminishing the utility of these resources. We hope our findings influence future mobile health-related app development and thereby improve patient outcomes in GERD and other chronic diseases. NA. Laryngoscope, 127:1775-1779, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Predictors of heartburn resolution and erosive esophagitis in patients with GERD.

    PubMed

    Orlando, Roy C; Monyak, John T; Silberg, Debra G

    2009-09-01

    The primary objective was to assess gastroesophageal reflux disease (GERD) symptom resolution rates with esomeprazole by erosive esophagitis (EE) status, and the secondary objective was to evaluate potential predictors of the presence of EE and heartburn resolution. Patients with GERD who have EE have higher reported symptom resolution rates than those with nonerosive reflux disease (NERD) when treated with proton pump inhibitors (PPIs). This open-label multicenter study included adults with GERD symptoms. Patients were stratified by EE status after endoscopy and received once-daily esomeprazole 40 mg for 4 weeks. Questionnaires determined symptom response rates, and baseline predictors of EE or heartburn resolution were evaluated. Potential predictors, including years with GERD, history of EE, and time to relief with antacids, were examined. Heartburn resolution rates at 4 weeks were higher for patients with EE than NERD (69% [124/179] vs. 48% [85/177]; p < 0.0001). Multivariate models had moderate predictive ability for EE (c-index, 0.76) and poor predictive ability (c-index, 0.57) for heartburn resolution. However, faster heartburn relief with antacid use, particularly within 15 min, was predictive of EE and heartburn resolution. Patients with EE have higher heartburn resolution rates than patients with NERD after treatment, although recall bias may be possible. Fast relief with antacid use is predictive of EE and heartburn resolution with a PPI and suggests that a history of antacid relief may provide corroborative evidence to empiric PPI therapy in determining whether patients with heartburn have acid reflux disease. ClinicalTrials.Gov IDENTIFIER: NCT00242736.

  18. The effect of endoscopic fundoplication and proton pump inhibitors on baseline impedance and heartburn severity in GERD patients.

    PubMed

    Rinsma, N F; Farré, R; Bouvy, N D; Masclee, A A M; Conchillo, J M

    2015-02-01

    Antireflux therapy may lead to recovery of impaired mucosal integrity in gastro-esophageal reflux disease (GERD) patients as reflected by an increase in baseline impedance. The study objective was to evaluate the effect of endoscopic fundoplication and proton pump inhibitor (PPI) PPI therapy on baseline impedance and heartburn severity in GERD patients. Forty-seven GERD patients randomized to endoscopic fundoplication (n = 32) or PPI therapy (n = 15), and 29 healthy controls were included. Before randomization and 6 months after treatment, baseline impedance was obtained during 24-h pH-impedance monitoring. Heartburn severity was evaluated using the GERD-HRQL questionnaire. Before treatment, baseline impedance in GERD patients was lower than in healthy controls (p < 0.001). Antireflux therapy increased baseline impedance (from 1498 [IQR 951-2472] to 2393 [IQR 1353-3027] Ω, p = 0.001), however it only led to a partial recovery when compared to healthy controls (2393 [IQR 1353-3027] vs 2983 [2335-3810] Ω, p < 0.01). The effect of both treatment options was not significantly different (p = 0.13) despite the increased number of non-acid reflux events in the PPI group. No correlation was found between baseline impedance and GERD symptoms before or after treatment. Reduction in acid reflux by endoscopic fundoplication or PPI therapy leads to an increase in baseline impedance in GERD patients, likely to reflect recovery of mucosal integrity. The impact of non-acid reflux events on esophageal mucosal integrity may be limited as no difference in the increase in baseline impedance was observed after both treatment options. The lack of association between impedance baseline and heartburn severity indicates that other factors may contribute to heartburn perception in GERD. © 2014 John Wiley & Sons Ltd.

  19. Development and Psychometric Evaluation of a Self-Administered Questionnaire to Assess Parental Attitudes Toward Firearms and Related Parenting Decisions.

    PubMed

    Davis, Amy B; White, Marney A

    2016-01-01

    The study sought to develop and evaluate the psychometric properties of the Parental Attitudes Toward Firearms Survey (PATFS), a self-report measure of parental attitudes about firearms and parenting behavior. The initial item pool was generated based on a literature review and discussion with experts in violence reduction, psychometrics, and public health. Data were collected online from 362 volunteers and subjected to exploratory factor analysis which revealed a 13-item, 3-factor solution accounting for 59.7% of the variance. The 3 conceptual factors (subscales) were interpreted as Firearms Exposure, Parental Control, and Violent Play. The PATFS demonstrated good internal consistency and content and construct validity. The PATFS can be used to investigate parenting attitudes and behaviors specific to firearms and violent play.

  20. A Validation Study of the Automated Self-Administered 24-Hour Dietary Recall for Children, 2014 Version, at School Lunch.

    PubMed

    Krehbiel, Caroline F; DuPaul, George J; Hoffman, Jessica A

    2017-05-01

    Obtaining valid and reliable estimates of usual dietary intake at a reasonable cost is a challenge in school-based nutrition research. The Automated Self-Administered 24-Hour Dietary Recall for Children, 2014 version (ASA24 Kids-2014), a self-administered, computerized 24-hour dietary recall, offers improved feasibility over traditional interviewer-administered 24-hour recalls. This mixed-methods study examined ASA24 Kids-2014's validity for measuring dietary intake from National School Lunch Program lunches. After 24% attrition, 96 middle-school students from three urban schools in eastern Pennsylvania participated in the study. A subsample of 27 participants completed qualitative interviews. Data were collected in the spring of 2014. Self-reported ASA24 Kids-2014 data were compared to direct observations of school lunch, which served as the criterion measure. Dependent variables included eight meal components selected from the National School Lunch Program guidelines (fruit, vegetables, grains, protein-rich foods, dairy, oils, solid fats, and added sugars). A supplemental interview collected qualitative data regarding students' perceptions of content and substantive validity. The Wilcoxon signed rank test and Spearman's ρ examined criterion-related validity; qualitative content analysis examined content and substantive validity. Participants inaccurately recalled food items eaten at lunch, as 58% of foods were reported in error. However, among foods recalled correctly, no statistically significant differences emerged for estimates of portions consumed for six meal components (fruit, vegetables, grains, protein-rich foods, oils, and added sugars). In addition, statistically significant positive correlations emerged between ASA24 Kids-2014 and direct observation for all estimates. Qualitative data identified students' interest and motivation, comprehension, memory, and English-language fluency as relevant sources of error. Middle school students have difficulty

  1. GluN2B-containing NMDA receptors blockade rescues bidirectional synaptic plasticity in the bed nucleus of the stria terminalis of cocaine self-administering rats.

    PubMed

    deBacker, Julian; Hawken, Emily R; Normandeau, Catherine P; Jones, Andrea A; Di Prospero, Cynthia; Mechefske, Elysia; Gardner Gregory, James; Hayton, Scott J; Dumont, Éric C

    2015-01-01

    Drugs of abuse have detrimental effects on homeostatic synaptic plasticity in the motivational brain network. Bidirectional plasticity at excitatory synapses helps keep neural circuits within a functional range to allow for behavioral flexibility. Therefore, impaired bidirectional plasticity of excitatory synapses may contribute to the behavioral hallmarks of addiction, yet this relationship remains unclear. Here we tracked excitatory synaptic strength in the oval bed nucleus of the stria terminalis (ovBNST) using whole-cell voltage-clamp recordings in brain slices from rats self-administering sucrose or cocaine. In the cocaine group, we measured both a persistent increase in AMPA to NMDA ratio (A:N) and slow decay time of NMDA currents throughout the self-administration period and after withdrawal from cocaine. In contrast, the sucrose group exhibited an early increase in A:N ratios (acquisition) that returned toward baseline values with continued self-administration (maintenance) and after withdrawal. The sucrose rats also displayed a decrease in NMDA current decay time with continued self-administration (maintenance), which normalized after withdrawal. Cocaine self-administering rats exhibited impairment in NMDA-dependent long-term depression (LTD) that could be rescued by GluN2B-containing NMDA receptor blockade. Sucrose self-administering rats demonstrated no impairment in NMDA-dependent LTD. During the maintenance period of self-administration, in vivo (daily intraperitoneally for 5 days) pharmacologic blockade of GluN2B-containing NMDA receptors did not reduce lever pressing for cocaine. However, in vivo GluN2B blockade did normalize A:N ratios in cocaine self-administrating rats, and dissociated the magnitude of ovBNST A:N ratios from drug-seeking behavior after protracted withdrawal. Altogether, our data demonstrate when and how bidirectional plasticity at ovBNST excitatory synapses becomes dysfunctional with cocaine self-administration and that NMDA

  2. Screening for early detection of parkinsonism using a self-administered questionnaire: a cross-sectional epidemiologic study

    PubMed Central

    Lundin, Jessica I.; Checkoway, Harvey; Criswell, Susan R.; Hobson, Angela; Harris, Rachel C.; Swisher, Laura M.; Evanoff, Bradley A.; Racette, Brad A.

    2013-01-01

    Background Manganese (Mn) is a common component of welding fume. Exposure to Mn fume has been associated with parkinsonism. A simple and reliable screening tool to evaluate Mn exposed workers for neurotoxic injury would have broad occupational health application. Methods This study investigated 490 occupational welders recruited from a trade union list. Subjects were examined by a movement disorders specialist using the Unified Parkinson Disease Rating Scale motor subsection 3 (UPDRS3). Parkinsonism, intermediate, and normal groups were defined as UPDRS3 score ≥15, 6–15, and <6, respectively. Workers completed a health status questionnaire (PDQ39) and a Parkinson’s disease (PD) Symptoms Questionnaire. Areas under receiver operator curve (AUC) were analyzed based on these scores, adjusted for age, smoking, race, gender, and neurologist, using normal as the reference. Results The AUC was 0.79 (95% Confidence Interval [CI] = 0.73–0.84) for PDQ39 and 0.78 (95% CI = 0.72–0.85) for PD Symptoms Questionnaire score. At 70% sensitivity, the specificity for PDQ39 score and PD Symptoms Questionnaire score for the prediction of parkinsonism was 73.1% and 80.1%, respectively. Conclusions These results suggest the questionnaires have reasonably good sensitivity and specificity to predict parkinsonism in Mn exposed workers. These questionnaires could be a valuable first step in a tiered screening approach for Mn exposed workers. PMID:24035927

  3. Orthorexia nervosa in the general population: a preliminary screening using a self-administered questionnaire (ORTO-15).

    PubMed

    Ramacciotti, C E; Perrone, P; Coli, E; Burgalassi, A; Conversano, C; Massimetti, G; Dell'Osso, L

    2011-06-01

    Orthorexia, from the Greek words orthos (straight, proper) and orexis (appetite), is a newly conceptualized disorder characterized by distorted eating habits and cognitions concerning supposedly healthy nutrition. In this article we present preliminary results of a wider research aimed to investigate the diffusion of Orthorexia in the general population and to highlight its characteristics and particularly the relationship with Eating Disorder and Obsessive-Compulsive Disorder. One-hundred and seventy seven adult subjects from the general population, were administered the ORTO-15 test, a selfadministered questionnaire specifically designed to assess orthorexic symptomatology; note that statistical analyses were repeated twice, referring to different diagnostic thresholds (40/35). Orthorexia had a 57.6% prevalence in our sample, using the 40-point threshold, with a female/male ratio 2:1; the figure was sensibly lower with the 35-point threshold (21%). The results of this study highlight the diffusion of Orthorexia which may constitute an important risk factor for mental and physical health, but also the opportunity of more specific diagnostic instruments, so to facilitate a thorough understanding of this disorder.

  4. Accuracy of audio computer-assisted self-interviewing (ACASI) and self-administered questionnaires for the assessment of sexual behavior.

    PubMed

    Morrison-Beedy, Dianne; Carey, Michael P; Tu, Xin

    2006-09-01

    This study examined the accuracy of two retrospective methods and assessment intervals for recall of sexual behavior and assessed predictors of recall accuracy. Using a 2 [mode: audio-computer assisted self-interview (ACASI) vs. self-administered questionnaire (SAQ)] by 2 (frequency: monthly vs. quarterly) design, young women (N =102) were randomly assigned to one of four conditions. Participants completed baseline measures, monitored their behavior with a daily diary, and returned monthly (or quarterly) for assessments. A mixed pattern of accuracy between the four assessment methods was identified. Monthly assessments yielded more accurate recall for protected and unprotected vaginal sex but quarterly assessments yielded more accurate recall for unprotected oral sex. Mode differences were not strong, and hypothesized predictors of accuracy tended not to be associated with recall accuracy. Choice of assessment mode and frequency should be based upon the research question(s), population, resources, and context in which data collection will occur.

  5. Food and nutrient intakes assessed with dietary records for the validation study of a self-administered food frequency questionnaire in JPHC Study Cohort I.

    PubMed

    Sasaki, Satoshi; Takahashi, Tosei; Iitoi, Yoji; Iwase, Yasuhiko; Kobayashi, Minatsu; Ishihara, Junko; Akabane, Masayuki; Tsugane, Shoichiro

    2003-01-01

    We present here the survey methods and basic results of dietary records which were used as reference values in the present validation study of a self-administered food frequency questionnaire (FFQ) for the 5-year follow-up survey of the JPHC study. A semi-weighed dietary record was kept for four seven consecutive days in each of the four seasons in 3 areas, i.e., Iwate, Akita, and Nagano, and for seven consecutive days in both winter and summer in Okinawa. The mean intakes were significantly different between areas for some nutrients and food groups. A significant seasonal difference in the mean intakes was also observed in some nutrients such as carotene and vitamin C, and in some food groups such as potatoes, vegetables, and fruits in both sexes, and alcoholic beverages in men and milks in women (p<0.001).

  6. Temporal and qualitative dynamics of conditioned taste aversions in C57BL/6J and DBA/2J mice self-administering LiCl.

    PubMed

    Rebecca Glatt, A; St John, Steven J; Lu, Lianyi; Boughter, John D

    2016-01-01

    Self-administration of LiCl solution has been shown to result in the formation of a conditioned taste aversion (CTA) that generalizes to NaCl in rats. This paradigm may have considerable ecological validity as it models CTA learning in natural settings, and also allows for the investigation of drinking microstructure as an assay of potential shifts in stimulus palatability. We used this paradigm to examine possible mouse strain differences in CTA acquisition, generalization, and extinction. In the first experiment, C57BL/6J (B6) and DBA/2J (D2) mice self-administered LiCl (or control NaCl) over a 20-minute free access acquisition period and were tested on the following day with a panel of taste solutions available in brief (5-s) trials delivered in random order. In the second experiment, mice again self-administered LiCl or NaCl (at low, 0.12 M, or high, 0.24 M concentrations) in a 20-minute session, and on the following day received a 20-minute free access period to equimolar NaCl. Strain differences were found for aspects of ingestive behavior, with B6 mice showing greater consumption of all stimuli, including water, while D2 mice lick faster, in less frequent but longer bursts. We did not, however, find evidence of a robust strain difference in taste aversion learning. Both strains demonstrated profound alterations in licking microstructure in the generalization session relative to controls. We suggest that a decrease in "lick efficiency" (the percentage of inter-lick intervals within a burst of short duration vs. longer duration) reflects avoidance behavior, and signals a shift in palatability of a stimulus following CTA.

  7. Directly observed pegylated interferon plus self-administered ribavirin for the treatment of hepatitis C virus infection in people actively using drugs: a randomized controlled trial.

    PubMed

    Hilsden, Robert J; Macphail, Gisela; Grebely, Jason; Conway, Brian; Lee, Samuel S

    2013-08-01

    This study investigated the efficacy and safety of directly observed pegylated interferon (peg-IFN) alfa-2a plus self-administered ribavirin (RBV) for the treatment of hepatitis C virus (HCV) among people with active drug use. A randomized, open-label, parallel group trial of immediate vs delayed treatment with peg-IFN alfa-2a plus RBV in participants with recent injection drug and/or crack cocaine use (prior 3 months). The primary end point was sustained virologic response (SVR). Sixty-six participants were randomized (immediate treatment, n = 48; delayed treatment, n = 18). Loss to follow-up was comparable among those randomized to immediate and delayed treatment (23% vs 33%, P = .389). In a post hoc intent-to-treat analysis of all randomized individuals, the SVR was 65% (95% confidence interval [CI], 49%-78%; 31/48) in those randomized to immediate treatment as compared to 39% (95% CI, 17%-64%; 7/18) in those randomized to delayed treatment (P = .060). Among those who received delayed treatment (12/18), SVR was 58% (7/12). Among 60 participants who received at least 1 dose of study medication, SVR was 63% (95% CI, 50%-75%, n = 38). Recent drug use at baseline (past month) did not impact completion or SVR. Discontinuation due to adverse events occurred in 7%. The HCV reinfection rate was 2.8 per 100 person-years (95% CI, 0.0-14.5 person-years) with 1 reinfection observed among 23 remaining in follow-up post-SVR (median, 1.8 years; range, 0.5-1.8 years). Among people actively using drugs treated with directly observed peg-IFN alfa-2a plus self-administered RBV, SVR is comparable to that seen in clinical trials of non-drug users, and the rate of HCV reinfection is low.

  8. Challenges in converting an interviewer-administered food probe database to self-administration in the National Cancer Institute Automated Self-administered 24-Hour Recall (ASA24)

    PubMed Central

    Zimmerman, Thea Palmer; Hull, Stephen G.; McNutt, Suzanne; Mittl, Beth; Islam, Noemi; Guenther, Patricia M.; Thompson, Frances E.; Potischman, Nancy A.; Subar, Amy F.

    2009-01-01

    The National Cancer Institute (NCI) is developing an automated, self-administered 24-hour dietary recall (ASA24) application to collect and code dietary intake data. The goal of the ASA24 development is to create a web-based dietary interview based on the US Department of Agriculture (USDA) Automated Multiple Pass Method (AMPM) instrument currently used in the National Health and Nutrition Examination Survey (NHANES). The ASA24 food list, detail probes, and portion probes were drawn from the AMPM instrument; portion-size pictures from Baylor College of Medicine’s Food Intake Recording Software System (FIRSSt) were added; and the food code/portion code assignments were linked to the USDA Food and Nutrient Database for Dietary Studies (FNDDS). The requirements that the interview be self-administered and fully auto-coded presented several challenges as the AMPM probes and responses were linked with the FNDDS food codes and portion pictures. This linking was accomplished through a “food pathway,” or the sequence of steps that leads from a respondent’s initial food selection, through the AMPM probes and portion pictures, to the point at which a food code and gram weight portion size are assigned. The ASA24 interview database that accomplishes this contains more than 1,100 food probes and more than 2 million food pathways and will include about 10,000 pictures of individual foods depicting up to 8 portion sizes per food. The ASA24 will make the administration of multiple days of recalls in large-scale studies economical and feasible. PMID:20161418

  9. Surgical adrenalectomy with diurnal corticosterone replacement slows escalation and prevents the augmentation of cocaine-induced reinstatement in rats self-administering cocaine under long-access conditions.

    PubMed

    Mantsch, John R; Baker, David A; Serge, Joseph P; Hoks, Michael A; Francis, David M; Katz, Eric S

    2008-03-01

    The loss of control over cocaine use and persistently heightened susceptibility to drug relapse that define human cocaine addiction are consequences of drug-induced neuroplasticity and can be studied in rats self-administering cocaine under conditions of daily long access (LgA) as escalating patterns of drug intake and heightened susceptibility to reinstatement. This study investigated the potential contribution of elevated glucocorticoids at the time of LgA cocaine self-administration (SA) to these behavioral indices of addiction-related neuroplasticity. Rats provided 14 days of 6-h access (LgA) to cocaine showed a progressive escalation of SA and were more susceptible to cocaine-induced reinstatement (10 mg/kg, i.p.) compared to rats self-administering under short-access (ShA; 2 h) conditions. A surgical adrenalectomy and corticosterone replacement (ADX/C) regimen that eliminated SA-induced increases in corticosterone (CORT) while maintaining the diurnal pattern of secretion failed to alter SA or reinstatement in ShA rats but slowed escalation and attenuated later reinstatement in LgA rats when applied before but not after chronic LgA SA testing. Although the contribution of other adrenal hormones cannot be ruled out, these data suggest that elevated glucocorticoids at the time of cocaine exposure may be required for the effects of LgA SA on cocaine intake and later reinstatement. The inability of daily CORT administration before daily ShA SA, at a dose that reproduced the response during LgA SA, to mimic the effects of LgA SA suggests that elevated glucocorticoids during SA may play a permissive role in cocaine-induced neuroplasticity that contributes to addiction.

  10. Efficacy, Safety, and Acceptability of Low-Dose Mifepristone and Self-Administered Misoprostol for Ultra-Early Medical Abortion: A Randomized Controlled Trial.

    PubMed

    Li, Cui-Lan; Song, Li-Ping; Tang, Shi-Yan; Zhou, Lee Jaden Gil Yu-Kang; He, Hong; Mo, Xue-Tang; Liao, Yi-Ming

    2017-05-01

    The aim of this study was to investigate the efficacy, safety, and acceptability of low-dose mifepristone combined with self-administered misoprostol for ultra-early medical abortion. A total of 744 women with ultra-early pregnancy (amenorrhea ≤35 days) who fulfilled the inclusion criteria were enrolled in the study. Equal numbers of participants were allocated randomly to the hospital administration and self-administration groups. All participants took 75 mg mifepristone at the initial visit and 400 µg oral misoprostol 24 hours later in the hospital or by self-administration. The primary end point was complete abortion. Secondary end points were rates of unscheduled reattendance, time required for and cost of hospital observation and follow-up, vaginal bleeding, adverse effects, menstrual disturbance in the posttreatment period, and satisfaction rating. No differences in the rates of complete abortion, unscheduled reattendance, vaginal bleeding, adverse effects, or return of posttreatment menstruation were observed. The time required for (and costs of) hospital observation and follow-up per participant was 557.82 minutes (and US$40.12) in the hospital administration group and 18.46 minutes (and US$1.96) in the self-administration group (both P < .001). Satisfaction rates were similar in both groups, but the rates of "very satisfied" responses (87.60% vs 25.41%) and follow-up compliance (loss to follow-up, 0.45% vs 7.70%) were higher in the self-administration group (both P < .001). Low-dose mifepristone combined with self-administered misoprostol for ultra-early pregnancy termination was as effective and safe as hospital administration, with greater acceptability and lower cost to the women.

  11. Development and validation of a simple and multifaceted instrument, GERD-TEST, for the clinical evaluation of gastroesophageal reflux and dyspeptic symptoms

    PubMed Central

    Nakada, Koji; Matsuhashi, Nobuyuki; Iwakiri, Katsuhiko; Oshio, Atsushi; Joh, Takashi; Higuchi, Kazuhide; Haruma, Ken

    2017-01-01

    AIM To evaluate the psychometric properties of a newly developed questionnaire, known as the gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test (GERD-TEST), in patients with GERD. METHODS Japanese patients with predominant GERD symptoms recruited according to the Montreal definition were treated for 4 wk using a standard dose of proton pump inhibitor (PPI). The GERD-TEST and the Medical Outcome Study Short Form-8 Health Survey (SF-8) were administered at baseline and after 4 wk of treatment. The GERD-TEST contains three domains: the severity of GERD and functional dyspepsia (FD) symptoms (5 items), the level of dissatisfaction with daily life (DS) (4 items), and the therapeutic efficacy as assessed by the patients and medication compliance (4 items). RESULTS A total of 290 patients were eligible at baseline; 198 of these patients completed 4 wk of PPI therapy. The internal consistency reliability as evaluated using the Cronbach’s α values for the GERD, FD and DS subscales ranged from 0.75 to 0.82. The scores for the GERD, FD and DS items/subscales were significantly correlated with the physical and mental component summary scores of the SF-8. After 4 wk of PPI treatment, the scores for the GERD items/subscales were greatly reduced, ranging in value from 1.51 to 1.87 and with a large effect size (P < 0.0001, Cohen’s d; 1.29-1.63). Statistically significant differences in the changes in the scores for the GERD items/subscales were observed between treatment responders and non-responders (P < 0.0001). CONCLUSION The GERD-TEST has a good reliability, a good convergent and concurrent validity, and is responsive to the effects of treatment. The GERD-TEST is a simple, easy to understand, and multifaceted PRO instrument applicable to both clinical trials and the primary care of GERD patients. PMID:28811716

  12. Self-Administered Outpatient Antimicrobial Infusion by Uninsured Patients Discharged from a Safety-Net Hospital: A Propensity-Score-Balanced Retrospective Cohort Study.

    PubMed

    Bhavan, Kavita P; Brown, L Steven; Haley, Robert W

    2015-12-01

    Outpatient parenteral antimicrobial therapy (OPAT) is accepted as safe and effective for medically stable patients to complete intravenous (IV) antibiotics in an outpatient setting. Since, however, uninsured patients in the United States generally cannot afford OPAT, safety-net hospitals are often burdened with long hospitalizations purely to infuse antibiotics, occupying beds that could be used for patients requiring more intensive services. OPAT is generally delivered in one of four settings: infusion centers, nursing homes, at home with skilled nursing assistance, or at home with self-administered therapy. The first three-termed healthcare-administered OPAT (H-OPAT)--are most commonly used in the United States by patients with insurance funding. The fourth--self-administered OPAT (S-OPAT)--is relatively uncommon, with the few published studies having been conducted in the United Kingdom. With multidisciplinary planning, we established an S-OPAT clinic in 2009 to shift care of selected uninsured patients safely to self-administration of their IV antibiotics at home. We undertook this study to determine whether the low-income mostly non-English-speaking patients in our S-OPAT program could administer their own IV antimicrobials at home with outcomes as good as, or better than, those receiving H-OPAT. Parkland Hospital is a safety-net hospital serving Dallas County, Texas. From 1 January 2009 to 14 October 2013, all uninsured patients meeting criteria were enrolled in S-OPAT, while insured patients were discharged to H-OPAT settings. The S-OPAT patients were trained through multilingual instruction to self-administer IV antimicrobials by gravity, tested for competency before discharge, and thereafter followed at designated intervals in the S-OPAT outpatient clinic for IV access care, laboratory monitoring, and physician follow-up. The primary outcome was 30-d all-cause readmission, and the secondary outcome was 1-y all-cause mortality. The study was adequately

  13. Self-Administered Outpatient Antimicrobial Infusion by Uninsured Patients Discharged from a Safety-Net Hospital: A Propensity-Score-Balanced Retrospective Cohort Study

    PubMed Central

    Bhavan, Kavita P.; Brown, L. Steven; Haley, Robert W.

    2015-01-01

    Background Outpatient parenteral antimicrobial therapy (OPAT) is accepted as safe and effective for medically stable patients to complete intravenous (IV) antibiotics in an outpatient setting. Since, however, uninsured patients in the United States generally cannot afford OPAT, safety-net hospitals are often burdened with long hospitalizations purely to infuse antibiotics, occupying beds that could be used for patients requiring more intensive services. OPAT is generally delivered in one of four settings: infusion centers, nursing homes, at home with skilled nursing assistance, or at home with self-administered therapy. The first three—termed healthcare-administered OPAT (H-OPAT)—are most commonly used in the United States by patients with insurance funding. The fourth—self-administered OPAT (S-OPAT)—is relatively uncommon, with the few published studies having been conducted in the United Kingdom. With multidisciplinary planning, we established an S-OPAT clinic in 2009 to shift care of selected uninsured patients safely to self-administration of their IV antibiotics at home. We undertook this study to determine whether the low-income mostly non-English-speaking patients in our S-OPAT program could administer their own IV antimicrobials at home with outcomes as good as, or better than, those receiving H-OPAT. Methods and Findings Parkland Hospital is a safety-net hospital serving Dallas County, Texas. From 1 January 2009 to 14 October 2013, all uninsured patients meeting criteria were enrolled in S-OPAT, while insured patients were discharged to H-OPAT settings. The S-OPAT patients were trained through multilingual instruction to self-administer IV antimicrobials by gravity, tested for competency before discharge, and thereafter followed at designated intervals in the S-OPAT outpatient clinic for IV access care, laboratory monitoring, and physician follow-up. The primary outcome was 30-d all-cause readmission, and the secondary outcome was 1-y all

  14. Development and validation of the self-administered Fibromyalgia Assessment Status: a disease-specific composite measure for evaluating treatment effect

    PubMed Central

    Salaffi, Fausto; Sarzi-Puttini, Piercarlo; Girolimetti, Rita; Gasparini, Stefania; Atzeni, Fabiola; Grassi, Walter

    2009-01-01

    Introduction The Fibromyalgia Impact Questionnaire (FIQ) is a composite disease-specific measure validated for fibromyalgia (FM), but it is rarely used in clinical practice. The objective was to develop and analyse the psychometric properties of a new composite disease-specific index (Fibromyalgia Assessment Status, FAS), a simple self-administered index that combines a patient's assessment of fatigue, sleep disturbances and pain evaluated on the basis of the 16 non-articular sites listed on the Self-Assessment Pain Scale (SAPS) in a single measure (range 0 to 10). Methods The FAS index was constructed using a traditional development strategy, and its psychometric properties were tested in 226 FM patients (209 women, 17 men); whose disease-related characteristics were assessed by means of an 11-numbered circular numerical rating scale (NRS) for pain, fatigue, sleep disturbances and general health (GH), the tender point score (TPS), the SAPS, the FIQ, and the SF-36. A group of 226 rheumatoid arthritis (RA) patients was used for comparative purposes. Of the 179 FM patients who entered the follow-up study, 152 completed the three-month period and were included in the responsiveness analyses. One hundred and fifty-four patients repeated the FAS questionnaire after an interval of one week, and its test/re-test reliability was calculated. Responsiveness was evaluated on the basis of effect size and the standardised response mean. Results The FAS index fulfilled the established criteria for validity, reliability and responsiveness. Factor analysis showed that SAPS and fatigue contributed most, and respectively explained 47.4% and 31.2% of the variance; sleep explained 21.3%. Testing for internal consistency showed that Cronbach's alpha was 0.781, thus indicating a high level of reliability. As expected, closer significant correlations were found when FAS was compared with total FIQ (rho = 0.347; P < 0.0001) and the FIQ subscales, particularly job ability, tiredness

  15. Development of a Comprehensive Assessment of Food Parenting Practices: The Home Self-Administered Tool for Environmental Assessment of Activity and Diet Family Food Practices Survey.

    PubMed

    Vaughn, Amber E; Dearth-Wesley, Tracy; Tabak, Rachel G; Bryant, Maria; Ward, Dianne S

    2017-02-01

    Parents' food parenting practices influence children's dietary intake and risk for obesity and chronic disease. Understanding the influence and interactions between parents' practices and children's behavior is limited by a lack of development and psychometric testing and/or limited scope of current measures. The Home Self-Administered Tool for Environmental Assessment of Activity and Diet (HomeSTEAD) was created to address this gap. This article describes development and psychometric testing of the HomeSTEAD family food practices survey. Between August 2010 and May 2011, a convenience sample of 129 parents of children aged 3 to 12 years were recruited from central North Carolina and completed the self-administered HomeSTEAD survey on three occasions during a 12- to 18-day window. Demographic characteristics and child diet were assessed at Time 1. Child height and weight were measured during the in-home observations (following Time 1 survey). Exploratory factor analysis with Time 1 data was used to identify potential scales. Scales with more than three items were examined for scale reduction. Following this, mean scores were calculated at each time point. Construct validity was assessed by examining Spearman rank correlations between mean scores (Time 1) and children's diet (fruits and vegetables, sugar-sweetened beverages, snacks, sweets) and body mass index (BMI) z scores. Repeated measures analysis of variance was used to examine differences in mean scores between time points, and single-measure intraclass correlations were calculated to examine test-retest reliability between time points. Exploratory factor analysis identified 24 factors and retained 124 items; however, scale reduction narrowed items to 86. The final instrument captures five coercive control practices (16 items), seven autonomy support practices (24 items), and 12 structure practices (46 items). All scales demonstrated good internal reliability (α>.62), 18 factors demonstrated construct

  16. The Automated Self-Administered 24-Hour Dietary Recall for Children, 2012 Version, for Youth Aged 9 to 11 Years: A Validation Study.

    PubMed

    Diep, Cassandra S; Hingle, Melanie; Chen, Tzu-An; Dadabhoy, Hafza R; Beltran, Alicia; Baranowski, Janice; Subar, Amy F; Baranowski, Tom

    2015-10-01

    Valid methods of diet assessment are important for nutrition research and practice, but can be difficult with children. To validate the 2012 version of the Automated Self-Administered 24-Hour Dietary Recall for Children (ASA24-Kids-2012), a self-administered web-based 24-hour dietary recall (24hDR) instrument, among children aged 9 to 11 years, in two sites. Quasiexperimental. In one site, trained staff members observed and recorded foods and drinks consumed by children (n=38) during school lunch. The next day, the observed children completed both ASA24-Kids-2012 and an interviewer-administered 24hDR in a randomized order. Procedures in a second site (n=31) were similar, except observations occurred during dinner in a community location. Foods were classified as matches (reported and consumed), intrusions (reported, but not consumed), or omissions (not reported, but consumed) for each participant. Rates of matches, intrusions, and omissions were calculated. Rates were compared between each recall method using repeated measures analysis of covariance. For matched foods, the authors determined correlation coefficients between observed and reported serving sizes. Match, intrusion, and omission rates between ASA24-Kids-2012 and observed intakes in Site 1 were 37%, 27%, and 35%, respectively. Comparable rates for interviewer-administered 24hDRs were 57%, 20%, and 23%, respectively. In Site 2, match, intrusion, and omission rates between ASA24-Kids-2012 and observed intakes were 53%, 12%, and 36%, respectively, vs 76% matches, 9% intrusions, and 15% omissions for interviewer-administered 24hDRs. The relationship strength between reported and observed serving sizes for matched foods was 0.18 in Site 1 and 0.09 in Site 2 for ASA24-Kids-2012, and 0.46 in Site 1 and 0.11 in Site 2 for interviewer-administered 24hDRs. ASA24-Kids-2012 was less accurate than interviewer-administered 24hDRs when compared with observed intakes, but both performed poorly. Additional research

  17. Feasibility study into self-administered training at home using an arm and hand device with motivational gaming environment in chronic stroke.

    PubMed

    Nijenhuis, Sharon M; Prange, Gerdienke B; Amirabdollahian, Farshid; Sale, Patrizio; Infarinato, Francesco; Nasr, Nasrin; Mountain, Gail; Hermens, Hermie J; Stienen, Arno H A; Buurke, Jaap H; Rietman, Johan S

    2015-10-09

    Assistive and robotic training devices are increasingly used for rehabilitation of the hemiparetic arm after stroke, although applications for the wrist and hand are trailing behind. Furthermore, applying a training device in domestic settings may enable an increased training dose of functional arm and hand training. The objective of this study was to assess the feasibility and potential clinical changes associated with a technology-supported arm and hand training system at home for patients with chronic stroke. A dynamic wrist and hand orthosis was combined with a remotely monitored user interface with motivational gaming environment for self-administered training at home. Twenty-four chronic stroke patients with impaired arm/hand function were recruited to use the training system at home for six weeks. Evaluation of feasibility involved training duration, usability and motivation. Clinical outcomes on arm/hand function, activity and participation were assessed before and after six weeks of training and at two-month follow-up. Mean System Usability Scale score was 69 % (SD 17 %), mean Intrinsic Motivation Inventory score was 5.2 (SD 0.9) points, and mean training duration per week was 105 (SD 66) minutes. Median Fugl-Meyer score improved from 37 (IQR 30) pre-training to 41 (IQR 32) post-training and was sustained at two-month follow-up (40 (IQR 32)). The Stroke Impact Scale improved from 56.3 (SD 13.2) pre-training to 60.0 (SD 13.9) post-training, with a trend at follow-up (59.8 (SD 15.2)). No significant improvements were found on the Action Research Arm Test and Motor Activity Log. Remotely monitored post-stroke training at home applying gaming exercises while physically supporting the wrist and hand showed to be feasible: participants were able and motivated to use the training system independently at home. Usability shows potential, although several usability issues need further attention. Upper extremity function and quality of life improved after training

  18. Improved Balance Confidence and Stability for Elderly After 6 Weeks of a Multimodal Self-Administered Balance-Enhancing Exercise Program

    PubMed Central

    Hafström, Anna; Malmström, Eva-Maj; Terdèn, Josefine; Fransson, Per-Anders; Magnusson, Måns

    2016-01-01

    Objective: To develop and assess the efficacy of a multimodal balance-enhancing exercise program (BEEP) designed to be regularly self-administered by community-dwelling elderly. The program aims to promote sensory reweighting, facilitate motor control, improve gaze stabilization, and stimulate continuous improvement by being constantly challenging. Method: Forty participants aged 60 to 80 years performed 6 weeks of BEEP training, on average for 16 min four times weekly, in a randomized one-arm crossover design. Results: One-leg standing time improved 32% with eyes open (EO), 206% with eyes closed (EC) on solid surface, and 54% EO on compliant surface (p < .001). Posturography confirmed balance improvements when perturbed on solid and compliant surfaces with EO and EC (p ≤ .033). Walking, step stool, and Timed Up and Go speeds increased (p ≤ .001), as did scores in Berg Balance and balance confidence scales (p ≤ .018). Discussion: Multimodal balance exercises offer an efficient, cost-effective way to improve balance control and confidence in elderly. PMID:28138495

  19. The Development of the Inventory of Problems-29: A Brief Self-Administered Measure for Discriminating Bona Fide From Feigned Psychiatric and Cognitive Complaints.

    PubMed

    Viglione, Donald J; Giromini, Luciano; Landis, Patricia

    2017-01-01

    This article describes the development of the Inventory of Problems-29 (IOP-29), a new, short, paper-and-pencil, self-administered measure of feigned mental and cognitive disorders. Four clinical comparison simulation studies were conducted. Study 1 (n = 451) selected the items and produced an index of potential feigning. Study 2 (n = 331) scaled this index to produce a probability score, and examined its psychometric properties. Study 3 tested the generalizability of Study 2's findings with 2 additional samples (ns = 128 and 90). Results supported the utility of the IOP-29 for discriminating bona fide from feigned psychiatric and cognitive complaints. Validity was demonstrated in feigning mild traumatic brain injury, psychosis, posttraumatic stress disorder, and depression. Within the independent samples of Studies 2 and 3, the brief IOP-29 performed similarly to the MMPI-2 and Personality Assessment Inventory, and perhaps better than the Test of Memory Malingering. Classifications within these samples with base rates of .5 produced sensitivity, specificity, positive predictive power, and negative predictive power statistics of about .80. Further research is needed testing the IOP-29 in ecologically valid field studies.

  20. Improved Balance Confidence and Stability for Elderly After 6 Weeks of a Multimodal Self-Administered Balance-Enhancing Exercise Program: A Randomized Single Arm Crossover Study.

    PubMed

    Hafström, Anna; Malmström, Eva-Maj; Terdèn, Josefine; Fransson, Per-Anders; Magnusson, Måns

    2016-01-01

    Objective: To develop and assess the efficacy of a multimodal balance-enhancing exercise program (BEEP) designed to be regularly self-administered by community-dwelling elderly. The program aims to promote sensory reweighting, facilitate motor control, improve gaze stabilization, and stimulate continuous improvement by being constantly challenging. Method: Forty participants aged 60 to 80 years performed 6 weeks of BEEP training, on average for 16 min four times weekly, in a randomized one-arm crossover design. Results: One-leg standing time improved 32% with eyes open (EO), 206% with eyes closed (EC) on solid surface, and 54% EO on compliant surface (p < .001). Posturography confirmed balance improvements when perturbed on solid and compliant surfaces with EO and EC (p ≤ .033). Walking, step stool, and Timed Up and Go speeds increased (p ≤ .001), as did scores in Berg Balance and balance confidence scales (p ≤ .018). Discussion: Multimodal balance exercises offer an efficient, cost-effective way to improve balance control and confidence in elderly.

  1. Delayed release dexlansoprazole in the treatment of GERD and erosive esophagitis

    PubMed Central

    Wittbrodt, Eric T; Baum, Charles; Peura, David A

    2009-01-01

    Although proton pump inhibitors (PPI) have a record of remarkable effectiveness and safety in the management of gastroesophageal reflux disease (GERD), several treatment challenges with PPI have emerged. Dexlansoprazole MR is the (R)-enantiomer of lansoprazole contained in a formulation that produces two distinct releases of drug and significantly extends the duration of active plasma concentrations and % time pH > 4 beyond that of conventional single-release PPI. Dexlansoprazole MR can be administered without regard to meals or the timing of meals in most patients. Dexlansoprazole MR 60 mg demonstrated similar efficacy for healing of erosive esophagitis at 8 weeks compared with lansoprazole 30 mg, and dexlansoprazole MR 30 mg was superior to placebo for maintenance of healed erosive esophagitis at 6 months with 99% of nights and 96% of days heartburn-free over 6 months in patients taking dexlansoprazole MR 30 mg. Superior relief of heartburn occurred in patients taking dexlansoprazole MR 30 mg (55% heartburn-free 24-hour periods) vs placebo (14%) for symptomatic nonerosive GERD. The safety profile of dexlansoprazole MR is similar to that of lansoprazole. The extended pharmacodynamic effects, added convenience, and efficacy and safety of dexlansoprazole MR offer a novel approach to gastric pH control in patients with acid-related disorders. PMID:21694835

  2. Diagnostic accuracy of the Self-administered, Self-reported History Questionnaire for lumbar spinal stenosis patients in Japanese primary care settings: a multicenter cross-sectional study (DISTO-project).

    PubMed

    Kato, Kinshi; Sekiguchi, Miho; Yonemoto, Koji; Kakuma, Tatsuyuki; Nikaido, Takuya; Watanabe, Kazuyuki; Otani, Koji; Yabuki, Shoji; Kikuchi, Shin-ichi; Konno, Shin-ichi

    2015-09-01

    Diagnostic support tools for lumbar spinal stenosis such as the Self-administered, Self-reported History Questionnaire have been developed in Japan, but no report has demonstrated the diagnostic accuracy of this questionnaire in Japanese primary care settings. This multicenter, cross-sectional survey was performed to evaluate and improve the diagnostic accuracy of this questionnaire for lumbar spinal stenosis patients in Japanese primary care settings. The lumbar spinal stenosis diagnosis support tool project was conducted in 1657 hospitals to evaluate the diagnostic accuracy of the Self-administered, Self-reported History Questionnaire in Japan from 2011 to 2012. Consecutive adults (≥50 years old) from physicians, including non-orthopedic general practitioners and orthopedic general practitioners, were considered for enrollment. Consecutive adults (≥50 years old) with low back pain from hospital-based orthopedic surgeons were also considered for enrollment. The diagnostic accuracy of the Self-administered, Self-reported History Questionnaire with initial and several new cutoff points in classifying patients according to the presence of lumbar spinal stenosis was assessed in terms of sensitivity, specificity and negative predictive values. Among the 33,545 patients, 10,199 (30.4 %) were diagnosed with lumbar spinal stenosis by the physicians. The Self-administered, Self-reported History Questionnaire version 1.1 with a new cutoff point was more sensitive than the Self-administered, Self-reported History Questionnaire version 1.0 with the initial cutoff point (79.8 vs. 68.3 %) and less specific (68.8 vs. 75.1 %) for lumbar spinal stenosis diagnosis. The respective negative predictive values were 88.5 and 84.3 %. The Self-administered, Self-reported History Questionnaire version 1.1 with the new cutoff was more sensitive and had higher negative predictive value than version 1.0 with the initial cutoff. Therefore, the improved Self-administered, Self

  3. A brief patient self-administered substance use screening tool for primary care: two-site validation study of the Substance Use Brief Screen (SUBS)

    PubMed Central

    McNeely, Jennifer; Strauss, Shiela M; Saitz, Richard; Cleland, Charles M; Palamar, Joseph J; Rotrosen, John; Gourevitch, Marc N

    2015-01-01

    Background Substance use screening is widely encouraged in healthcare settings, but the lack of a screening approach that fits easily into clinical workflows has restricted its broad implementation. The Substance Use Brief Screen (SUBS) was developed as a brief, self-administered instrument to identify unhealthy use of tobacco, alcohol, illicit drugs, and prescription drugs. We evaluated the validity and test-retest reliability of the SUBS in adult primary care patients. Methods Adults age 18-65 were enrolled from urban safety net primary care clinics to self-administer the SUBS using touch-screen tablet computers for a test-retest reliability study (n=54) and a two-site validation study (n=586). In the test-retest reliability study, the SUBS was administered twice within a 2-week period. In the validation study, the SUBS was compared to reference standard measures, including self-reported measures and saliva drug tests. We measured test-retest reliability and diagnostic accuracy of the SUBS for detection of unhealthy use and substance use disorder for tobacco, alcohol, and drugs (illicit and prescription drug misuse). Results Test-retest reliability was good or excellent for each substance class. For detection of unhealthy use, the SUBS had sensitivity and specificity of 97.8% (95% CI 93.7 to 99.5) and 95.7% (95% CI 92.4 to 97.8), respectively, for tobacco; and 85.2% (95% CI 79.3 to 89.9) and 77.0% (95% CI 72.6 to 81.1) for alcohol. For unhealthy use of illicit or prescription drugs, sensitivity was 82.5% (95% CI 75.7 to 88.0) and specificity 91.1% (95% CI 87.9 to 93.6). With respect to identifying a substance use disorder, the SUBS had sensitivity and specificity of 100.0% (95% CI 92.7 to 100.0) and 72.1% (95% CI 67.1 to 76.8) for tobacco; 93.5% (95% CI 85.5 to 97.9) and 64.6% (95% CI 60.2 to 68.7) for alcohol; and 85.7% (95% CI 77.2 to 92.0) and 82.0% (95% CI 78.2 to 85.3) for drugs. Analyses of area under the receiver operating curve (AUC) indicated good

  4. Estimation of eicosapentaenoic acid and docosahexaenoic acid intakes in pregnant Japanese women without nausea by using a self-administered diet history questionnaire.

    PubMed

    Shiraishi, Mie; Haruna, Megumi; Matsuzaki, Masayo; Murayama, Ryoko; Yatsuki, Yuko; Sasaki, Satoshi

    2013-06-01

    Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intakes during pregnancy affect fetal development and maternal mental health; therefore, an accurate assessment of EPA and DHA intakes is required. We hypothesized that a self-administered diet history questionnaire (DHQ) that was developed for non-pregnant adults could be used for estimating EPA and DHA intakes in pregnant Japanese women; thus, we evaluated the validity and reproducibility of the DHQ during pregnancy. We recruited 262 healthy participants with singleton pregnancies during their second trimester at a university hospital in Tokyo between June 2010 and July 2011. Plasma concentrations of EPA and DHA were measured as reference values. Fifty-eight women completed the DHQ twice, within a 4- to 5-week period to assess the reproducibility of the results. Among the participants without pregnancy-associated nausea (n = 180), significantly positive correlations were observed between energy-adjusted intakes and plasma concentrations of EPA (r(s) = 0.388), DHA (r(s) = 0.264), and EPA + DHA (r(s) = 0.328). More than 60% of the participants without nausea fell into the same or adjacent quintiles according to energy-adjusted intakes and plasma concentrations of EPA, DHA, and EPA + DHA. Meanwhile, among the participants with nausea, a low correlation for EPA and no correlation for DHA and EPA + DHA were found. Intraclass correlation coefficients for the 2-time DHQ measurements were 0.691 (EPA) and 0.663 (DHA). The results indicate that the DHQ has an acceptable level of validity and reproducibility for assessing EPA, DHA, and EPA + DHA intakes in pregnant Japanese women without nausea. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Validity of a self-administered version of the brief index of lupus damage in a predominantly African American systemic lupus erythematosus cohort.

    PubMed

    Drenkard, C; Yazdany, J; Trupin, L; Katz, P P; Dunlop-Thomas, C; Bao, G; Lim, S S

    2014-06-01

    To assess the reliability and criterion and construct validity of the self-administered Brief Index of Lupus Damage (SA-BILD), a patient-reported measure of organ damage in systemic lupus erythematosus (SLE). The validity of the SA-BILD was assessed using data from the Georgians Organized Against Lupus (GOAL) survey. GOAL is a longitudinal cohort of SLE patients predominantly derived from the Georgia Lupus Registry, a population-based registry established in Atlanta, Georgia. In total, 711 participants with documented SLE completed the SA-BILD. To test reliability, the SA-BILD was readministered to 32 patients. Criterion validity was examined in 150 respondents for whom the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) was also completed. Construct validity was assessed among 711 GOAL participants by dividing the SA-BILD scores into quartiles and examining the association with demographics, health status, and health care utilization. The test-retest correlation score was 0.93 (P < 0.0001), the item-by-item agreement with the SDI was >80% for most SA-BILD items, and the Spearman's rho correlation coefficient for the SDI and SA-BILD was moderately high (ρ = 0.59, P < 0.0001). SA-BILD scores showed significant associations in the expected directions with age, disease duration, disease activity, overall health, comorbidity index, and physician visits. The SA-BILD was reliable and had very good or good criterion validity compared with the SDI when tested in a predominantly African American cohort of US SLE patients. Associations of SA-BILD scores with sociodemographics and health status were consistent with previous studies. These findings support the use of the SA-BILD as a valid measure of patient-reported damage in SLE. Copyright © 2014 by the American College of Rheumatology.

  6. Assessment of the accuracy of portion size reports using computer-based food photographs aids in the development of an automated self-administered 24-hour recall.

    PubMed

    Subar, Amy F; Crafts, Jennifer; Zimmerman, Thea Palmer; Wilson, Michael; Mittl, Beth; Islam, Noemi G; McNutt, Suzanne; Potischman, Nancy; Buday, Richard; Hull, Stephen G; Baranowski, Tom; Guenther, Patricia M; Willis, Gordon; Tapia, Ramsey; Thompson, Frances E

    2010-01-01

    To assess the accuracy of portion-size estimates and participant preferences using various presentations of digital images. Two observational feeding studies were conducted. In both, each participant selected and consumed foods for breakfast and lunch, buffet style, serving themselves portions of nine foods representing five forms (eg, amorphous, pieces). Serving containers were weighed unobtrusively before and after selection as was plate waste. The next day, participants used a computer software program to select photographs representing portion sizes of foods consumed the previous day. Preference information was also collected. In Study 1 (n=29), participants were presented with four different types of images (aerial photographs, angled photographs, images of mounds, and household measures) and two types of screen presentations (simultaneous images vs an empty plate that filled with images of food portions when clicked). In Study 2 (n=20), images were presented in two ways that varied by size (large vs small) and number (4 vs 8). Convenience sample of volunteers of varying background in an office setting. Repeated-measures analysis of variance of absolute differences between actual and reported portions sizes by presentation methods. Accuracy results were largely not statistically significant, indicating that no one image type was most accurate. Accuracy results indicated the use of eight vs four images was more accurate. Strong participant preferences supported presenting simultaneous vs sequential images. These findings support the use of aerial photographs in the automated self-administered 24-hour recall. For some food forms, images of mounds or household measures are as accurate as images of food and, therefore, are a cost-effective alternative to photographs of foods. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  7. Time and Sex-Dependent Effects of an Adenosine A2A/A1 Receptor Antagonist on Motivation to Self-Administer Cocaine in Rats

    PubMed Central

    Doyle, Susan E.; Breslin, Florence J.; Rieger, Jayson M.; Beauglehole, Anthony; Lynch, Wendy J.

    2012-01-01

    Adenosine is an important neuromodulator, known to interact with both dopaminergic and glutamatergic systems to influence psychostimulant action. In the present study, we examined the effects of ATL444, a novel adenosine receptor antagonist, on motivation for cocaine in male and female rats. Adult male and female Sprague-Dawley rats were trained to self-administer cocaine (1.5 mg/kg/infusion) on a fixed-ratio 1 schedule with a daily maximum of 20 infusions. Following 5 consecutive sessions during which all 20 available infusions were obtained, motivation for cocaine (0.5 mg/kg/infusion) was assessed under a progressive ratio (PR) schedule, and once responding stabilized, the effect of treatment with ATL444 (0, 15, and 30 mg/kg, i.p.) was examined. As a control, we also assessed its effects on PR responding for sucrose. Binding studies revealed that ATL 444 was 3-fold, 25-fold, and 400-fold more selective for the A2A receptor as compared to A1, A2B, and A3 receptors, respectively. ATL444 produced a significant increase in motivation for cocaine on the day of treatment in females with a trend for an increase in males. In addition, over the two PR sessions following ATL444 treatment a significant decrease in responding was observed in males but not females. Responding for sucrose was unaffected by ATL444 treatment. Our results reveal that adenosine receptor blockade may mediate both acute increases in the reinforcing effects of cocaine, and longer term inhibitory effects on cocaine reinforcement that differ according to sex. PMID:22579716

  8. Validity and reliability of the Spanish-language version of the self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale.

    PubMed

    López-de-Uralde-Villanueva, I; Gil-Martínez, A; Candelas-Fernández, P; de Andrés-Ares, J; Beltrán-Alacreu, H; La Touche, R

    2016-12-08

    The self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale is a tool designed to identify patients with pain with neuropathic features. To assess the validity and reliability of the Spanish-language version of the S-LANSS scale. Our study included a total of 182 patients with chronic pain to assess the convergent and discriminant validity of the S-LANSS; the sample was increased to 321 patients to evaluate construct validity and reliability. The validated Spanish-language version of the ID-Pain questionnaire was used as the criterion variable. All participants completed the ID-Pain, the S-LANSS, and the Numerical Rating Scale for pain. Discriminant validity was evaluated by analysing sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). Construct validity was assessed with factor analysis and by comparing the odds ratio of each S-LANSS item to the total score. Convergent validity and reliability were evaluated with Pearson's r and Cronbach's alpha, respectively. The optimal cut-off point for S-LANSS was ≥12 points (AUC=.89; sensitivity=88.7; specificity=76.6). Factor analysis yielded one factor; furthermore, all items contributed significantly to the positive total score on the S-LANSS (P<.05). The S-LANSS showed a significant correlation with ID-Pain (r=.734, α=.71). The Spanish-language version of the S-LANSS is valid and reliable for identifying patients with chronic pain with neuropathic features. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Design and validation of a self-administered test to assess bullying (bull-M) in high school Mexicans: a pilot study

    PubMed Central

    2013-01-01

    Background Bullying (Bull) is a public health problem worldwide, and Mexico is not exempt. However, its epidemiology and early detection in our country is limited, in part, by the lack of validated tests to ensure the respondents’ anonymity. The aim of this study was to validate a self-administered test (Bull-M) for assessing Bull among high-school Mexicans. Methods Experts and school teachers from highly violent areas of Ciudad Juarez (Chihuahua, México), reported common Bull behaviors. Then, a 10-item test was developed based on twelve of these behaviors; the students’ and peers’ participation in Bull acts and in some somatic consequences in Bull victims with a 5-point Likert frequency scale. Validation criteria were: content (CV, judges); reliability [Cronbach’s alpha (CA), test-retest (spearman correlation, rs)]; construct [principal component (PCA), confirmatory factor (CFA), goodness-of-fit (GF) analysis]; and convergent (Bull-M vs. Bull-S test) validity. Results Bull-M showed good reliability (CA = 0.75, rs = 0.91; p < 0.001). Two factors were identified (PCA) and confirmed (CFA): “bullying me (victim)” and “bullying others (aggressor)”. GF indices were: Root mean square error of approximation (0.031), GF index (0.97), and normalized fit index (0.92). Bull-M was as good as Bull-S for measuring Bull prevalence. Conclusions Bull-M has a good reliability and convergent validity and a bi-modal factor structure for detecting Bull victims and aggressors; however, its external validity and sensitivity should be analyzed on a wider and different population. PMID:23577755

  10. Medication adherence and persistence over time with self-administered TNF-alpha inhibitors among young adult, middle-aged, and older patients with rheumatologic conditions.

    PubMed

    Calip, Gregory S; Adimadhyam, Sruthi; Xing, Shan; Rincon, Julian C; Lee, Wan-Ju; Anguiano, Rebekah H

    2017-03-21

    Self-injectable TNF inhibitors are increasingly used early in the chronic treatment of moderate to severe rheumatologic conditions. We estimated medication adherence/persistence over time following initiation in young adult and older adult patients with rheumatoid arthritis, ankylosing spondylitis or psoriatic arthritis. We conducted a retrospective cohort study of patients aged 18+ years newly initiating etanercept, adalimumab, certolizumab pegol, or golimumab using the Truven Health MarketScan Database between 2009 and 2013. Pharmacy dispensing data were used to calculate 12-month medication possession ratios (MPR) and determine adherence (MPR ≥ 0.80) for up to 3 years after starting therapy. Persistence over each 12-month interval was defined as not having a ≥92-day treatment gap. Multivariable generalized estimating equation models were used to calculate odds ratios (OR) and robust 95% confidence intervals (CI) for associations between patient characteristics and repeated adherence/persistence measures over time. Among 53,477 new users, 14% were young adults (18-34 years), 49% middle-aged (35-54 years), and 37% older adults (55+ years). Overall, 37% of patients were adherent and 83% were persistent in the first year of therapy. The lowest adherence (17%) and persistence (70%) were observed among young adult patients by Year +3. Compared to older adults, middle-aged (OR = 0.73, 95% CI: 0.71-0.76) and young adults (OR = 0.50, 95% CI: 0.47-0.53) were less likely to be adherent. Higher Charlson comorbidity scores, hospitalizations, and emergency department visits were associated with non-adherence/non-persistence. We observed low adherence to self-administered TNF inhibitors but most patients remained persistent over time. Further efforts to improve adherence in young adults and patients with greater comorbidity are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Distinct Neurochemical Adaptations Within the Nucleus Accumbens Produced by a History of Self-Administered vs Non-Contingently Administered Intravenous Methamphetamine

    PubMed Central

    Lominac, Kevin D; Sacramento, Arianne D; Szumlinski, Karen K; Kippin, Tod E

    2012-01-01

    Methamphetamine is a highly addictive psychomotor stimulant yet the neurobiological consequences of methamphetamine self-administration remain under-characterized. Thus, we employed microdialysis in rats trained to self-administer intravenous (IV) infusions of methamphetamine (METH-SA) or saline (SAL) and a group of rats receiving non-contingent IV infusions of methamphetamine (METH-NC) at 1 or 21 days withdrawal to determine the dopamine and glutamate responses in the nucleus accumbens (NAC) to a 2 mg/kg methamphetamine intraperitoneal challenge. Furthermore, basal NAC extracellular glutamate content was assessed employing no net-flux procedures in these three groups at both time points. At both 1- and 21-day withdrawal points, methamphetamine elicited a rise in extracellular dopamine in SAL animals and this effect was sensitized in METH-NC rats. However, METH-SA animals showed a much greater sensitized dopamine response to the drug challenge compared with the other groups. Additionally, acute methamphetamine decreased extracellular glutamate in both SAL and METH-NC animals at both time-points. In contrast, METH-SA rats exhibited a modest and delayed rise in glutamate at 1-day withdrawal and this rise was sensitized at 21 days withdrawal. Finally, no net-flux microdialysis revealed elevated basal glutamate and increased extraction fraction at both withdrawal time-points in METH-SA rats. Although METH-NC rats exhibited no change in the glutamate extraction fraction, they exhibited a time-dependent elevation in basal glutamate levels. These data illustrate for the first time that a history of methamphetamine self-administration produces enduring changes in NAC neurotransmission and that non-pharmacological factors have a critical role in the expression of these methamphetamine-induced neurochemical adaptations. PMID:22030712

  12. Distinct neurochemical adaptations within the nucleus accumbens produced by a history of self-administered vs non-contingently administered intravenous methamphetamine.

    PubMed

    Lominac, Kevin D; Sacramento, Arianne D; Szumlinski, Karen K; Kippin, Tod E

    2012-02-01

    Methamphetamine is a highly addictive psychomotor stimulant yet the neurobiological consequences of methamphetamine self-administration remain under-characterized. Thus, we employed microdialysis in rats trained to self-administer intravenous (IV) infusions of methamphetamine (METH-SA) or saline (SAL) and a group of rats receiving non-contingent IV infusions of methamphetamine (METH-NC) at 1 or 21 days withdrawal to determine the dopamine and glutamate responses in the nucleus accumbens (NAC) to a 2 mg/kg methamphetamine intraperitoneal challenge. Furthermore, basal NAC extracellular glutamate content was assessed employing no net-flux procedures in these three groups at both time points. At both 1- and 21-day withdrawal points, methamphetamine elicited a rise in extracellular dopamine in SAL animals and this effect was sensitized in METH-NC rats. However, METH-SA animals showed a much greater sensitized dopamine response to the drug challenge compared with the other groups. Additionally, acute methamphetamine decreased extracellular glutamate in both SAL and METH-NC animals at both time-points. In contrast, METH-SA rats exhibited a modest and delayed rise in glutamate at 1-day withdrawal and this rise was sensitized at 21 days withdrawal. Finally, no net-flux microdialysis revealed elevated basal glutamate and increased extraction fraction at both withdrawal time-points in METH-SA rats. Although METH-NC rats exhibited no change in the glutamate extraction fraction, they exhibited a time-dependent elevation in basal glutamate levels. These data illustrate for the first time that a history of methamphetamine self-administration produces enduring changes in NAC neurotransmission and that non-pharmacological factors have a critical role in the expression of these methamphetamine-induced neurochemical adaptations.

  13. Relationship between symptoms, subjective well-being and medication use in gastro-oesophageal reflux disease

    PubMed Central

    Jones, R; Liker, H R; Ducrotté, P

    2007-01-01

    Aim: To report data from a multinational survey investigating the relationship between gastro-oesophageal reflux disease (GERD) symptoms, treatment and subjective well-being. Methods: Patients formally diagnosed with GERD (n = 929) and undiagnosed subjects with symptoms suggestive of GERD (n = 924) were included. Results: Sixty per cent of diagnosed (mean age: 51.7 years) and 54% of undiagnosed (mean age: 44.3 years) participants were female. Over 50% of participants were overweight or obese. Most respondents consumed alcohol, and one-third were smokers. In total, 78% of diagnosed subjects were currently receiving medication prescribed by their doctor, and 65% were taking over-the-counter (OTC) treatments. The majority (97%) of undiagnosed subjects were taking OTC medication, the most common of which were antacids (78%). Despite medication, 58% of diagnosed and 73% of undiagnosed subjects still experienced GERD symptoms some of the time. Approximately one-third of subjects in each group reported that they ate less than usual, felt generally unwell, were tired/worn out or worried/fearful for the majority of the time because of their GERD symptoms, and around half reported decreased well-being, including reduced work or leisure time productivity. Conclusions: These findings attest to the severity and impact of GERD symptoms, highlighting the need to improve the management of GERD in routine practice. Many symptomatic and long-term sufferers, for example, may benefit from taking steps towards a healthier lifestyle (e.g. weight reduction) in addition to optimisation of acid-suppressive therapy. PMID:17590216

  14. Expert and self-assessment of lifetime symptoms and diagnosis of major depressive disorder in large-scale genetic studies in the general population: comparison of a clinical interview and a self-administered checklist

    PubMed Central

    Martin, Jessica; Streit, Fabian; Treutlein, Jens; Lang, Maren; Frank, Josef; Forstner, Andreas J.; Degenhardt, Franziska; Witt, Stephanie H.; Schulze, Thomas G.; Cichon, Sven; Nöthen, Markus M.; Rietschel, Marcella

    2017-01-01

    Major depression disorder (MDD) is a complex neuropsychiatric disorder and an increasing number of genetic risk variants are being identified. Investigation of their influence in the general population requires accurate and efficient assessment of depressive symptoms. Here, clinical interviews conducted by clinicians are the gold standard. We investigated whether valid and reliable clinical phenotypes can be obtained efficiently using self-administered instruments. Lifetime depressive symptoms and lifetime MDD diagnosis were assessed in 464 population-based individuals using a clinical interview and a structured, self-administered checklist. Analyses were carried out of the following: (i) intraclass correlations (ICC) between checklist and interview; (ii) sensitivity/specificity of the checklist; and (iii) the association of interview and checklist with a positive family history of MDD (FH-MDD+). The correspondence of the self-administered checklist with the clinical interview was good for most depressive symptoms (ICC=0.60–0.80) and moderate for MDD diagnosis (ICC=0.45). With the consecutive inclusion of MDD diagnostic criteria, sensitivity decreased from 0.67 to 0.46, whereas specificity remained high (0.95). For checklist and interview, strong associations were found between FH-MDD+ and most depressive symptoms and MDD diagnosis (all odds ratio≥1.83). The self-administered checklist showed high reliability for both the assessment of lifetime depressive symptoms and screening for individuals with no lifetime diagnosis of MDD. However, attention is warranted when the aim is to identify MDD cases. The positive association between depressive symptomatology and FH-MDD+ indicates the usefulness of both instruments to assess patients in genetic studies. Our data suggest that the more time-efficient and cost-efficient self-administered instruments also allow for the assessment of depressive symptoms accurate enough to investigate the influence of MDD genetic risk

  15. Specific count model for investing the related factors of cost of GERD and functional dyspepsia

    PubMed Central

    Abadi, Alireza; Chaibakhsh, Samira; Safaee, Azadeh; Moghimi-Dehkordi, Bijan

    2013-01-01

    Aim The purpose of this study is to analyze the cost of GERD and functional dyspepsia for investing its related factors. Background Gastro-oesophageal reflux disease GERD and dyspepsia are the most common symptoms of gastrointestinal disorders. Recent studies showed high prevalence and variety of clinical presentation of these two symptoms imposed enormous economic burden to the society. Cost data that related to economics burden have specific characteristics. So this kind of data needs to specific models. Poisson regression (PR) and negative binomial regression (NB) are the models that were used for analyzing cost data in this paper. Patients and methods This study designed as a cross-sectional household survey from May 2006 to December 2007 on a random sample of individual in the Tehran province, Iran to find the prevalence of gastrointestinal symptoms and disorders and its related factors. The Cost in each item was counted. PR and NB were carried out to the data respectively. Likelihood ratio test was performed for comparison between models. Also Log likelihood, Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to compare performance of the models. Results According to Likelihood ratio test and all three criterions that we used to compare performance of the models, NB was the best model for analyzing this cost data. Sex, age and insurance statues were being significant. Conclusion PR and NB models were carried out for this data and according the results improved fit of the NB model over PR, it clearly indicates that over-dispersion is involved due to unobserved heterogeneity and/or clustering. NB model in cost data more appropriate fit than PR. PMID:24834282

  16. A validation study of the Automated Self-Administered 24-Hour Dietary Recall for Children (ASA24-Kids) among 9 to 11-year-old youth

    PubMed Central

    Diep, Cassandra S.; Hingle, Melanie; Chen, Tzu-An; Dadabhoy, Hafza R.; Beltran, Alicia; Baranowski, Janice; Subar, Amy F.; Baranowski, Tom

    2015-01-01

    Background Valid methods of diet assessment are important for nutrition research and practice but can be difficult with children. Objective To validate ASA24-Kids-2012, a self-administered web-based 24-hour dietary recall (24hDR) among 9-11-year-old children, in two sites. Design Quasi-experimental Participants/setting In one site, trained staff observed and recorded foods and drinks consumed by children (n=38) during school lunch. The next day, the observed children completed both ASA24-Kids-2012 and an interviewer-administered 24hDR in a randomized order. Procedures in a second site (n=31) were similar, except observations occurred during dinner in a community location. Statistical analyses Foods were classified as matches (reported and consumed), intrusions (reported, but not consumed), or omissions (not reported, but consumed) for each participant. Rates of matches, intrusions, and omissions were calculated. Rates were compared between each recall method using repeated measures analysis of covariance. For matched foods, the authors determined correlation coefficients between observed and reported serving sizes. Results Match, intrusion, and omission rates between ASA24-Kids-2012 and observed intakes in site 1 were 37%, 27%, and 35%, respectively. Comparable rates for interviewer-administered 24hDRs were 57%, 20%, and 23%, respectively. In site 2, match, intrusion, and omission rates between ASA24-Kids-2012 and observed intakes were 53%, 12%, and 36%, respectively, vs. 76% matches, 9% intrusions, and 15% omissions for interviewer-administered 24hDRs. The relationship strength between reported and observed serving sizes for matched foods was 0.18 in site 1 and 0.09 in site 2 for ASA24-Kids-2012, and 0.46 in site 1 and 0.11 in site 2 for interviewer-administered 24hDRs. Conclusions ASA24-Kids-2012 was less accurate than interviewer-administered 24hDRs when compared to observed intakes, but both performed poorly. Additional research should assess the age at which

  17. Usability characteristics of self-administered computer-assisted interviewing in the emergency department: factors affecting ease of use, efficiency, and entry error.

    PubMed

    Herrick, D B; Nakhasi, A; Nelson, B; Rice, S; Abbott, P A; Saber Tehrani, A S; Rothman, R E; Lehmann, H P; Newman-Toker, D E

    2013-01-01

    Self-administered computer-assisted interviewing (SACAI) gathers accurate information from patients and could facilitate Emergency Department (ED) diagnosis. As part of an ongoing research effort whose long-range goal is to develop automated medical interviewing for diagnostic decision support, we explored usability attributes of SACAI in the ED. Cross-sectional study at two urban, academic EDs. Convenience sample recruited daily over six weeks. Adult, non-level I trauma patients were eligible. We collected data on ease of use (self-reported difficulty, researcher documented need for help), efficiency (mean time-per-click on a standardized interview segment), and error (self-report age mismatched with age derived from electronic health records) when using SACAI on three different instruments: Elo TouchSystems ESY15A2 (finger touch), Toshiba M200 (with digitizer pen), and Motion C5 (with digitizer pen). We calculated descriptive statistics and used regression analysis to evaluate the impact of patient and computer factors on time-per-click. 841 participants completed all SACAI questions. Few (<1%) thought using the touch computer to ascertain medical information was difficult. Most (86%) required no assistance. Participants needing help were older (54 ± 19 vs. 40 ± 15 years, p<0.001) and more often lacked internet at home (13.4% vs. 7.3%, p = 0.004). On multivariate analysis, female sex (p<0.001), White (p<0.001) and other (p = 0.05) race (vs. Black race), younger age (p<0.001), internet access at home (p<0.001), high school graduation (p = 0.04), and touch screen entry (vs. digitizer pen) (p = 0.01) were independent predictors of decreased time-per-click. Participant misclick errors were infrequent, but, in our sample, occurred only during interviews using a digitizer pen rather than a finger touch-screen interface (1.9% vs. 0%, p = 0.09). Our results support the facility of interactions between ED patients and SACAI. Demographic factors associated with need for

  18. Patient adherence to and tolerability of self-administered interferon β-1a using an electronic autoinjection device: a multicentre, open-label, phase IV study

    PubMed Central

    2012-01-01

    Background Achieving good adherence to self-injected treatments for multiple sclerosis can be difficult. Injection devices may help to overcome some of the injection-related barriers to adherence that can be experienced by patients. We sought to assess short-term adherence to, and tolerability of, interferon (IFN) β-1a administered via electronic autoinjection device in patients with relapsing-remitting multiple sclerosis (RRMS). Methods BRIDGE (RebiSmart to self-inject Rebif serum-free formulation in a multidose cartridge) was a 12-week, multicentre, open-label, single-arm, observational, Phase IV study in which patients self-administered IFN β-1a (titrated to 44 μg), subcutaneously (sc), three times weekly, via electronic autoinjection device. Patients were assessed at baseline and 4-weekly intervals to Week 12 or early termination (ET) for: physical examinations; diary card completion (baseline, Weeks 4, 8 only); neurological examinations (baseline, Week 12/ET only); MS Treatment Concern Questionnaire (MSTCQ; Weeks 4, 8, 12 only); Convenience Questionnaire (Week 12 only); Hospital Anxiety and Depression Scale (HADS); and Paced Auditory Serial Addition Task (PASAT; baseline only). Adherence was defined as administration of ≥ 80% of scheduled injections, recorded by the autoinjection device. Results Overall, 88.2% (105/119; intent-to-treat population) of patients were adherent; 67.2% (80/119) administered all scheduled injections. Medical reasons accounted for 35.6% (31/87) of missed injections, forgetfulness for 20.6% (18/87). Adherence did not correlate with baseline Expanded Disability Status Scale (P = 0.821) or PASAT (P = 0.952) scores, or pre-study therapy (P = 0.303). No significant changes (baseline-Week 12) in mean HADS depression (P = 0.482) or anxiety (P = 0.156) scores were observed. 'Overall convenience' was the most important reported benefit of the autoinjection device. Device features associated with handling and ease of use were highly rated

  19. Patient adherence to and tolerability of self-administered interferon β-1a using an electronic autoinjection device: a multicentre, open-label, phase IV study.

    PubMed

    Lugaresi, Alessandra; Florio, Ciro; Brescia-Morra, Vincenzo; Cottone, Salvatore; Bellantonio, Paolo; Clerico, Marinella; Centonze, Diego; Uccelli, Antonio; di Ioia, Maria; De Luca, Giovanna; Marcellusi, Andrea; Paolillo, Andrea

    2012-03-05

    Achieving good adherence to self-injected treatments for multiple sclerosis can be difficult. Injection devices may help to overcome some of the injection-related barriers to adherence that can be experienced by patients. We sought to assess short-term adherence to, and tolerability of, interferon (IFN) β-1a administered via electronic autoinjection device in patients with relapsing-remitting multiple sclerosis (RRMS). BRIDGE (RebiSmart to self-inject Rebif serum-free formulation in a multidose cartridge) was a 12-week, multicentre, open-label, single-arm, observational, Phase IV study in which patients self-administered IFN β-1a (titrated to 44 μg), subcutaneously (sc), three times weekly, via electronic autoinjection device. Patients were assessed at baseline and 4-weekly intervals to Week 12 or early termination (ET) for: physical examinations; diary card completion (baseline, Weeks 4, 8 only); neurological examinations (baseline, Week 12/ET only); MS Treatment Concern Questionnaire (MSTCQ; Weeks 4, 8, 12 only); Convenience Questionnaire (Week 12 only); Hospital Anxiety and Depression Scale (HADS); and Paced Auditory Serial Addition Task (PASAT; baseline only). Adherence was defined as administration of ≥ 80% of scheduled injections, recorded by the autoinjection device. Overall, 88.2% (105/119; intent-to-treat population) of patients were adherent; 67.2% (80/119) administered all scheduled injections. Medical reasons accounted for 35.6% (31/87) of missed injections, forgetfulness for 20.6% (18/87). Adherence did not correlate with baseline Expanded Disability Status Scale (P = 0.821) or PASAT (P = 0.952) scores, or pre-study therapy (P = 0.303). No significant changes (baseline-Week 12) in mean HADS depression (P = 0.482) or anxiety (P = 0.156) scores were observed. 'Overall convenience' was the most important reported benefit of the autoinjection device. Device features associated with handling and ease of use were highly rated. Mean MSTCQ scores for 'flu

  20. The effect of self-administered superficial local hot and cold application methods on pain, functional status and quality of life in primary knee osteoarthritis patients.

    PubMed

    Aciksoz, Semra; Akyuz, Aygul; Tunay, Servet

    2017-09-07

    To investigate the effect of the self-administered superficial local hot and cold applications on pain, and the functional status and the quality of life in primary knee osteoarthritis patients. Superficial local hot and cold application is used as a non-pharmacological method for the treatment of knee osteoarthritis. However, various guidelines for the management of knee osteoarthritis have conflicting recommendation for hot and cold therapy. A randomized clinical trial design. The sample consisted of patients (n=96) who were diagnosed with primary knee osteoarthritis. During the application stage, patients were designated to the hot and cold application groups and administered hot and cold application twice a day for three weeks together with standard osteoarthritis treatment. The control group only used standard osteoarthritis treatment. The data were collected with a Descriptive Information Form, a Pain Scale, the WOMAC Osteoarthritis Index, the Nottingham Health Profile and a Patient Satisfaction Evaluation Form. Outcome measures included pain intensity, functional status and quality of life. We found decreased primary measurement pain scores, and improved functional status scores and quality of life scores after the application program compared to the pre-application stage in both the hot and cold application groups. Once the application was completed, the pain scores, functional status scores and quality of life scores on the second measurements were found to be still statistically lower than the pre-application scores but higher than the first measurement (p<0.001, χ2=48.000; p<0.001, χ2=34.000), (p<0.001, χ2=22.000; p=0.001 χ2=14.000), (p=0.005, χ2=16.000; p=0.001, χ2=12.500). There was no difference in the perceived pain, functional status, and quality of life between the pre-application, post-application and two weeks post-application periods of the individuals in three groups (p>0.05). It was found that both hot and cold application resulted in a

  1. Performance of the Automated Self-Administered 24-hour Recall relative to a measure of true intakes and to an interviewer-administered 24-h recall123

    PubMed Central

    Kirkpatrick, Sharon I; Subar, Amy F; Douglass, Deirdre; Zimmerman, Thea P; Thompson, Frances E; Kahle, Lisa L; George, Stephanie M; Dodd, Kevin W; Potischman, Nancy

    2014-01-01

    Background: The Automated Self-Administered 24-hour Recall (ASA24), a freely available Web-based tool, was developed to enhance the feasibility of collecting high-quality dietary intake data from large samples. Objective: The purpose of this study was to assess the criterion validity of ASA24 through a feeding study in which the true intake for 3 meals was known. Design: True intake and plate waste from 3 meals were ascertained for 81 adults by inconspicuously weighing foods and beverages offered at a buffet before and after each participant served him- or herself. Participants were randomly assigned to complete an ASA24 or an interviewer-administered Automated Multiple-Pass Method (AMPM) recall the following day. With the use of linear and Poisson regression analysis, we examined the associations between recall mode and 1) the proportions of items consumed for which a match was reported and that were excluded, 2) the number of intrusions (items reported but not consumed), and 3) differences between energy, nutrient, food group, and portion size estimates based on true and reported intakes. Results: Respondents completing ASA24 reported 80% of items truly consumed compared with 83% in AMPM (P = 0.07). For both ASA24 and AMPM, additions to or ingredients in multicomponent foods and drinks were more frequently omitted than were main foods or drinks. The number of intrusions was higher in ASA24 (P < 0.01). Little evidence of differences by recall mode was found in the gap between true and reported energy, nutrient, and food group intakes or portion sizes. Conclusions: Although the interviewer-administered AMPM performed somewhat better relative to true intakes for matches, exclusions, and intrusions, ASA24 performed well. Given the substantial cost savings that ASA24 offers, it has the potential to make important contributions to research aimed at describing the diets of populations, assessing the effect of interventions on diet, and elucidating diet and health

  2. Effect of seasonality on the estimated mean value of nutrients and ranking ability of a self-administered diet history questionnaire.

    PubMed

    Suga, Hitomi; Asakura, Keiko; Sasaki, Satoshi; Nojima, Masanori; Okubo, Hitomi; Hirota, Naoko; Notsu, Akiko; Fukui, Mitsuru; Date, Chigusa

    2014-05-31

    We examined the effect of seasonality on the validity (ability to estimate the mean intake of a group and ranking ability) of nutrient intakes estimated with a comprehensive self-administered diet history questionnaire (DHQ) developed for the assessment of Japanese diets during the preceding one month, using semi-weighed dietary records (DRs) as a reference method. This study was conducted in three areas in Japan (Osaka, Nagano, and Tottori). The study population included 92 Japanese men aged 32-76 years and 92 Japanese women aged 31-69 years (30 from Osaka, 31 from Nagano, and 31 from Tottori for each sex). A DHQ and a four-day DR were completed four times at 3-month intervals, once per season. The effect of seasonality was examined by the level of agreement among seasons using mean nutrient intake and correlation coefficients. Significant differences in estimated energy-adjusted intakes of 42 selected nutrients between the average of DRs administered 16 times throughout a year and that of the DHQ administered four times in each season (fall, winter, spring, and summer) were observed for 30, 29, 30, and 31 nutrients for men and 21, 28, 30, and 31 nutrients for women, respectively. Pearson correlation coefficients between the DRs and the DHQs for energy-adjusted intakes of the 42 nutrients showed significant inter-season differences in 11 nutrients for men and 13 nutrients for women. Particularly, correlation coefficients of fat, monounsaturated fat, polyunsaturated fat, n-6 polyunsaturated fat, α-linolenic acid, and cholesterol in spring and cryptoxanthin in summer for men, and fat, saturated fat, and monounsaturated fat in spring and summer and thiamin and iron in summer for women were markedly altered by seasonality. Mean nutrient intake estimated by the DHQ varied by season, indicating that any consideration of nutrient intake estimated by the DHQ as a yearly average intake may be problematic. In contrast, the effect of seasonality on the ranking ability of

  3. Weight loss and waist reduction is associated with improvement in gastroesophageal disease reflux symptoms: A longitudinal study of 15 295 subjects undergoing health checkups.

    PubMed

    Park, S-K; Lee, T; Yang, H-J; Park, J H; Sohn, C I; Ryu, S; Park, D I

    2017-05-01

    General obesity and abdominal obesity is an established risk factor of gastroesophageal reflux disease (GERD). However, the influence of weight or waist change on improvement of GERD is unclear. Our aim was to investigate if weight loss or waist reduction improves GERD symptoms and esophagitis. A retrospective longitudinal study of 15 295 subjects who underwent gastroscopy for a health checkup and reported GERD symptoms between 2011 and 2013, and repeated a checkup until 2014 was conducted. The improvement of GERD symptoms and esophagitis according to weight loss (≥-2, -0.5 to -2 kg/m(2) in body mass index [BMI]), waist reduction (≥-5, -0.1 to -0.5 cm) and baseline BMI/waist circumference (WC) categories was assessed using logistic regression. Weight loss or waist reduction was associated with improvement in GERD symptoms only in subjects with general or abdominal obesity. Among subjects with general obesity (BMI ≥25 kg/m(2) ) and decreased ≥2 kg/m(2) in BMI, the adjusted odds ratio (OR) of improvement in GERD symptoms was 2.34 (95% confidence interval [CI] 1.70-2.83). Among subjects with abdominal obesity (WC ≥90 cm) and decreased ≥5 cm in WC, the corresponding OR was 2.16 (95% CI 1.56-2.90). There was no association between weight loss or waist reduction and improvement in esophagitis. Weight loss or waist reduction was associated with improvement in GERD symptoms only in subjects with general or abdominal obesity. Weight loss or waist reduction will be an important treatment option in obese patients. © 2016 John Wiley & Sons Ltd.

  4. Managing heartburn at the 'base' of the GERD 'iceberg': effervescent ranitidine 150 mg b.d. provides faster and better heartburn relief than antacids.

    PubMed

    Earnest, D; Robinson, M; Rodriguez-Stanley, S; Ciociola, A A; Jaffe, P; Silver, M T; Kleoudis, C S; Murdock, R H

    2000-07-01

    Many individuals with heartburn self-medicate with antacids for relief of their symptoms. To compare efficacy of effervescent ranitidine to as-needed calcium carbonate antacids in subjects who self-treat heartburn. A total of 155 subjects with frequent antacid-responsive heartburn were randomized to receive effervescent ranitidine 150 mg tablets b.d., or as-needed calcium carbonate 750 mg for 12 weeks. Endoscopic oesophagitis severity and mucosal histology were assessed at baseline, and at weeks 6 and 12. Heartburn frequency, severity, and antacid consumption were recorded daily, and quality of life was assessed at baseline, and at weeks 6 and 12. Heartburn frequency and severity were significantly decreased after 1 day of ranitidine (P < 0.02). By week 6, ranitidine had significantly decreased rescue antacid consumption (7.3 tablets, P < 0.001) vs. antacids (14.1 tablets). Endoscopic oesophagitis healing (subjects self-administering antacids for chronic heartburn, effervescent ranitidine 150 mg b.d. is more effective than antacids in reducing heartburn, healing erosive oesophagitis, alleviating pain, and improving quality of life.

  5. Surgical treatment of GERD. Comperative study of WTP vs. Toupet fundoplication – results of 151 consecutive cases

    PubMed Central

    Wróblewski, Tadeusz; Nowosad, Małgorzata; Krawczyk, Marek

    2016-01-01

    Introduction Gastroesophageal reflux disease (GERD) is recognized as one of the most common disorders of the upper gastrointestinal tract (GIT). The best choice of management for advanced GERD is laparoscopic surgery. Aim To compare and evaluate the results of surgical treatment of GERD patients operated on using two different techniques. Material and methods Between 2001 and 2012, 353 patients (211 female and 142 male), aged 17–76 years (mean 44), underwent laparoscopic antireflux surgery. The study included patients who underwent a Toupet fundoplication or Wroblewski Tadeusz procedure (WTP). Results The mean age of the group was 47.77 years (17–80 years). Forty-nine (32.45%) patients had severe symptoms, 93 (61.58%) had mild symptoms and 9 (5.96%) had a single mild but intolerable sign of GERD. Eighty-six (56.95%) patients had a Toupet fundoplication and 65 (43.04%) had a WTP. The follow-up period was 18–144 months. The average operating time for Toupet fundoplication and the WTP procedure was 164 min (90–300 min) and 147 min (90–210 min), respectively. The perioperative mortality rate was 0.66%. The average post-operative hospitalization period was 5.4 days (2–16 post-operative days (POD) = Toupet) vs. 4.7 days (2–9 POD = WTP). No reoperations were performed. No major surgical complications were identified. Conclusions Wroblewski Tadeusz procedure due to a low percentage of post-operative complications, good quality of life of patients and a zero recurrence rate of hiatal hernia should be a method of choice. PMID:27458484

  6. Endoscopic, deep mural implantation of Enteryx for the treatment of GERD: 6-month follow-up of a multicenter trial.

    PubMed

    Johnson, David A; Ganz, Robert; Aisenberg, James; Cohen, Lawrence B; Deviere, Jacques; Foley, T Raymond; Haber, Gregory B; Peters, Jeffrey H; Lehman, Glen A

    2003-02-01

    This prospective, multicenter, single-arm study evaluated the safety and efficacy of the endoscopic implantation of Enteryx, a biocompatible, non-biodegradable liquid polymer for the treatment of GERD. Eighty-five patients with heartburn symptoms responsive to proton pump inhibitor (PPI) use were enrolled. Inclusion requirements were HRQL score < or = 11 on PPI and > or = 20 off PPI, and 24-hour PH probe with > or = 5% total time at PH < or = 4. Patients with a hiatus hernia > 3 cm, grade 3 or 4 esophagitis, or esophageal motility disorder were excluded. Using a 4-mm needle tipped catheter during standard endoscopy, implants were made in 3-4 quadrants deep into the wall of the cardia. Use of PPI medications, pH-metry, manometry, GERD symptoms, and patient quality of life were assessed over a 6-month follow-up period. At 6 months, PPI use was eliminated in 74% and reduced by > 50% in 10% of patients. The median HRQL score improved from 24.0 pre-implant (baseline off PPIs) to 4.0 at 6 months (p < 0.001). Mean total esophageal acid exposure time was 9.5% pretherapy and 6.7% at 6 months (p < 0.001). Mean LES length increased from 2.0 cm at baseline to 3.0 cm posttherapy (p = 0.003). There were no clinically serious adverse events. Transient mild-to-moderate chest pain commonly occurred after implantation. The endoscopic implantation of Enteryx is a safe and effective therapy for eliminating or decreasing the need for PPI medications, improving GERD symptoms and patient quality of life, and decreasing esophageal acid exposure among patients suffering from GERD.

  7. Potential mechanism of corpus-predominant gastritis after PPI therapy in Helicobacter pylori-positive patients with GERD.

    PubMed

    Mukaisho, Ken-ichi; Hagiwara, Tadashi; Nakayama, Takahisa; Hattori, Takanori; Sugihara, Hiroyuki

    2014-09-14

    The long-term use of proton pump inhibitors (PPIs) exacerbates corpus atrophic gastritis in patients with Helicobacter pylori (H. pylori) infection. To identify a potential mechanism for this change, we discuss interactions between pH, bile acids, and H. pylori. Duodenogastric reflux, which includes bile, occurs in healthy individuals, and bile reflux is increased in patients with gastroesophageal reflux disease (GERD). Diluted human plasma and bile acids have been found to be significant chemoattractants and chemorepellents, respectively, for the bacillus H. pylori. Although only taurine conjugates, with a pKa of 1.8-1.9, are soluble in an acidic environment, glycine conjugates, with a pKa of 4.3-5.2, as well as taurine-conjugated bile acids are soluble in the presence of PPI therapy. Thus, the soluble bile acid concentrations in the gastric contents of patients with GERD after continuous PPI therapy are considerably higher than that in those with intact acid production. In the distal stomach, the high concentration of soluble bile acids is likely to act as a bactericide or chemorepellent for H. pylori. In contrast, the mucous layer in the proximal stomach has an optimal bile concentration that forms chemotactic gradients with plasma components required to direct H. pylori to the epithelial surface. H. pylori may then colonize in the stomach body rather than in the pyloric antrum, which may explain the occurrence of corpus-predominant gastritis after PPI therapy in H. pylori-positive patients with GERD.

  8. A Causal Relationship Between Cough and Gastroesophageal Reflux Disease (GERD) Has Been Established: a Pro/Con Debate

    PubMed Central

    Kahrilas, Peter J.; Smith, Jaclyn A.; Dicpinigaitis, Peter V.

    2014-01-01

    Along with upper airway cough syndrome (formerly, postnasal drip syndrome) and eosinophilic airway inflammation (asthma, non-asthmatic eosinophilic bronchitis), gastroesophageal reflux disease (GERD) is generally considered among the most common etiologies of chronic cough. Indeed, cough management guidelines published by numerous respiratory societies worldwide recommend evaluation and treatment of GERD as an integral component of the diagnostic/therapeutic algorithm for the management of chronic cough. However, a significant number of patients with chronic cough presumed due to GERD do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory cases may be due to the recently appreciated entity of non-acid or weakly acidic reflux. Further contributing to the controversy are recent studies demonstrating that patients with chronic cough do not have excessive reflux events relative to healthy volunteers. Although a temporal relationship between cough and reflux events has been suggested by studies utilizing impedance-pH monitoring of reflux events and objective cough recording, consensus is lacking in terms of whether this temporal relationship proves a causal link between reflux and cough. The 4th American Cough Conference, held in New York in June, 2013, provided an ideal forum for the debate of this issue between two internationally recognized experts in the field of reflux and chronic cough. PMID:24221340

  9. Development and the initial validation of a new self-administered questionnaire for an early detection of health status changes in smokers at risk for chronic obstructive pulmonary disease (MARKO questionnaire).

    PubMed

    Vrbica, Žarko; Labor, Marina; Košćec Đuknić, Adrijana; Radošević-Vidaček, Biserka; Gudelj, Ivan; Labor, Slavica; Jurić, Iva; Calverley, Peter Ma; Plavec, Davor

    2016-10-31

    To develop and do an initial validation of a new simple tool (self-administered questionnaire) that would be sensitive and specific enough to detect early changes in smokers leading to future development of chronic obstructive pulmonary disease (COPD). 224 consecutive participants (50.9% women), with mean±standard deviation age of 52.3±6.7 years, 37.5±16.7 pack-years smoking history (85.8% active smokers), and no prior diagnosis of COPD were recruited. The MARKO questionnaire was self-administered twice; at the general practitioner's office and after 2-4 weeks at the tertiary care hospital. Participants were assessed for COPD by a pulmonologist after filling in a quality of life (QoL) questionnaires, history-taking, physical examination, lung function test, 6-minute walk test, and laboratory tests. They were divided into four subgroups: "healthy" smokers, symptomatic smokers, and smokers with mild and moderately severe COPD. Psychometric analyses indicated that the 18-item questionnaire had a very good internal consistency (Cronbach's alpha=0.91) and test-retest reliability for a four week period (c=0.89, 95% confidence interval [CI] 0.85-0.92, Lin's concordance). A significant correlations of MARKO scores were found with two QoL questionnaires; r=0.69 (P<0.001) and r=0.81 (P<0.001). Receiver operating characteristic curve analysis showed an area under the curve of 0.753 (95% CI 0.691-0.808, <0.001), with a sensitivity of 71.83% and specificity of 64.24% to discriminate "healthy" smokers from other subgroups. Based on psychometric analyses and high convergent validity correlation with already validated QoL questionnaires, the newly developed MARKO questionnaire was shown to be a reliable self-administered short health status assessment tool.

  10. Recruiting a U.S. national sample of HIV-negative gay and bisexual men to complete at-home self-administered HIV/STI testing and surveys: Challenges and Opportunities

    PubMed Central

    Grov, Christian; Cain, Demetria; Whitfield, Thomas H. F.; Rendina, H. Jonathon; Pawson, Mark; Ventuneac, Ana; Parsons, Jeffrey T.

    2015-01-01

    We describe enrollment for the One Thousand Strong panel, present characteristics of the panel relative to other large U.S. national studies of gay and bisexual men (GBM), and examine demographic and behavioral characteristics that were associated with passing enrollment milestones. A U.S. national sample of HIV-negative men were enrolled via an established online panel of over 22,000 GBM. Participants (n = 1071) passed three milestones to join our panel. Milestone 1 was screening eligible and providing informed consent. Milestone 2 involved completing an hour-long at-home computer-assisted self-interview (CASI) survey. Milestone 3 involved completing at-home self-administered rapid HIV testing and collecting/returning urine and rectal samples for gonorrhea and chlamydia testing. Compared to those who completed milestones: those not passing milestone 1 were more likely to be non-White and older; those not passing milestone 2 were less likely to have insurance or a primary care physician; and those not passing milestone 3 were less educated, more likely to be bisexual as opposed to gay, more likely to live in the Midwest, had fewer male partners in the past year, and less likely to have tested for HIV in the past year. Effect sizes for significant findings were small. We successfully enrolled a national sample of HIV-negative GBM who completed at-home CASI assessments and at-home self-administered HIV and urine and rectal STI testing. This indicates high feasibility and acceptability of incorporating self-administered biological assays into otherwise fully online studies. Differences in completion of study milestones indicate a need for further investigation into the reasons for lower engagement by certain groups. PMID:26858776

  11. Randomised controlled comparison of the Health Survey Short Form (SF-12) and the Graded Chronic Pain Scale (GCPS) in telephone interviews versus self-administered questionnaires. Are the results equivalent?

    PubMed Central

    Lungenhausen, Margitta; Lange, Stefan; Maier, Christoph; Schaub, Claudia; Trampisch, Hans J; Endres, Heinz G

    2007-01-01

    Background The most commonly used survey methods are self-administered questionnaires, telephone interviews, and a mixture of both. But until now evidence out of randomised controlled trials as to whether patient responses differ depending on the survey mode is lacking. Therefore this study assessed whether patient responses to surveys depend on the mode of survey administration. The comparison was between mailed, self-administered questionnaires and telephone interviews. Methods A four-armed, randomised controlled two-period change-over design. Each patient responded to the same survey twice, once in written form and once by telephone interview, separated by at least a fortnight. The study was conducted in 2003/2004 in Germany. 1087 patients taking part in the German Acupuncture Trials (GERAC cohort study), who agreed to participate in a survey after completing acupuncture treatment from an acupuncture-certified family physician for headache, were randomised. Of these, 823 (664 women) from the ages of 18 to 83 (mean 51.7) completed both parts of the study. The main outcome measure was the comparison of the scores on the 12-Item Short-Form Health Survey (SF-12) and the Graded Chronic Pain Scale (GCPS) questionnaire for the two survey modes. Results Computer-aided telephone interviews (CATI) resulted in significantly fewer missing data (0.5%) than did mailed questionnaires (2.8%; p < 0.001). The analysis of equivalence revealed a difference between the survey modes only for the SF-12 mental scales. On average, reported mental status score was 3.5 score points (2.9 to 4.0) lower on the self-administered questionnaire compared to the telephone interview. The order of administration affected results. Patients who responded to the telephone interview first reported better mental health in the subsequent paper questionnaire (mean difference 2.8 score points) compared to those who responded to the paper questionnaire first (mean difference 4.1 score points). Conclusion

  12. Randomised controlled comparison of the Health Survey Short Form (SF-12) and the Graded Chronic Pain Scale (GCPS) in telephone interviews versus self-administered questionnaires. Are the results equivalent?

    PubMed

    Lungenhausen, Margitta; Lange, Stefan; Maier, Christoph; Schaub, Claudia; Trampisch, Hans J; Endres, Heinz G

    2007-11-22

    The most commonly used survey methods are self-administered questionnaires, telephone interviews, and a mixture of both. But until now evidence out of randomised controlled trials as to whether patient responses differ depending on the survey mode is lacking. Therefore this study assessed whether patient responses to surveys depend on the mode of survey administration. The comparison was between mailed, self-administered questionnaires and telephone interviews. A four-armed, randomised controlled two-period change-over design. Each patient responded to the same survey twice, once in written form and once by telephone interview, separated by at least a fortnight. The study was conducted in 2003/2004 in Germany. 1087 patients taking part in the German Acupuncture Trials (GERAC cohort study), who agreed to participate in a survey after completing acupuncture treatment from an acupuncture-certified family physician for headache, were randomised. Of these, 823 (664 women) from the ages of 18 to 83 (mean 51.7) completed both parts of the study. The main outcome measure was the comparison of the scores on the 12-Item Short-Form Health Survey (SF-12) and the Graded Chronic Pain Scale (GCPS) questionnaire for the two survey modes. Computer-aided telephone interviews (CATI) resulted in significantly fewer missing data (0.5%) than did mailed questionnaires (2.8%; p < 0.001). The analysis of equivalence revealed a difference between the survey modes only for the SF-12 mental scales. On average, reported mental status score was 3.5 score points (2.9 to 4.0) lower on the self-administered questionnaire compared to the telephone interview. The order of administration affected results. Patients who responded to the telephone interview first reported better mental health in the subsequent paper questionnaire (mean difference 2.8 score points) compared to those who responded to the paper questionnaire first (mean difference 4.1 score points). Despite the comparatively high cost of

  13. The test-retest reliability and concurrent validity of the Subjective Complaints Questionnaire for low back pain.

    PubMed

    Ford, Jon Joseph; Story, Ian; McMeeken, Joan

    2009-06-01

    Physiotherapists commonly record detailed patient information regarding subjective complaints for low back pain (LBP), particularly to assist in the process of classifying patients into specific subgroups. A self-administered Subjective Complaints Questionnaire for LBP (SCQ-LBP) measuring such information was developed for the purposes of future clinical research, particularly in the area of LBP classification. The development comprised literature review, feedback from experienced physiotherapists and pilot questionnaire testing in a patient population. Test-retest reliability of the questionnaire in a self administered format as well as concurrent validity against a suitable reference standard was evaluated. The agreement between the self administered questionnaire compared to when administered by a physiotherapist was also tested as the latter method is the most common form of retrieving subjective complaints in clinical practice. Thirty participants with LBP were recruited and at least moderate test-retest reliability was demonstrated in 56 of the 57 self administered questionnaire items. Preliminary evidence was found supporting the concurrent validity of selected items. At least moderate agreement was demonstrated in 51 of the 57 items when comparing between the self administered and physiotherapist administered conditions. The questionnaire is a useful tool for collecting subjective complaints information, particularly for clinical research on the classification of LBP, however, further research regarding validity is required.

  14. Refractory GERD: increased body mass index is associated with persisting acid exposure but not hypersensitive esophagus or functional heartburn.

    PubMed

    Viazis, Nikos; Karamanolis, George P; Anastasiou, Jiannis; Keyoglou, Anastasia; Vlachogiannakos, Jiannis; Ladas, Spiros D; Karamanolis, Dimitrios G

    2013-12-01

    To compare the incidence of persistent abnormal acid exposure, hypersensitive esophagus (HE), and functional heartburn (FH) in obese/overweight and normal-weight patients referred for impedance-pH monitoring, because of persisting gastroesophageal reflux disease (GERD) symptoms despite therapy with proton pump inhibitors (PPIs). ΜETHODS: Patients with normal endoscopy and typical GERD symptoms, despite PPI therapy twice daily, underwent 24-h impedance-pH monitoring while on therapy. Distal esophageal acid exposure (% time pH<4) was measured and reflux episodes were classified into acid or nonacid. A positive symptom index was defined when at least 50% of symptom events were preceded by reflux episodes. Patients were categorized as those with persistent abnormal acid exposure, those with HE, and those with FH. The incidence of persistent abnormal acid exposure, HE, and FH between overweight/obese patients (BMI≥25 kg/m) and normal-weight patients (BMI<25 kg/m) was subsequently evaluated. A total of 246 patients (women: 158, men: 88, increased BMI: 151, normal BMI: 95, mean age 55, range 18-75 years) were included. Persistent abnormal acid exposure was found in 39 patients (increased BMI: 31, normal BMI: 8), HE in 77 patients (increased BMI: 43, normal BMI: 34), and FH in 118 patients (increased BMI: 69, normal BMI: 49). When comparing BMI among all three groups, patients with increased BMI were more likely to have acid reflux than HE or FH (P=0.03). In patients with GERD symptoms refractory to double-dose PPI therapy, those with increased BMI are more likely to have persistent abnormal acid exposure than HE or FH.

  15. Validation study of the Esohisto consensus guidelines for the recognition of microscopic esophagitis (histoGERD Trial).

    PubMed

    Schneider, Nora I; Plieschnegger, Wolfgang; Geppert, Michael; Wigginghaus, Bernd; Hoess, Gabriele M; Eherer, Andreas; Wolf, Eva-Maria; Rehak, Peter; Vieth, Michael; Langner, Cord

    2014-05-01

    In patients with gastroesophageal reflux disease (GERD), histology is generally believed to be a tool of limited diagnostic value. Our study aimed to assess the prevalence of microscopic esophageal lesions as defined by the Esohisto consensus guidelines, which have proven high interobserver agreement in previous studies. In the prospective Central European multicenter histoGERD trial, we recruited 1071 individuals (576 females and 495 males; median age, 53 years; range, 15-93 years) undergoing gastroscopy for nonselected reasons. Biopsy material was systematically sampled from above and below the gastroesophageal junction. Overall, histologic diagnosis of mild and severe esophagitis was made in 423 (39.5%) and 296 (27.6%) individuals, respectively, whereas the squamous mucosa of 352 individuals (32.9%) was normal upon histology or showed only insignificant findings. Proliferative changes of the squamous epithelium, in particular basal cell layer hyperplasia, papillary elongation, and intercellular space dilation, were more common than inflammatory cell infiltration. The presence of microscopic esophagitis was associated with male sex (P = .009), patients' symptoms (P = .003), history of proton pump inhibitor intake (P < .001), and the endoscopic diagnosis of esophagitis (P < .001). Notably, among the 450 patients with no endoscopic signs of esophagitis (Los Angeles Category N), 41.8% and 17.1% were identified with mild and severe (microscopic) esophagitis, respectively, indicating higher sensitivity of histologic diagnosis. In conclusion, our data illustrate the value of histology in the workup of patients with reflux disease. We suggest that biopsies should routinely be obtained when patients undergo upper gastrointestinal endoscopy for evaluation of GERD and may particularly be beneficial in patients with nonerosive reflux disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. [Prevalence and characterization of overactive bladder detected in a population in Madrid with self-administered OAB-V3 questionnaire in Primary Care].

    PubMed

    Angulo, Javier C; Calderín, María P; Fernández, Yolanda; González, Miriam; Gómez, Esther; Herreros, Maria B; Peñasco, Purificación; Zapatero, Manuela; Dorado, Juan F

    2017-07-24

    Determining the prevalence of symptoms suggestive of overactive bladder (OAB) in a Spanish population and evaluate the impact of these symptoms on well-being and labour productivity in this population. Transversal study. Primary health care, Madrid, Spain. Males and females >30 years. Classification by primary care physicians with the Overactive Bladder Awareness Tool abbreviated version (OAB-V3). Subjects with score ≥3 and a similarly balanced control population with score <3 were clinically investigated. History, physical examination, urinalysis, sonography, general well-being scale and the questionnaires PPBC, OAB-q y WPAI-SHP. A total 923 subjects were screened, of which 209 (22.6%), 35% males and 65% females, had probable OAB. Age distribution increased from 11.1% in 4th decade to 44.4% in 9th decade. Kappa coefficient between suspected OAB and definite diagnosis was .83. The area under ROC curve for diagnosis based on OAB-V3 questionnaire and the presence of perceived bother and coping strategies was 92%. Subjects classified by score ≥3 had worse well-being, higher PPBC score and worse parameters on total OAB-q and transformed scores for each OAB-q subscale (P<.0001). In these subjects labour productivity was not affected (P=.14) but the capacity to perform regular activities was (P<.0001). OAB-V3 is a simple questionnaire to screen OAB with good predictive accuracy in a primary care setting and reveals important implications on health related quality of life issues. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  17. C-TOC (Cognitive Testing on Computer): investigating the usability and validity of a novel self-administered cognitive assessment tool in aging and early dementia.

    PubMed

    Jacova, Claudia; McGrenere, Joanna; Lee, Hyunsoo S; Wang, William W; Le Huray, Sarah; Corenblith, Emily F; Brehmer, Matthew; Tang, Charlotte; Hayden, Sherri; Beattie, B Lynn; Hsiung, Ging-Yuek R

    2015-01-01

    Cognitive Testing on Computer (C-TOC) is a novel computer-based test battery developed to improve both usability and validity in the computerized assessment of cognitive function in older adults. C-TOC's usability was evaluated concurrently with its iterative development to version 4 in subjects with and without cognitive impairment, and health professional advisors representing different ethnocultural groups. C-TOC version 4 was then validated against neuropsychological tests (NPTs), and by comparing performance scores of subjects with normal cognition, Cognitive Impairment Not Dementia (CIND) and Alzheimer disease. C-TOC's language tests were validated in subjects with aphasic disorders. The most important usability issue that emerged from consultations with 27 older adults and with 8 cultural advisors was the test-takers' understanding of the task, particularly executive function tasks. User interface features did not pose significant problems. C-TOC version 4 tests correlated with comparator NPT (r=0.4 to 0.7). C-TOC test scores were normal (n=16)>CIND (n=16)>Alzheimer disease (n=6). All normal/CIND NPT performance differences were detected on C-TOC. Low computer knowledge adversely affected test performance, particularly in CIND. C-TOC detected impairments in aphasic disorders (n=11). In general, C-TOC had good validity in detecting cognitive impairment. Ensuring test-takers' understanding of the tasks, and considering their computer knowledge appear important steps towards C-TOC's implementation.

  18. [Evaluation of action, efficacy, and onset dynamics of a single dose of alginates in patients with heartburn and GERD].

    PubMed

    Bordin, D S; Masharova, A A; Firsova, L D; Kozhurina, T S; Safonova, O V

    2009-01-01

    We conducted a crossover study, in which the efficacy and the onset of action of a single dose of Gaviscon (suspension) and Gaviscon forte (suspension) in 52 patients with heartburn of moderate intensity and gastroesophageal reflux disease (GERD) have been investigated. The average age of the patients was 44.0 +/- 17.3-years-old. The patients have undergone clinical evaluation of intensity of GERD symptoms and psychological assessment (questionnaires SF-36, SMOL, LOBI). Alginates' effects and qualities were evaluated using stopwatch technique, clinical examination, and organoleptic assessment. Primary sensation of a cooling (soothing) effect after use of a single dose of Gaviscon has been reported in 65.7 seconds (on average), and Gaviscon forte--in 66.1 seconds. Fourty three (82.7%) patients with heartburn have described the effects of both medications as "instant" cooling effects. Heartburn was relieved in 3.3 minutes in all patients after a single dose of Gaviscon, and in 3.6 minutes in 51 (98.1%) patients who have received a single dose of Gaviscon forte. Organoleptic qualities averaged at 3.6 points (on a scale of 1-5) for Gaviscon, and at 3.5 points for Gaviscon forte. Assessment of mental status of the patients suggested that a "delayed" effect of the medications in relieving heartburn in some patients may have occurred due to possible physical disadaptation.

  19. Development and the initial validation of a new self-administered questionnaire for an early detection of health status changes in smokers at risk for chronic obstructive pulmonary disease (MARKO questionnaire)

    PubMed Central

    Vrbica, Žarko; Labor, Marina; Košćec Đuknić, Adrijana; Radošević-Vidaček, Biserka; Gudelj, Ivan; Labor, Slavica; Jurić, Iva; Calverley, Peter MA; Plavec, Davor

    2016-01-01

    Aim To develop and do an initial validation of a new simple tool (self-administered questionnaire) that would be sensitive and specific enough to detect early changes in smokers leading to future development of chronic obstructive pulmonary disease (COPD). Methods 224 consecutive participants (50.9% women), with mean ± standard deviation age of 52.3 ± 6.7 years, 37.5 ± 16.7 pack-years smoking history (85.8% active smokers), and no prior diagnosis of COPD were recruited. The MARKO questionnaire was self-administered twice; at the general practitioner's office and after 2-4 weeks at the tertiary care hospital. Participants were assessed for COPD by a pulmonologist after filling in a quality of life (QoL) questionnaires, history-taking, physical examination, lung function test, 6-minute walk test, and laboratory tests. They were divided into four subgroups: “healthy” smokers, symptomatic smokers, and smokers with mild and moderately severe COPD. Results Psychometric analyses indicated that the 18-item questionnaire had a very good internal consistency (Cronbach’s alpha = 0.91) and test-retest reliability for a four week period (ρc = 0.89, 95% confidence interval [CI] 0.85-0.92, Lin’s concordance). A significant correlations of MARKO scores were found with two QoL questionnaires; r = 0.69 (P < 0.001) and r = 0.81 (P < 0.001). Receiver operating characteristic curve analysis showed an area under the curve of 0.753 (95% CI 0.691-0.808, P < 0.001), with a sensitivity of 71.83% and specificity of 64.24% to discriminate “healthy” smokers from other subgroups. Conclusion Based on psychometric analyses and high convergent validity correlation with already validated QoL questionnaires, the newly developed MARKO questionnaire was shown to be a reliable self-administered short health status assessment tool. Trial registration Clinicaltrial.gov NCT01550679 PMID:27815933

  20. Prevalence of gallstones in 1,229 patients submitted to surgical laparoscopic treatment of GERD and esophageal achalasia: associated cholecystectomy was a safe procedure

    PubMed Central

    SALLUM, Rubens Antonio Aissar; PADRÃO, Eduardo Messias Hirano; SZACHNOWICZ, Sergio; SEGURO, Francisco C. B. C.; BIANCHI, Edno Tales; CECCONELLO, Ivan

    2015-01-01

    Background Association between esophageal achalasia/ gastroesophageal reflux disease (GERD) and cholelithiasis is not clear. Epidemiological data are controversial due to different methodologies applied, the regional differences and the number of patients involved. Results of concomitant cholecistectomy associated to surgical treatment of both diseases regarding safety is poorly understood. Aim To analyze the prevalence of cholelithiasis in patients with esophageal achalasia and gastroesophageal reflux submitted to cardiomyotomy or fundoplication. Also, to evaluate the safety of concomitant cholecistectomy. Methods Retrospective analysis of 1410 patients operated from 2000 to 2013. They were divided into two groups: patients with GERD submitted to laparocopic hiatoplasty plus Nissen fundoplication and patients with esophageal achalasia to laparoscopic cardiomyotomy plus partial fundoplication. It was collected epidemiological data, specific diagnosis and subgroups, the presence or absence of gallstones, surgical procedure, operative and clinical complications and mortality. All groups/subgroups were compared. Results From 1,229 patients with GERD or esophageal achalasia, submitted to laparoscopic cardiomyotomy or fundoplication, 138 (11.43%) had cholelitiasis, occurring more in females (2.38:1) with mean age of 50,27 years old. In 604 patients with GERD, 79 (13,08%) had cholelitiasis. Lower prevalence occurred in Barrett's esophagus patients 7/105 (6.67%) (p=0.037). In 625 with esophageal achalasia, 59 (9.44%) had cholelitiasis, with no difference between chagasic and idiopathic forms (p=0.677). Complications of patients with or without cholecystectomy were similar in fundoplication and cardiomyotomy (p=0.78 and p=1.00).There was no mortality or complications related to cholecystectomy in this series. Conclusions Prevalence of cholelithiasis was higher in patients submitted to fundoplication (GERD). Patients with chagasic or idiopatic forms of achalasia had the

  1. Tribute to: Self-administered nicotine activates the mesolimbic dopamine system through the ventral tegmental area [William Corrigall, Kathleen Coen and Laurel Adamson, Brain Res. 653 (1994) 278-284].

    PubMed

    Leri, Francesco; Vaccarino, Franco J

    2016-08-15

    In this paper, Dr. Corrigall and collaborators described elegant experiments designed to elucidate the neurobiology of nicotine reinforcement. The nicotinic receptor antagonist dihydro-β-erythroidine (DHβE) was infused in the ventral tegmental area (VTA) or nucleus accumbens (NAC) of rats trained to self-administer nicotine intravenously. Additionally, DHβE was infused in the VTA of rats trained to self-administer food or cocaine, and nicotine self-administration was assessed in rats with lesions to the peduculopontine tegmental nucleus (PPT). A number of key themes emerged from this fundamental study that remain relevant today. The primary finding was that infusions of DHβE in the VTA, but not in the NAC, lowered nicotine self-administration, suggesting that nicotinic receptors in VTA are involved in the reinforcing action of nicotine. This conclusion has been confirmed by subsequent findings, and the nature of the nicotinic receptors has also been elucidated. The authors also reported that DHβE in the VTA had no effect on food or cocaine self-administration, and that lesions to the PPT did not alter nicotine self-administration. Since this initial investigation, the question of whether nicotinic receptors in the VTA are necessary for the reinforcing action of other stimuli, and by which mechanisms, has been extensively explored. Similarly, many groups have further investigated the role of mesopontine cholinergic nuclei in reinforcement. This paper not only contributed in important ways to our understanding of the neurochemical basis of nicotine reinforcement, but was also a key catalyst that gave rise to several research themes central to the neuropharmacology of substance abuse. This article is part of a Special Issue entitled SI:50th Anniversary Issue. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Validity of a multipass, web-based, 24-hour self-administered recall for assessment of total energy intake in blacks and whites.

    PubMed

    Arab, Lenore; Tseng, Chi-Hong; Ang, Alfonso; Jardack, Patricia

    2011-12-01

    To date, Web-based 24-hour recalls have not been validated using objective biomarkers. From 2006 to 2009, the validity of 6 Web-based DietDay 24-hour recalls was tested among 115 black and 118 white healthy adults from Los Angeles, California, by using the doubly labeled water method, and the results were compared with the results of the Diet History Questionnaire, a food frequency questionnaire developed by the National Cancer Institute. The authors performed repeated measurements in a subset of 53 subjects approximately 6 months later to estimate the stability of the doubly labeled water measurement. The attenuation factors for the DietDay recall were 0.30 for blacks and 0.26 for whites. For the Diet History Questionnaire, the attenuation factors were 0.15 and 0.17 for blacks and whites, respectively. Adjusted correlations between true energy intake and the recalls were 0.50 and 0.47 for blacks and whites, respectively, for the DietDay recall. For the Diet History Questionnaire, they were 0.34 and 0.36 for blacks and whites, respectively. The rate of underreporting of more than 30% of calories was lower with the recalls than with the questionnaire (25% and 41% vs. 34% and 52% for blacks and whites, respectively). These findings suggest that Web-based DietDay dietary recalls offer an inexpensive and widely accessible dietary assessment alternative, the validity of which is equally strong among black and white adults. The validity of the Web-administered recall was superior to that of the paper food frequency questionnaire.

  3. A Test of Concept Study of At-Home, Self-Administered HIV Testing With Web-Based Peer Counseling Via Video Chat for Men Who Have Sex With Men.

    PubMed

    Maksut, Jessica L; Eaton, Lisa A; Siembida, Elizabeth J; Driffin, Daniel D; Baldwin, Robert

    2016-12-14

    Men who have sex with men (MSM), particularly MSM who identify as African-American or Black (BMSM), are the sociodemographic group that is most heavily burdened by the human immunodeficiency virus (HIV) epidemic in the United States. To meet national HIV testing goals, there must be a greater emphasis on novel ways to promote and deliver HIV testing to MSM. Obstacles to standard, clinic-based HIV testing include concerns about stigmatization or recognition at in-person testing sites, as well as the inability to access a testing site due to logistical barriers. This study examined the feasibility of self-administered, at-home HIV testing with Web-based peer counseling to MSM by using an interactive video chatting method. The aims of this study were to (1) determine whether individuals would participate in at-home HIV testing with video chat-based test counseling with a peer counselor, (2) address logistical barriers to HIV testing that individuals who report risk for HIV transmission may experience, and (3) reduce anticipated HIV stigma, a primary psychosocial barrier to HIV testing. In response to the gap in HIV testing, a pilot study was developed and implemented via mailed, at-home HIV test kits, accompanied by HIV counseling with a peer counselor via video chat. A total of 20 MSM were enrolled in this test of concept study, 80% of whom identified as BMSM. All participants reported that at-home HIV testing with a peer counseling via video chat was a satisfying experience. The majority of participants (13/18, 72%) said they would prefer for their next HIV testing and counseling experience to be at home with Web-based video chat peer counseling, as opposed to testing in an office or clinic setting. Participants were less likely to report logistical and emotional barriers to HIV testing at the 6-week and 3-month follow-ups. The results of this study suggest that self-administered HIV testing with Web-based peer counseling is feasible and that MSM find it to be a

  4. A Test of Concept Study of At-Home, Self-Administered HIV Testing With Web-Based Peer Counseling Via Video Chat for Men Who Have Sex With Men

    PubMed Central

    Eaton, Lisa A; Siembida, Elizabeth J; Driffin, Daniel D; Baldwin, Robert

    2016-01-01

    Background Men who have sex with men (MSM), particularly MSM who identify as African-American or Black (BMSM), are the sociodemographic group that is most heavily burdened by the human immunodeficiency virus (HIV) epidemic in the United States. To meet national HIV testing goals, there must be a greater emphasis on novel ways to promote and deliver HIV testing to MSM. Obstacles to standard, clinic-based HIV testing include concerns about stigmatization or recognition at in-person testing sites, as well as the inability to access a testing site due to logistical barriers. Objective This study examined the feasibility of self-administered, at-home HIV testing with Web-based peer counseling to MSM by using an interactive video chatting method. The aims of this study were to (1) determine whether individuals would participate in at-home HIV testing with video chat–based test counseling with a peer counselor, (2) address logistical barriers to HIV testing that individuals who report risk for HIV transmission may experience, and (3) reduce anticipated HIV stigma, a primary psychosocial barrier to HIV testing.   Methods In response to the gap in HIV testing, a pilot study was developed and implemented via mailed, at-home HIV test kits, accompanied by HIV counseling with a peer counselor via video chat. A total of 20 MSM were enrolled in this test of concept study, 80% of whom identified as BMSM. Results All participants reported that at-home HIV testing with a peer counseling via video chat was a satisfying experience. The majority of participants (13/18, 72%) said they would prefer for their next HIV testing and counseling experience to be at home with Web-based video chat peer counseling, as opposed to testing in an office or clinic setting. Participants were less likely to report logistical and emotional barriers to HIV testing at the 6-week and 3-month follow-ups. Conclusions The results of this study suggest that self-administered HIV testing with Web-based peer

  5. Randomised clinical trial: the clinical efficacy and safety of an alginate-antacid (Gaviscon Double Action) versus placebo, for decreasing upper gastrointestinal symptoms in symptomatic gastroesophageal reflux disease (GERD) in China.

    PubMed

    Sun, J; Yang, C; Zhao, H; Zheng, P; Wilkinson, J; Ng, B; Yuan, Y

    2015-10-01

    There is a paucity of large-scale studies evaluating the clinical benefit of the Gaviscon Double Action (DA) alginate-antacid formulation for treating gastroesophageal reflux disease (GERD) symptoms. Randomised double-blind placebo-controlled parallel-group study to evaluate efficacy and safety of Gaviscon DA in reducing heartburn, regurgitation and dyspepsia symptoms in individuals with mild-to-moderate GERD in China. Participants with symptomatic GERD (n = 1107) were randomised to receive Gaviscon DA or placebo (two tablets four times daily) for seven consecutive days. The primary endpoint compared the change in Reflux Disease Questionnaire (RDQ) score for the GERD (heartburn + regurgitation) dimension between Gaviscon DA and placebo. Secondary endpoints compared the change in RDQ scores for individual heartburn, regurgitation and dyspepsia dimensions, overall treatment evaluation (OTE) scores and incidence of adverse events (AEs). Mean RDQ GERD scores: 2.51 for Gaviscon DA and 2.50 for placebo at baseline; 1.25 for Gaviscon DA and 1.46 for placebo post treatment. Gaviscon DA was statistically superior to placebo in reducing GERD and dyspepsia RDQ scores [least-squares mean (LSM) difference: GERD -0.21, P < 0.0001; dyspepsia -0.18, P = 0.0004], despite a substantial placebo response. The Gaviscon DA group reported more favourable overall treatment responses than the placebo group across all OTE categories (P < 0.0001). Superior relief of GERD symptoms was observed both in those with non-erosive and those with erosive reflux disease (LSM difference -0.14 [P = 0.038] and -0.29 [P < 0.0001] respectively). Incidence of AEs was similar in both groups. Gaviscon DA tablets provide effective and safe reduction in acid reflux and dyspepsia symptoms in Chinese individuals with mild-to-moderate GERD. ClinicalTrials.gov: NCT01869491. © 2015 The Authors. Alimentary Pharmacology & Therapeutics Published by John Wiley & Sons Ltd.

  6. Diagnosis and Anti-Reflux Therapy for GERD with Respiratory Symptoms: A Study Using Multichannel Intraluminal Impedance-pH Monitoring

    PubMed Central

    Zhang, Chao; Wu, Jimin; Hu, Zhiwei; Yan, Chao; Gao, Xiang; Liang, Weitao; Liu, Diangang; Li, Fei; Wang, Zhonggao

    2016-01-01

    Background/Aims Respiratory symptoms are often associated with gastroesophageal reflux disease (GERD). Although the role of multichannel intraluminal impedance–pH (MII-pH) monitoring in GERD is clear, little is known regarding the characteristics of patients with respiratory symptoms based on MII-pH monitoring and anti-reflux therapy. We evaluated a cohort of GERD patients to identify the MII-pH parameters of GERD-related respiratory symptoms and to assess the anti-reflux therapy outcomes. Methods We undertook a prospective study of patients who were referred for GERD evaluation from January 2011 to January 2012. One hundred ninety-five patients underwent MII-pH monitoring and esophageal manometry, and one hundred sixty-five patients underwent invasive anti-reflux therapy that included laparoscopic Toupet fundoplication (LTF) and the Stretta procedure. The patient characteristics and MII-pH parameters were analyzed, and the symptom scores were assessed at baseline and at 1- and 3-year follow-up evaluations. Results Of the 195 patients, 96 (49.2%) exhibited respiratory symptoms and significantly more reflux episodes (70.7±29.3) than patients without respiratory symptoms (64.7±24.4, p = 0.044) based on the MII-pH monitoring results. Moreover, the group of patients with respiratory symptoms exhibited more proximal reflux episodes (35.2±21.3) than the non-respiratory symptomatic group (28.3±17.9, p = 0.013). One hundred twenty-five patients following the Stretta procedure (n = 60, 31 with respiratory symptoms) or LTF (n = 65, 35 with respiratory symptoms) completed the designated 3-year follow-up period and were included in the final analysis. The symptom scores after anti-reflux therapy all decreased relative to the corresponding baseline values (p<0.05), and there were no significant differences in the control of respiration between the Stretta procedure and LTF (p>0.05). However, LTF significantly reduced the recurrence (re-operation) rate compared with the

  7. Effect of low-proof alcoholic beverages on duodenogastro-esophageal reflux in health and GERD.

    PubMed

    Seidl, H; Gundling, F; Schepp, W; Schmidt, T; Pehl, C

    2011-02-01

    Alcoholic beverages are known to increase acidic gastro-esophageal reflux (GER) and the risk of esophagitis. Moreover, duodenogastro-esophageal reflux (DGER), containing bile acids, was shown to harmfully alter the esophageal mucosa, alone and synergistically with HCl and pepsin. However, studies directly addressing potential effects of different low proof alcoholic beverages on DGER in health and disease are missing. Bilitec readings for beer and white, rose, and red wine were obtained in vitro from pure and from mixtures with bile. One-hour DGER monitoring and pH-metry were performed in 12 healthy subjects and nine reflux patients with DGER after ingestion of a standardized liquid meal together with 300 mL of water, white wine, and in the volunteers, beer and rose wine. Bilitec measurement was found to be feasible in the presence of beer, white wine, and using a threshold of 0.25, rose wine. However, the presence of red wine resulted in extinction values above this threshold. The consumption of all investigated alcoholic beverages, especially of white wine, triggered increased acidic GER, both in healthy participants and patients with reflux disease. In contrast, no relevant DGER was found after intake of alcoholic beverages. Fiber-optic bilirubin monitoring can be used for DGER monitoring in combination with alcoholic beverages, except with red wine. Low-proof alcoholic beverages are a strong trigger of GER, but not of DGER, both in healthy subjects and patients with reflux disease. © 2010 Blackwell Publishing Ltd.

  8. A Multicenter, Randomized, Open-Label, Pharmacokinetics and Safety Study of Pantoprazole Tablets in Children and Adolescents Aged 6 Through 16 Years With GERD

    PubMed Central

    Ward, Robert M.; Kearns, Gregory L.; Tammara, Brinda; Bishop, Phyllis; O’Gorman, Molly A.; James, Laura P.; Katz, Mitchell H.; Maguire, Mary K.; Rath, Natalie; Meng, Xu; Comer, Gail M.

    2011-01-01

    SUMMARY Children with GERD may benefit from gastric acid suppression with proton pump inhibitors such as pantoprazole. Effective treatment with pantoprazole requires correct dosing and understanding of the drug’s kinetic profile in children. The aim of these studies was to characterize the pharmacokinetic (PK) profile of single and multiple doses of pantoprazole delayed-release tablets in pediatric patients with GERD aged ≥6 through 11 years (study 1) and 12 through 16 years (study 2). Patients were randomly assigned to receive pantoprazole 20 or 40 mg once daily. Plasma pantoprazole concentrations were obtained at intervals through 12 hours after the single dose, and at 2 and 4 hours after multiple doses for PK evaluation. PK parameters were derived by standard noncompartmental methods and examined as a function of both drug dose and patient age. Safety was also monitored. Pantoprazole PK was dose independent (when dose normalized) and similar toPK reported from adult studies. There was no evidence of accumulation with multiple dosing or reports of serious drug-associated adverse events. In children aged 6 to 16 years with GERD, currently available pantoprazole delayed-release tablets can be used to provide systemic exposure similar to that in adults. PMID:20852004

  9. Effectiveness and Tolerability of Different Recommended Doses of PPIs and H2RAs in GERD: Network Meta-Analysis and GRADE system

    PubMed Central

    Zhang, Chao; Kwong, Joey S. W.; Yuan, Rui-Xia; Chen, Hao; Xu, Chang; Wang, Yi-Pin; Yang, Gong-Li; Yan, Jin-Zhu; Peng, Le; Zeng, Xian-Tao; Weng, Hong; Luo, Jie; Niu, Yu-Ming

    2017-01-01

    Proton pump inhibitors (PPIs) and histamine-2-receptor antagonists (H2RAs) are used for gastro-esophageal reflux disease (GERD); however, the clinical evidence for treatment is poor. We evaluated the effectiveness and tolerability of different doses of PPIs, H2RAs and placebo in adults with GERD. Six online databases were searched through September 1, 2016. All related articles were included and combined with a Bayesian network meta-analysis from randomized controlled trials (RCTs). The GRADE systems were employed to assess the main outcome. Ninety-eight RCTs were identified, which included 45,964 participants. Our analysis indicated that the full/standard dose of esomeprazole at 40 mg per day was the most efficient in healing among nine different dosages of PPIs and H2RAs. The main efficacy outcome did not change after adjustments for the area, age, level of disease from endoscopy, year of publication, pharmaceutical industry sponsorship, Intention-to-treat (ITT)/per-protocol (PP), withdrawal rate, pre-set select design bias, single blinded and unblinded studies, study origination in China, study arms that included zero events, inconsistency node or discontinued drug were accounted for in the meta-regressions and sensitivity analyses. This research suggests that the full/standard doses (40 mg per day) of esomeprazole should be recommended as first-line treatments for GERD in adults for short-term therapy. PMID:28102361

  10. Comparison of relative validity of food group intakes estimated by comprehensive and brief-type self-administered diet history questionnaires against 16 d dietary records in Japanese adults.

    PubMed

    Kobayashi, Satomi; Murakami, Kentaro; Sasaki, Satoshi; Okubo, Hitomi; Hirota, Naoko; Notsu, Akiko; Fukui, Mitsuru; Date, Chigusa

    2011-07-01

    To compare the relative validity of food group intakes derived from a comprehensive self-administered diet history questionnaire (DHQ) and a brief-type DHQ (BDHQ) developed for the assessment of Japanese diets during the previous month using semi-weighed dietary records (DR) as a reference method. Between November 2002 and September 2003, a 4 d DR (covering four non-consecutive days), a DHQ (150-item semi-quantitative questionnaire) and a BDHQ (fifty-eight-item fixed-portion-type questionnaire) were completed four times (once per season) at 3-month intervals. Three areas in Japan: Osaka, Nagano and Tottori. Ninety-two Japanese women aged 31-69 years and ninety-two Japanese men aged 32-76 years. Median food group intakes were estimated well for approximately half of the food groups. No statistically significant differences were noted between a 16 d DR and the first DHQ (DHQ1) or between the DR and the first BDHQ (BDHQ1) in fifteen (44 %) and fifteen (52 %) food items for women and in fourteen (41 %) and sixteen (55 %) food items for men, respectively, indicating that both questionnaires estimated median values reasonably well. Median Spearman's correlation coefficients with the DR were 0·43 (range: -0·09 to 0·77) for DHQ1 and 0·44 (range: 0·14 to 0·82) for BDHQ1 in women, with respective values of 0·44 (range: 0·08 to 0·87) and 0·48 (range: 0·22 to 0·83) in men, indicating reasonable ranking ability. Similar results were observed for mean values of the four DHQ and BDHQ. In terms of food intake estimates, both the DHQ and the BDHQ showed reasonable validity.

  11. Adult Playfulness, Humor Styles, and Subjective Happiness.

    PubMed

    Yue, Xiao D; Leung, Chun-Lok; Hiranandani, Neelam A

    2016-12-01

    Playfulness has been referred to as a disposition that involves reframing a situation to amuse others and to make the situation more stimulating and enjoyable. It may serve to shift one's perspective when dealing with environmental threats. Despite all the benefits of playfulness towards psychological well-being, it remains a largely understudied subject in psychology, particularly in Chinese societies. Hence, this study examined the association between adult playfulness, humor styles, and subjective happiness among a sample of 166 university students in Hong Kong and 159 students in Guangzhou, who completed a self-administered questionnaire, including the Short Measure for Adult Playfulness, the Chinese Humor Styles Questionnaire, and the Subjective Happiness Scale. Results showed that adult playfulness was positively correlated with affiliative humor, self-enhancing humor, and subjective happiness in both Hong Kong and Guangzhou samples. By its implication, highly playful Chinese students preferred using affiliative and self-enhancing humor to amuse themselves and others.

  12. Proton pump inhibitor responders who are not confirmed as GERD patients with impedance and pH monitoring: who are they?

    PubMed

    de Bortoli, N; Martinucci, I; Savarino, E; Bellini, M; Bredenoord, A J; Franchi, R; Bertani, L; Furnari, M; Savarino, V; Blandizzi, C; Marchi, S

    2014-01-01

    A short-course of proton pump inhibitors (PPIs) is often used to confirm gastroesophageal reflux disease (GERD). However, some patients with PPI responsive heartburn do not seem to have evidence of GERD on impedance-pH monitoring (MII-pH). The aim of the study was to evaluate patients with reflux symptoms and a negative endoscopy, who well respond to PPIs with MII-pH. We enrolled 312 patients with GERD symptoms and negative endoscopy: 144 reported well-controlled symptoms after 8-week PPIs and 155 were non-responders. Symptom relief was evaluated with GERD Impact Scale and visual analog scale score. All patients underwent MII-pH off-therapy. Thirteen patients were excluded from analysis. Patients were grouped as follows: non-erosive reflux disease (NERD; increased acid exposure time, AET); hypersensitive esophagus (HE; normal AET, positive symptom association, SI/SAP); MII-pH-/PPI+ (normal AET, negative SI/SAP) in the responder group; MII-pH-/PPI- in non-responders. MII-pH in PPI responders (symptom relief during PPI therapy > 75%) showed: 79/144 NERD (54.9%); 37/144 HE (25.7%); 28/144 MII-pH-/PPI+ (19.4%). MII-pH-/PPI+ patients reported the same symptom relief when compared with NERD and HE. In non-responder (symptom relief during PPI therapy < 50%) group, 27/155 patients were NERD (17.4%); 53/155 were HE (34.2%); 75/155 were MII-pH-/PPI- (48.4%). NERD diagnosis was significantly higher in responder group (p < 0.01). In a substantial subgroup of patients responding to PPI with typical reflux symptoms, the diagnosis of GERD cannot be confirmed with pH-impedance monitoring. Proton pump inhibitor response and presence of typical symptoms are thus not reliable predictors of the diagnosis and antireflux surgery should always be preceded by reflux monitoring. © 2013 John Wiley & Sons Ltd.

  13. Value of the Gastroesophageal Reflux Disease Questionnaire (GerdQ) in predicting the proton pump inhibitor response in coronary artery disease patients with gastroesophageal reflux-related chest pain.

    PubMed

    He, S; Liu, Y; Chen, Y; Tang, Y; Xu, J; Tang, C

    2016-05-01

    Chest pain experienced by patients with coronary artery disease can be partly due to gastroesophageal reflux-induced chest pain (GERP). Empirical proton pump inhibitor (PPI) therapy has been recommended as an initial clinical approach for treating GERP. However, PPI use may lead to some health problems. The Gastroesophageal Reflux Disease Questionnaire (GerdQ) may represent a noninvasive and cost-effective approach for avoiding PPI misuse and for identifying the appropriate patients for the PPI trial test. The aim of this pilot study was to prospectively evaluate the association between GerdQ scores and PPI response in patients with coronary artery disease (CAD) and GERP to determine whether the GerdQ predicts the PPI response in patients with CAD and GERP and to further validate the clinical application value of the GerdQ. A total of 154 consecutive patients with potential GERP were recruited to complete a GerdQ with subsequent PPI therapy. Based on the PPI trial result, patients were divided into a PPI-positive response group and a PPI-negative response group. The difference in the GerdQ scores between the two groups was assessed. The receiver operating characteristic (ROC) curve of GerdQ score was drawn according to the PPI response as the gold standard. The ability of GerdQ to predict the PPI response was assessed. A total of 96 patients completed the entire study; 62 patients (64.6%) were assigned to the PPI-positive response group, and 34 patients (35.4%) to the PPI-negative response group. The GerdQ score of the PPI-positive response group (8.11 ± 3.315) was significantly higher than that of the PPI-negative response group (4.41 ± 2.743), and the difference was statistically significant (t = 5.863, P = 0.000). The ROC curve was drawn according to a PPI response assessment result with a score above 2 as the gold standard. The area under curve was 0.806. When the critical value of GerdQ score was 7.5, Youden index was up to 0.514, the diagnostic sensitivity

  14. Efficacy, safety, and tolerability of pantoprazole magnesium in the treatment of reflux symptoms in patients with gastroesophageal reflux disease (GERD): a prospective, multicenter, post-marketing observational study.

    PubMed

    Remes-Troche, José María; Sobrino-Cossío, Sergio; Soto-Pérez, Julio César; Teramoto-Matsubara, Oscar; Morales-Arámbula, Miguel; Orozco-Gamiz, Antonio; Tamayo de la Cuesta, José Luis; Mateos, Gualberto

    2014-02-01

    To improve proton pump inhibitor effects, pharmacological modifications have been developed such as the use of enantiomer molecules (e.g., S-omeprazole, S-pantoprazole, or dexlansoprazole), or addition of NaHCO3 (for an immediate release) or magnesium (with a lower absorption for a more sustained effect). The objective of this study was to assess the efficacy, safety, and tolerability of pantoprazole magnesium 40 mg once daily for 4 weeks, on the relief of reflux symptoms in gastroesophageal reflux disease (GERD) patients. A phase IV, open-label, prospective, multicenter study was designed. Patients included were prescribed pantoprazole magnesium 40 mg orally once daily for 28±2 days. All patients had a history of persistent or recurrent heartburn and/or acid regurgitation for at least 3 months. Effectiveness and tolerability data obtained from patients who completed a minimum of 4 weeks of pantoprazole magnesium treatment were considered for analysis. The account of baseline characteristics and demographics of GERD symptom intensity was made by analyzing the group of 4,343 patients that fulfilled all inclusion criteria; 54% were females (n=2,345) and 46% (n=1,998) males, with a mean age of 36.2±7.5 years. Severity of symptoms, assessed by the physician using the 4-point Likert scale, reduced by at least 80% from baseline intensity after treatment in the per protocol population. In the case of the intention-to-treat population, the improvement in symptom intensity was 73%. The number of patients that experienced any adverse events was 175/5,027 (3.48%). Pantoprazole magnesium is a safe, effective, and well-tolerated drug that significantly improves GERD symptoms.

  15. Multilayered epithelium at the gastroesophageal junction is a marker of gastroesophageal reflux disease: data from a prospective Central European multicenter study (histoGERD trial).

    PubMed

    Langner, Cord; Wolf, Eva-Maria; Plieschnegger, Wolfgang; Geppert, Michael; Wigginghaus, Bernd; Höss, Gabriele M; Eherer, Andreas; Schneider, Nora I; Rehak, Peter; Vieth, Michael

    2014-04-01

    Multilayered epithelium is defined as hybrid epithelium with characteristics of both squamous and columnar epithelia. Our aim was to evaluate the clinicopathological significance of the lesion by relating its presence to various histological and clinical and/or endoscopic features indicating gastroesophageal reflux disease (GERD). A total of 1,071 individuals participated in a prospective cross-sectional study (576 females and 495 males; median age 53 years). Biopsy material was systematically sampled from the gastroesophageal junction. The histological diagnosis of esophagitis was made according to the Esohisto consensus guidelines. The endoscopic diagnosis of esophagitis was made according to the modified Los Angeles classification and the diagnosis of Barrett's esophagus according to Prague's C & M criteria, respectively. Multilayered epithelium was identified in 103 (9.6 %) individuals, frequently within or adjacent to the ducts of esophageal glands. Its presence was associated with increasing age (p < 0.001), high BMI (p = 0.026), hiatal hernia (p < 0.001), and the endoscopic diagnoses of esophagitis (p = 0.002) and Barrett's esophagus (p < 0.001). Upon histology, multilayered epithelium was associated with features of the squamous epithelium indicating GERD, particularly intercellular space dilation (p = 0.005), and presence of cardiac mucosa (<0.001). For intestinal metaplasia, a trend was noted (p = 0.094). In conclusion, multilayered epithelium was observed in about every tenth individual undergoing upper gastrointestinal endoscopy. The association with histological and clinical features indicating GERD advocates the lesion as a promising new marker for reflux esophagitis. The association with cardiac mucosa and Barrett's esophagus suggests multilayered epithelium to be an intermediate step in the development of columnar metaplasia and, ultimately, Barrett's esophagus.

  16. Endoscopic valvuloplasty for GERD.

    PubMed

    Martinez-Serna, T; Davis, R E; Mason, R; Perdikis, G; Filipi, C J; Lehman, G; Nigro, J; Watson, P

    2000-11-01

    The transoral, endoscopic route has been suggested as a possible approach for the correction of severe gastroesophageal reflux. Such a procedure would involve no mobilization of the cardia or other structures. The optimal placement, number, and configuration of sutures remains undefined. With the use of a previously developed endoscopic sewing machine, this study was undertaken in baboons with two suture arrangements immediately below the lower esophageal sphincter. A linear arrangement (group I) and a circular arrangement (group II) were compared. During the 6 months after the procedure, the animals were evaluated using manometry, fluoroscopic barium swallow, upper gastrointestinal endoscopy, and a pressure volume test. A significant increase in lower esophageal sphincter length was demonstrated only in group II (p = 0. 010). A significant increase in lower esophageal sphincter pressure was demonstrated only in group I animals (p = 0.008). The abdominal length increased in group I (p = 0.004) and group II (p = 0.004). The yield pressure and yield volume did not differ significantly from those measured previously in control animals. No evidence of reflux, stricture formation, esophagitis, or other pathology was noted. Some manometric parameters associated with gastroesophageal reflux are altered by the endoscopic placement of sutures below the gastroesophageal junction, with no associated serious complications.

  17. Gastroesophageal Reflux Disease (GERD)

    MedlinePlus

    ... kids and teens who have diseases of the gastrointestinal system (the esophagus, stomach, intestines, and other organs that ... Parents MORE ON THIS TOPIC Lactose Intolerance Ulcers Digestive System Irritable Bowel Syndrome Celiac Disease Hernias Contact Us ...

  18. Effects of baclofen on the functional anatomy of the oesophago-gastric junction and proximal stomach in healthy volunteers and patients with GERD assessed by magnetic resonance imaging and high-resolution manometry: a randomised controlled double-blind study.

    PubMed

    Curcic, J; Schwizer, A; Kaufman, E; Forras-Kaufman, Z; Banerjee, S; Pal, A; Hebbard, G S; Boesiger, P; Fried, M; Steingoetter, A; Schwizer, W; Fox, M

    2014-11-01

    The mechanism of reflux protection may involve a 'flap valve' at the oesophago-gastric junction (OGJ). To assess the effects of baclofen, a gamma-aminobutyric acid receptor type-B (GABA-B) agonist known to suppress reflux events, on the 'functional anatomy' of the OGJ and proximal stomach after a large test meal. Twelve healthy volunteers (HVs) and 12 patients with gastro-oesophageal reflux disease (GERD); with erosive oesophagitis or pathological oesophageal acid exposure completed a randomised, double-blind, cross-over study. On 2 test days participants received 40-mg baclofen or placebo before ingestion of a large test meal. OGJ structure and function were assessed by high-resolution manometry (HRM) and magnetic resonance imaging (MRI) using validated methods. Measurements of the oesophago-gastric angle were derived from three-dimensional models reconstructed from anatomic MRI images. Cine-MRI and HRM identified postprandial reflux events. Mixed model analysis and Wilcoxon rank signed tests assessed differences between participant groups and treatment conditions. In both HVs and GERD patients, baclofen reduced the frequency of postprandial reflux events. The oesophago-gastric insertion angle in GERD patients was reduced (-4.1 ± 1.8, P = 0.025), but was unchanged in healthy controls. In both study groups, baclofen augmented lower oesophageal sphincter (LES) pressure (HVs: +7.3 ± 1.8 mmHg, P < 0.0001, GERD: +4.50 ± 1.49 mmHg, P < 0.003) and increased LES length (HVs: +0.48 ± 0.11 cm, P < 0.0003, GERD: +0.35 ± 0.06 cm, P < 0.0001). Baclofen inhibits transient LES relaxations and augments LES pressure and length. Additionally, baclofen has effects on the 'functional anatomy' of the OGJ and proximal stomach in GERD patients, which may suppress reflux by means of a 'flap valve' mechanism. © 2014 John Wiley & Sons Ltd.

  19. Multicenter, randomized, double-blind study comparing 20 and 40 mg of pantoprazole for symptom relief in adolescents (12 to 16 years of age) with gastroesophageal reflux disease (GERD)

    USDA-ARS?s Scientific Manuscript database

    An age-appropriate questionnaire (GASP-Q) was used to assess the frequency and severity of the gastroesophageal reflux disease (GERD) symptoms: abdominal/belly pain, chest pain/heartburn, pain after eating, nausea, burping/belching, vomiting/regurgitation, choking when eating, and difficulty swallow...

  20. Novel measurement of rapid treatment success with ReQuest: first and sustained symptom relief as outcome parameters in patients with endoscopy-negative GERD receiving 20 mg pantoprazole or 20 mg esomeprazole.

    PubMed

    Mönnikes, Hubert; Pfaffenberger, Bernd; Gatz, Gudrun; Hein, Jasper; Bardhan, Karna Dev

    2007-01-01

    A prime concern for gastroesophageal reflux disease (GERD) patients is fast symptom control. Sparse valid information is available on the rapidity of the effect of proton pump inhibitors in providing symptom relief. The new reflux questionnaire ReQuest is validated for daily assessment of changes in GERD symptoms. Therefore, this study investigated the efficacy of 20 mg pantoprazole and 20 mg esomeprazole with regard to the time to symptom relief in patients with endoscopy-negative GERD (enGERD) using ReQuest. 529 patients were treated with pantoprazole or esomeprazole over 4 weeks. ReQuest symptom scores were assessed daily. The mean and median times to first and sustained symptom relief were determined. Median time to first symptom relief was 2 days for both drugs (intention-to-treat population). The median time to sustained symptom relief was 3 days shorter with pantoprazole (10.0 vs. 13.0 days). The Hodges-Lehmann estimator for the difference in time to reach first and sustained symptom relief between both groups was 0.00 days. For both variables the one-sided 95% CI (Moses) was [0.00; infinity[, documenting no significant differences between the treatment groups. The rapidity of symptom control can be evaluated by clinically significant parameters using ReQuest. Pantoprazole and esomeprazole are equally effective in the time to first and sustained symptom relief. Copyright 2007 S. Karger AG, Basel.

  1. Gaviscon Double Action Liquid (antacid & alginate) is more effective than antacid in controlling postprandial esophageal acid exposure in GERD patients; a double-blind crossover study

    PubMed Central

    De Ruigh, Annemijn; Roman, Sabine; Chen, Joan; Pandolfino, John E.; Kahrilas, Peter J.

    2015-01-01

    Background Recent studies have shown that Gaviscon Double Action Liquid (a combination alginate-antacid) administered postprandially co-localizes with the acid pocket, the ‘reservoir’ for postprandial acid reflux. Aim This study compared the effectiveness of Gaviscon Double Action Liquid to an equivalent strength antacid without alginate in controlling postprandial acid reflux in GERD patients. Methods 14 GERD patients undertook two 3.5-hour high-resolution manometry/pH-impedance studies during which they ate a standardized meal. In a double-blinded randomized crossover design they then took Gaviscon or CVS brand antacid, each with ~18 mmol/l acid neutralizing capacity. The primary outcome was distal esophageal acid exposure; secondary outcomes were number of reflux events, proximal extent of reflux, nadir pH of the refluxate, mechanism of reflux, and reflux symptoms scored with a validated instrument. Results 10 patients completed the study. Gaviscon studies had significantly less distal esophageal acid exposure and greater nadir refluxate pH in the 30–150 minute postprandial period than antacid studies. There were no differences in the number of reflux events (acid or weakly acidic) or the number of proximal reflux events (15–17 cm above the LES) with either study medication. Conclusions Gaviscon Double Action Liquid was more effective than an antacid without alginate in controlling postprandial esophageal acid exposure. However, the number and spatial distribution of reflux events within the esophagus were similar. This suggests that Gaviscon main effectiveness related to its co-localization with and displacement/neutralization of the post-prandial acid pocket, rather than preventing reflux. PMID:25041141

  2. "Normal Values of 24H Multichannel Intraluminal Impedance pH-Metry in a Greek Obese Population Based on Montreal Definition of Gerd".

    PubMed

    Doulami, Georgia; Triantafyllou, Stamatina; Natoudi, Maria; Albanopoulos, Konstantinos; Menenakos, Evangelos; Filis, Konstantinos; Zografos, Georgios; Theodorou, Dimitrios

    2016-01-01

    Although several studies reporting normal values of 24h multichannel intraluminal impedance pH (MIIpH) have been published, none of them has ever studied obese individuals. The purpose of this study is to determine overall frequency and duration of reflux episodes (acid and non-acid, supine-upright, post and preprandial) in obese asymptomatic volunteers. Obese volunteers were enlisted during their preoperative evaluation for bariatric surgery. Volunteers had no gastroesophageal reflux disease (GERD) symptoms and no evidence of esophageal mucosal injury on endoscopy. Participants underwent a 24h MIIpH. In this prospective observational study, data of 22 obese individuals were analyzed. Mean age was 41.9 years and mean BMI was 47.1 kg/m(2). Mean total reflux episodes was 55.6 and 95th percentile was 99.7. Mean percentage of total time with pH <4 was 2.59 % and 95th percentile was 8.57 %. Mean percentage of bolus exposure was 1.84 % with 95th percentile being 4.47 %. Postprandial acid reflux episodes were statistical significant more frequent in comparison to preprandial acid reflux episodes (19.41 vs. 15, p = 0.008). Mean acid clearance duration was 3.6 times higher than median bolus clearance duration (56.05 and 15.55 s, respectively, p = 0.868). Our study is the first to provide normal values of 24h MIIpH of asymptomatic obese. Normal values of 24h MIIpH of obese asymptomatic individuals differ from the reported normal values of non-obese healthy individuals; having more reflux episodes and equal or slightly higher median bolus exposure and acid clearance. Our results imply that new cut-off values should be employed in order to define GERD in obese individuals.

  3. Comparison of three composite compliance indices in a trial of self-administered preventive therapy for tuberculosis in HIV-infected Ugandan adults. Uganda-Case Western Reserve University Research Collaboration.

    PubMed

    Pekovic, V; Mayanja, H; Vjecha, M; Johnson, J; Okwera, A; Nsubuga, P; Mugerwa, R; Ellner, J; Whalen, C

    1998-07-01

    Compliance with tuberculosis preventive therapy in a randomized placebo-controlled trial in 2736 HIV-infected Ugandans was measured using urinary isoniazid metabolite testing, clinic attendance, and self-report. Overall, 77% of urine tests were positive, subjects kept 85% of their scheduled visits while on therapy, and 69% reportedly never forgot to take their medication. Different strategies were used for constructing three composite compliance indices in active arms: (1) an unweighted index of the summed scores on scaled compliance measures; (2) a weighted index using weights obtained from a survey of experts on tuberculosis; and (3) a statistically weighted index using principal components analysis. Composite indices were evaluated for reliability, validity, and practical utility. Understanding of the regimen, study arm, subsequent follow-up, tuberculosis status, and urine spot-check result were associated with composite compliance scores. The unweighted index in this study performed as well as the weighted indices.

  4. A multicenter, observational, prospective study of self- and parent-reported quality of life in adolescent multiple sclerosis patients self-administering interferon-β1a using RebiSmart™-the FUTURE study.

    PubMed

    Ghezzi, A; Bianchi, A; Baroncini, D; Bertolotto, A; Malucchi, S; Bresciamorra, V; Lanzillo, R; Milani, N; Martinelli, V; Patti, F; Chisari, C; Rottoli, M; Simone, M; Paolicelli, D; Visconti, A

    2017-08-22

    Besides the impact of disease per se, the use of immunomodulatory therapies in adolescents with relapsing-remitting multiple sclerosis (RRMS) may have an effect on quality of life (QL). The FUTURE (Quality of liFe in adolescent sUbjecTs affected by mUltiple sclerosis treated with immunomodulatoRy agEnt using self-injecting device) study was designed to evaluate the changes in QL of Italian adolescents with RRMS receiving treatment with IFN-β1a (Rebif; 22 μg), administered subcutaneously three times weekly using the RebiSmart™ electronic autoinjection device over a 52-week period. Fifty adolescents with RRMS were enrolled and 40 completed the study. Changes from baseline to end of treatment (EoT) in adolescent self-reported and parent-reported QL were assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL), which has been validated for use in pediatric MS and for which an Italian version is available. The adolescent self-reported total PedsQL4.0 score and all of its subscales tended to increase from baseline to EoT, the only exception being "Emotional functioning." In parent-reported measures, the total PedsQL4.0 score increased significantly from baseline to EoT (+ 5.27 points, p = 0.041). Significant increases were also evident for parent-reported "Psychosocial health summary score" (+ 5.90 points; p = 0.015) and "School functioning" (+ 7.84 points; p = 0.029). Our results indicate that adolescents with RRMS using the electronic injection device RebiSmart™ for self-administration of Rebif® can experience long-term improvements in QL.

  5. Emotional factors and subjective quality of life in subjects with spinal cord injuries.

    PubMed

    Bénony, Hervé; Daloz, Lionel; Bungener, Catherine; Chahraoui, Khadija; Frenay, Cécile; Auvin, Jacqueline

    2002-06-01

    To compare depression, subjective perception of quality of life, and social support in patients with spinal cord injuries 4 yr or more after trauma vs. controls. The Rorschach inkblot method, the Diagnostic Interview Schedule Self-Administered, the Progressive Matrix 38, the Social Support Appraisals, and the Subjective Quality of Life Profile were used to assess 33 patients with spinal cord injuries and 33 matched controls. No significant difference was observed for levels of general intelligence and depressive disorders. Subjects with spinal cord injuries assessed the general subjective quality of life as satisfactory, with exceptions for sexuality, physical condition, leisure activities, and holidays. A high degree of satisfaction with medical staff and inward life was observed. Social support was perceived as positive. However, they presented emotional distress, deteriorating perceptions, extreme preoccupation with their bodies, and diffuse anxiety. Although quality of life as evaluated by the persons concerned was good, areas of their lives remained unsatisfactory and a source of mental suffering. The next stage would study the factors involved and the means needed to help these subjects improve these aspects of life.

  6. Effects of caffeine on alcohol reinforcement: beverage choice, self-administration, and subjective ratings.

    PubMed

    Sweeney, Mary M; Meredith, Steven E; Evatt, Daniel P; Griffiths, Roland R

    2017-03-01

    Combining alcohol and caffeine is associated with increased alcohol consumption, but no prospective experimental studies have examined whether added caffeine increases alcohol consumption. This study examined how caffeine alters alcohol self-administration and subjective reinforcing effects in healthy adults. Thirty-one participants completed six double-blind alcohol self-administration sessions: three sessions with alcohol only (e.g., beverage A) and three sessions with alcohol and caffeine (e.g., beverage B). Participants chose which beverage to consume on a subsequent session (e.g., beverage A or B). The effects of caffeine on overall beverage choice, number of self-administered drinks, subjective ratings (e.g., Biphasic Alcohol Effects Scale), and psychomotor performance were examined. A majority of participants (65%) chose to drink the alcohol beverage containing caffeine on their final self-administration session. Caffeine did not increase the number of self-administered drinks. Caffeine significantly increased stimulant effects, decreased sedative effects, and attenuated decreases in psychomotor performance attributable to alcohol. Relative to nonchoosers, caffeine choosers reported overall lower stimulant ratings and reported greater drinking behavior prior to the study. Although caffeine did not increase the number of self-administered drinks, most participants chose the alcohol beverage containing caffeine. Given the differences in subjective ratings and pre-existing differences in self-reported alcohol consumption for caffeine choosers and nonchoosers, these data suggest that decreased stimulant effects of alcohol and heavier self-reported drinking may predict subsequent choice of combined caffeine and alcohol beverages. These predictors may identify individuals who would benefit from efforts to reduce risk behaviors associated with combining alcohol and caffeine.

  7. Dental Erosion in Children with Gastroesophageal Reflux Disease.

    PubMed

    De Oliveira, Patricia Alves Drummond; Paiva, Saul Martins; De Abreu, Mauro Henrique Nogueira Guimarães; Auad, Sheyla Márcia

    2016-01-01

    The purpose of this study was to investigate the impact of gastroesophageal reflux disease (GERD) on dental erosion (DE) in children and analyze the association between dental erosion and diet, oral hygiene, and sociodemographic characteristics. This case-control study encompassed 43 two- to 14-year-olds diagnosed positive for GERD by the 24-hour pH monitoring, paired by age group with 136 healthy controls, in Belo Horizonte, Minas Gerais, Brazil. DE was assessed by one calibrated examiner using the O'Sullivan index. A questionnaire was self-administered by parents collecting information regarding sociodemographics, oral hygiene, and dietary habits. Dental erosion experience was compared between the groups, and a stratified analysis was performed (P<0.05). Dental erosion was diagnosed in 10.6 percent (N equals 19) of all the children; 25.6 percent (N equals 11) of GERD children and 5.9 percent (N equals eight) of children without GERD, P=0.001). Dental erosion was not associated with dietary consumption or sociodemographic characteristics in both groups (P≥0.05). Children who used adult toothpaste had a 5.79 higher chance of having dental erosion in the group with GERD. Children diagnosed with gastroesophageal reflux disease were at an increased risk of having dental erosion when compared to healthy subjects; among the GERD children, dental erosion was associated with the use of adult toothpaste.

  8. [A self administered survey to assess bullying in schools].

    PubMed

    Lecannelier, Felipe; Varela, Jorge; Rodríguez, Jorge; Hoffmann, Marianela; Flores, Fernanda; Ascanio, Lorena

    2011-04-01

    Bullying is common in schools and has negative consequences. It can be assessed using a self-reported instrument. To validate a Spanish self-reporting tool called "Survey of High School Bullying Abuse of Power" (MIAP). The instrument has 13 questions, of which 7 are multiple choice, rendering a total of 49 items. It was applied to 2.341 children of seventh and eighth grade attending private, subsidized and municipal schools in the city of Concepción, Chile. Expert judge analysis and estimated reliability using the Cronbach Alpha were used to validate the survey. The instrument obtained a Cronbach Alpha coefficient of 0.8892, classified as good. This analysis generated four scales that explained 30.9% of the variance. They were called "Witness Bullying" with 18 items, accounting for 11.4% of the variance, "Bullying Victim" with 12 items, accounting for 7.5% of the variance, "Bullying Perpetrator and Severe bullying Victim", with 10 items explaining 6.4% of the variance and "Aggressor Bullying" with 6 items accounting for 5.7% of the variance. The MIAP can recognize four basic factors that facilitate the analysis and understanding of bullying, with good levels of reliability and validity. The remaining questions also deliver valuable information.

  9. The Self Administered Inventory of Learning Strengths for College Students.

    ERIC Educational Resources Information Center

    Siegel, Janna; Lester, Shaun E.

    Understanding how they learn best is important for beginning and returning college students. This self-awareness can assist students in developing their classroom learning, study skills, and instructional habits throughout their college careers. For this reason, a quick, inexpensive learning style inventory appropriate for college populations was…

  10. Developing a self-administered CKD symptom assessment instrument.

    PubMed

    Agarwal, Rajiv

    2010-01-01

    Current disease-centred therapies for CKD focus on preserving the GFR but often ignore patient-reported symptoms. This purpose of this report is to describe the development of an instrument to measure the presence and severity of a wide range of symptoms commonly attributable to CKD. A 37-item questionnaire was administered along with the Kidney Disease Quality of Life instrument to 92 patients with CKD not on dialysis (24% black, 5% women, mean age 68 years, 68% with diabetes mellitus). To discover groups of symptoms, agglomerative cluster analysis followed by exploratory common factor analysis was performed. Construct validity, internal reliability, convergent and discriminant validity, test-retest reliability and finally the association of various symptom domains with objective measurements such as estimated GFR and haemoglobin were tested. The top five symptoms of at least moderate severity in decreasing order of prevalence were 'tire easily', limited physical activity, nocturia, joint pain and 'stop and rest often'. Four common factors emerged that could be broadly classified into neuropsychiatric, cardiovascular, uraemia and anaemia symptoms accounting for 73% of the total variance in the sample. The coefficient alpha for each of these factors approached 0.9. The test-retest reliability in 41 patients over 8 weeks was likewise high. There was good convergent and divergent validity. However, there was little relationship between estimated GFR and symptom scores. The assessment of symptom burden among patients with CKD may be facilitated by incorporating this instrument in routine practice and clinical trials.

  11. Web-based evaluation of Parkinson's disease subjects: objective performance capacity measurements and subjective characterization profiles.

    PubMed

    Kondraske, George V; Stewart, R Malcolm

    2008-01-01

    Parkinson's Disease (PD) is classified as a progressively degenerative movement disorder, affecting approximately 0.2% of the population and resulting in decreased performance in a wide variety of activities of daily living. Motivated by needs associated with the conduct of multi-center clinical trials, early detection, and the optimization of routine management of individuals with PD, we have developed a three-tiered approach to evaluation of PD and other neurologic diseases/disorders. One tier is characterized as 'web-based evaluation', consisting of objective performance capacity tests and subjective questionnaires that target history and symptom evaluation. Here, we present the initial evaluation of three representative, self-administered, objective, web-based performance capacity tests (simple visual-hand response speed, rapid alternating movement quality, and upper extremity neuromotor channel capacity). Twenty-one subjects (13 with PD, 8 without neurologic disease) were evaluated. Generally good agreement was obtained with lab-based tests executed with an experienced test administrator. We conclude that objective performance capacity testing is a feasible component of a web-based evaluation for PD, providing a sufficient level of fidelity to be useful.

  12. Minocycline attenuates subjective-rewarding effects of dextroamphetamine in humans

    PubMed Central

    Sofuoglu, Mehmet; Mooney, Marc; Kosten, Thomas; Waters, Andrew; Hashimoto, Kenji

    2010-01-01

    Rationale Minocycline, a tetracycline antibiotic, interacts with brain glutamate and dopamine neurotransmission. In preclinical studies, minocycline attenuated amphetamine-induced acute dopamine release and subsequent behavioral sensitization. The goal of this study was to determine minocycline’s effects on the acute physiological, behavioral, and subjective responses to dextroamphetamine (DAMP) in healthy volunteers. Methods Ten healthy volunteers participated in an outpatient double-blind, placebo-controlled, crossover study. Subjects had a 5-day treatment period with either minocycline (200 mg/day) or placebo and then were crossed over for 5-days of the other treatment. After two days of taking the study medication, on days 3 and 4, subjects were randomly assigned to double-blind acute challenge with either 20 mg/70 kg DAMP or placebo DAMP (randomly labeled as drug A or B) and then crossed-over to the other challenge. On Day 5 (Experimental Session 3), subjects had the opportunity to self-administer either placebo or DAMP capsules by working on a progressive ratio computer task. Results Minocycline attenuated DAMP-induced subjective-rewarding effects but did not change DAMP choice behavior. Minocycline treatment speeded reaction times on a Go No-Go task and reduced plasma cortisol levels. Conclusions These findings warrant further studies examining the potential use of minocycline for stimulant addiction. PMID:20838775

  13. Predictive factors of silent reflux in subjects with erosive esophagitis.

    PubMed

    Lei, Wei-Yi; Yu, Hao-Chun; Wen, Shu-Hui; Liu, Tso-Tsai; Yi, Chih-Hsun; Wang, Chia-Chi; Hsu, Ching-Sheng; Chen, Chien-Hwa; Chen, Chien-Lin; Pace, Fabio

    2015-01-01

    Asymptomatic erosive esophagitis by definition is a condition lacking any reflux symptom. We aimed to investigate the prevalence of asymptomatic erosive esophagitis in a general population undergoing periodic health checkup. Consecutive subjects undergoing a medical checkup were enrolled for evaluation of reflux disease with upper endoscopy and a validated reflux questionnaire. The presence and severity of erosive esophagitis were evaluated. In all subjects, demographic characteristics and biochemical data were recorded, and sleep and psychological characteristics were assessed by means of self-administered Pittsburgh Sleep Quality Index score, Taiwanese Depression Questionnaire score, and State-Trait Anxiety Inventory score. Of 2568 subjects eligible for this study, erosive esophagitis was found in 676 subjects (26.3%), in whom the proportions of asymptomatic and symptomatic erosive esophagitis were 59.2% (400 subjects) and 40.8% (276 subjects) respectively. At a univariate analysis, it was found that asymptomatic erosive esophagitis subjects were more frequently of female gender, of older age, with a lower level of education. They also showed less alcohol and tea consumption, less depression, less anxiety, lower serum level of triglyceride, and lower prevalence of metabolic syndrome. Multivariate analysis revealed that female sex (OR = 1.645, p = 0.0146) was a positive predictive factor for asymptomatic erosive esophagitis, whereas higher level of education (OR = 0.564, p = 0.044), higher Taiwanese Depression Questionnaire score (OR = 0.922, p < 0.001), and the presence of metabolic syndrome (OR = 0.625, p = 0.0379) were negative predictive factors. Asymptomatic erosive esophagitis is a common feature in otherwise healthy subjects and is independently associated with female gender, lower education level, less depression, and lower prevalence of metabolic syndrome. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights

  14. Impact of gastroesophageal reflux disease on patients' daily lives: a European observational study in the primary care setting

    PubMed Central

    Gisbert, Javier P; Cooper, Alun; Karagiannis, Dimitrios; Hatlebakk, Jan; Agréus, Lars; Jablonowski, Helmut; Zapardiel, Javier

    2009-01-01

    Background The impact of gastroesophageal reflux disease (GERD) on the daily lives of patients managed in primary care is not well known. We report the burden of GERD in a large population of patients managed in primary care, in terms of symptoms and impact on patients' daily lives. Methods RANGE (Retrospective ANalysis of GERD) was an observational study that was conducted at 134 primary care sites across six European countries. All adult subjects who had consulted their primary care physician (PCP) during a 4-month identification period were screened retrospectively and those consulting at least once for GERD-related reasons were identified. From this population, a random sample of patients was selected to enter the study and attended a follow-up appointment, during which the Reflux Disease Questionnaire (RDQ), the GERD Impact Scale (GIS) and an extra-esophageal symptoms questionnaire were self-administered. Based on medical records, data were collected on demographics, history of GERD, its diagnostic work-up and therapy. Results Over the 4-month identification period, 373,610 subjects consulted their PCP and 12,815 (3.4%) did so for GERD-related reasons. From 2678 patients interviewed (approximately 75% of whom reported taking medication for GERD symptoms), symptom recurrence following a period of remission was the most common reason for consultation (35%). At the follow-up visit, with regard to RDQ items (score range 0–5, where high score = worse status), mean Heartburn dimension scores ranged from 0.8 (Sweden) to 1.2 (UK) and mean Regurgitation dimension scores ranged from 1.0 (Norway) to 1.4 (Germany). Mean overall GIS scores (range 1–4, where low score = worse status) ranged from 3.3 (Germany) to 3.5 (Spain). With regard to extra-esophageal symptoms, sleep disturbance was common in all countries in terms of both frequency and intensity. Conclusion In this large European observational study, GERD was associated with a substantial impact on the daily lives

  15. Relationships between pathologic subjective halitosis, olfactory reference syndrome, and social anxiety in young Japanese women.

    PubMed

    Tsuruta, Miho; Takahashi, Toru; Tokunaga, Miki; Iwasaki, Masanori; Kataoka, Shota; Kakuta, Satoko; Soh, Inho; Awano, Shuji; Hirata, Hiromi; Kagawa, Masaharu; Ansai, Toshihiro

    2017-03-14

    Pathologic subjective halitosis is known as a halitosis complaint without objective confirmation of halitosis by others or by halitometer measurements; it has been reported to be associated with social anxiety disorder. Olfactory reference syndrome is a preoccupation with the false belief that one emits a foul and offensive body odor. Generally, patients with olfactory reference syndrome are concerned with multiple body parts. However, the mouth is known to be the most common source of body odor for those with olfactory reference syndrome, which could imply that the two conditions share similar features. Therefore, we investigated potential causal relationships among pathologic subjective halitosis, olfactory reference syndrome, social anxiety, and preoccupations with body part odors. A total of 1360 female students (mean age 19.6 ± 1.1 years) answered a self-administered questionnaire regarding pathologic subjective halitosis, olfactory reference syndrome, social anxiety, and preoccupation with odors of body parts such as mouth, body, armpits, and feet. The scale for pathologic subjective halitosis followed that developed by Tsunoda et al.; participants were divided into three groups based on their scores (i.e., levels of pathologic subjective halitosis). A Bayesian network was used to analyze causal relationships between pathologic subjective halitosis, olfactory reference syndrome, social anxiety, and preoccupations with body part odors. We found statistically significant differences in the results for olfactory reference syndrome and social anxiety among the various levels of pathologic subjective halitosis (P < 0.001). Residual analyses indicated that students with severe levels of pathologic subjective halitosis showed greater preoccupations with mouth and body odors (P < 0.05). Bayesian network analysis showed that social anxiety directly influenced pathologic subjective halitosis and olfactory reference syndrome. Preoccupations with mouth and

  16. African-Americans, Hispanic Americans, and non-Hispanic whites without GERD or reflux symptoms have equivalent 24-h pH esophageal acid exposure.

    PubMed

    Vega, Kenneth J; Langford, Tracy; Palacio, Carlos; Watts, Janet; Jamal, M Mazen

    2013-12-01

    Ambulatory esophageal pH monitoring is, currently, the recommended diagnostic exam for gastroesophageal reflux disease. Data are currently available for African-American (AA) and non-Hispanic white (nHw) volunteers among United States ethnic groups. The purpose of this study was to obtain normal values of 24-h esophageal pH by monitoring healthy adult Hispanic American (HA) volunteers and to compare these with values obtained from healthy AA and nHw volunteers to determine if ethnic variation exists in 24-h esophageal pH. 24-h Dual esophageal pH monitoring was performed for healthy AA, HA, and nHw. Values for total number of reflux episodes, episodes longer than 5 min, total reflux time, and longest reflux episode in the proximal and/or distal esophagus were obtained for all groups. Differences between groups were considered significant if p<0.05. One-hundred and thirty-six subjects volunteered and completed 24-h pH testing. Fifty-three were AA, 25 HA, and 58 nHw, with males accounting for 52, 47, and 47%, respectively, of each group. AA were older than nHw only and nHw had a lower body mass index than both AA and HA. Shorter study duration was observed for HA than for AA and nHw. No difference was observed between ethnic groups for any measured pH data in the proximal or distal esophagus. No difference exists in values obtained during esophageal pH monitoring among healthy AA, HA, and nHw. This indicates that currently accepted normal values of ambulatory esophageal pH monitoring can be used for all major United States ethnic groups without compromising diagnostic accuracy.

  17. Pharmacokinetics and tolerability of rabeprazole sodium in subjects aged 12 to 16 years with gastroesophageal reflux disease: an open-label, single- and multiple-dose study.

    PubMed

    James, Laura; Walson, Philip; Lomax, Kathleen; Kao, Richard; Varughese, Shanti; Reyes, Josephine

    2007-09-01

    This study was conducted to characterize the pharmacokinetic and safety profile of rabeprazole sodium tablets in children and adolescents with gastroesophageal reflux disease (GERD). This was a multicenter, open-label, single- and multiple-dose study in subjects aged 12 to 16 years with GERD. Subjects were stratified by age (12-<14 years and 14-16 years) and were randomized to receive oral rabeprazole 10 or 20 mg/d over 5 or 7 days (to accommodate weekends). The pharmacokinetic parameters calculated included C(max), T(max), AUC, t(1/2), and apparent oral clearance (day 5/7 only). Blood samples for pharmacokinetic determinations were obtained on study days 1, 2, and 5 (or 7) and at discharge on day 6 (or 8). Safety assessments, including adverse events (AEs), were performed at all study visits. Twenty-four subjects were enrolled in the study (12 in each dose group); they were predominantly white, had a mean age of 14.2 years, and had a mean body mass index of 24.3 kg/m(2) (the 90th percentile for adolescents of this age in the United States). Mean age and weight did not differ significantly between the 2 dose groups. On day 1, C(max) was significantly greater in the rabeprazole 20-mg group compared with the rabeprazole 10-mg group (P = 0.024); on day 5/7, both AUC and C(max) were significantly greater in the rabeprazole 20-mg group compared with the rabeprazole 10-mg group (P = 0.005 and P = 0.007, respectively). Within-period comparisons for both groups indicated that the AUC and C(max) for rabeprazole and its thioether metabolite did not differ significantly from day 1 to day 5/7. In addition, the T(max) and t(1/2) were relatively unchanged from day 1 to day 5/7 in both dose groups. Treatment-emergent signs and symptoms occurred in 11 subjects, 6 in the 10-mg group and 5 in the 20-mg group. The most frequently reported AEs were headache and nausea (16.7% and 8.3%, respectively). No statistically significant differences were observed between dose groups in terms of

  18. Do subjective cognitive complaints correlate with cognitive impairment in systemic lupus erythematosus? A Danish outpatient study.

    PubMed

    Vogel, A; Bhattacharya, S; Larsen, J L; Jacobsen, S

    2011-01-01

    This study examined the prevalence of cognitive impairment and its association with depressive symptoms and self-reported cognitive complaints in Danish outpatients with systemic lupus erythematosus (SLE). Fifty-seven consecutive female SLE-outpatients were examined with a comprehensive neuropsychological test-battery, a 20-item self-administered Perceived Deficits Questionnaire (PDQ) and a self-rated depression scale (Major Depression Inventory). Twenty-two patients (38.5%) were classified as cognitively impaired, mostly with deficits in executive functions and attention. Among cognitively impaired patients only 18.2% had significantly higher PDQ scores than the normal range. PDQ scores were highly correlated to depressive symptoms (r = 0.67, p < 0.001). Only two neuropsychological tests were significantly correlated with subjective cognitive complaints. When these variables and self-rated depression score were entered into a regression model both depression score and Symbol Digit Modalities Test performances were significantly associated with the PDQ score. In conclusion, cognitive impairments were common in this group of (mild) SLE outpatients, but the level of significant subjective cognitive complaints was low even among patients with cognitive impairment. Affective status may influence subjective experience of cognitive functions even more than cognitive functioning itself, and absence of subjective cognitive complaints did not exclude the presence of cognitive impairments.

  19. Non response, incomplete and inconsistent responses to self-administered health-related quality of life measures in the general population: patterns, determinants and impact on the validity of estimates — a population-based study in France using the MOS SF-36

    PubMed Central

    2013-01-01

    Background Health-related quality of life (HRQoL) measures are increasingly used in the general population. However, little is known about patterns and determinants of unanswered or unusable questionnaires and their consequences on estimates of HRQoL. Methods The 2003 Decennial Health Survey collected socio-demographic and health information, including HRQoL, for 30,782 adults representative of the French population. The pattern, determinants and impact on estimate validity of non, incomplete and inconsistent responses to the SF-36 questionnaire were determined. For this, phi coefficients, polytomous logistic regression models and multiple imputation methods were used. Results Only 48% of the subjects eligible for the HRQoL measurement provided a complete and consistent SF-36 questionnaire. Three patterns of non-response and five of partial (incomplete or inconsistent) response were identified, sharing largely similar socio-demographic profiles (higher age, lower educational level and economic status, foreign background, and isolated). The consequences of non and partial responses on HRQoL estimates were large in several groups of subjects although these biases ran in opposite directions and partially neutralized each other. Conclusions When measuring HRQoL in the general population, missing and inconsistent data are frequent, especially in elderly, educationally and socio-economically deprived, foreign and isolated groups. Methods for handling missing data are required to correct for potentially the associated and serious selection and non-differential information biases in studies targeting or investigating these groups. PMID:23497315

  20. Non response, incomplete and inconsistent responses to self-administered health-related quality of life measures in the general population: patterns, determinants and impact on the validity of estimates - a population-based study in France using the MOS SF-36.

    PubMed

    Coste, Joel; Quinquis, Laurent; Audureau, Etienne; Pouchot, Jacques

    2013-03-13

    Health-related quality of life (HRQoL) measures are increasingly used in the general population. However, little is known about patterns and determinants of unanswered or unusable questionnaires and their consequences on estimates of HRQoL. The 2003 Decennial Health Survey collected socio-demographic and health information, including HRQoL, for 30,782 adults representative of the French population. The pattern, determinants and impact on estimate validity of non, incomplete and inconsistent responses to the SF-36 questionnaire were determined. For this, phi coefficients, polytomous logistic regression models and multiple imputation methods were used. Only 48% of the subjects eligible for the HRQoL measurement provided a complete and consistent SF-36 questionnaire. Three patterns of non-response and five of partial (incomplete or inconsistent) response were identified, sharing largely similar socio-demographic profiles (higher age, lower educational level and economic status, foreign background, and isolated). The consequences of non and partial responses on HRQoL estimates were large in several groups of subjects although these biases ran in opposite directions and partially neutralized each other. When measuring HRQoL in the general population, missing and inconsistent data are frequent, especially in elderly, educationally and socio-economically deprived, foreign and isolated groups. Methods for handling missing data are required to correct for potentially the associated and serious selection and non-differential information biases in studies targeting or investigating these groups.

  1. Validation of a subjective quality of life questionnaire (S.QUA.LA) in schizophrenia.

    PubMed

    Nadalet, Liliane; Kohl, Frantz-Samy; Pringuey, Dominique; Berthier, Frédéric

    2005-07-01

    We developed and validated a self-administered questionnaire (Subjective Quality of Life Analysis, S.QUA.L.A.) to measure subjective quality of life. S.QUA.L.A. is a multidimensional instrument. This scale includes 22 domains of life. It covers traditional areas (food, family relation etc)., and more abstract aspects of life (politic, justice, freedom, truth, beauty and art, love). For each domain, patients are asked to evaluate their degree of satisfaction. They have also to indicate how important this domain is for them. We questioned 92 patients with schizophrenia and 357 para-medical students. The research demonstrated reproducibility, high internal consistency reliability, and sensitivity to change. Principal components analysis with varimax rotation was performed. A five-factor solution was selected, showing a great contribution of different dimensions of the self. Determinants of quality of life were identified by using correlations with Lehman's Quality of Life Interview (QOLI), and with measures of psychopathology and social functioning. Satisfaction approach and QOLI showed the same construct. We confirmed the influence of symptoms of depression and anxiety on subjective quality of life assessment, and the poor impact of disease parameters.

  2. [GERD related respiratory symptoms: diagnosis and treatment].

    PubMed

    Cuenca-Abente, Federico; Faerberg, Alejandro; Marty, Pablo Fernández; Corti, Rodolfo

    2006-03-01

    Gastroesophageal reflux disease can cause respiratory symptoms. These symptoms are triggered by reflux events that reach the pharynx, causing microaspiration or through vagal reflex. Respiratory symptoms can be vague and coexist with gastroesophageal reflux disease, without a real link between the two entities. To effectively treat these patients, it is important tofind an association between the two diseases. Work up should include the diagnosis of reflux disease, the diagnosis of pharyngeal reflux events--microaspiration--and, if possible, of laryngeal injury. Once the diagnosis has been established, an effective therapy must be offered to the patient. In these patients, medical treatment is less effective when compared to the results in the population with typical symptoms. This may be due to the fact that non-acid reflux episodes are causing the respiratory symptoms or as a result of an irreversible damage generated in the airway. Antireflux surgery is an effective therapy that reduces both acid and non-acid reflux events. This article describes the different diagnostic tests as well as the results obtained with surgical treatment in this population. Additionally, it describes potential applications of esophageal and pharyngeal impedance monitoring in these patients.

  3. Have You Heard of GERD? (For Kids)

    MedlinePlus

    ... uncomfortable burning feeling behind the breastbone. Heartburn has nothing to do with the heart, but everything to ... and help the stomach empty more quickly. If nothing else works, a person may need surgery to ...

  4. Gastroesophageal Reflux Disease (GERD) (and Asthma)

    MedlinePlus

    ... within two to three hours of eating • Decrease caffeine intake • Avoid theophylline (if possible) Your physician may also recommend medications to treat reflux or relieve symptoms. Over-the-counter antacids and H2 blockers may help decrease the effects of stomach acid. Proton pump inhibitors block acid ...

  5. The role of hiatus hernia in GERD.

    PubMed Central

    Kahrilas, P. J.

    1999-01-01

    Increased esophageal acid exposure in gastroesophageal reflux disease has several potential causes, some related primarily to physiological dysfunction of the LES and others related to anatomic distortion of the gastroesophageal junction as occurs with hiatus hernia. One attractive feature of implicating hiatal hernias in the pathogenesis of reflux disease is that, like reflux disease, axial hernias become more common with age and obesity. However, the importance of hiatus hernia is obscured by imprecise definition and an all-or-none conceptualization that has led to wide variation in estimates of prevalence among normal or diseased populations. There are at least three potentially significant radiographic features of a hiatus hernia: axial length during distention, axial length at rest, and competence of the diaphragmatic hiatus. Although any or all of these features may be abnormal in a particular instance of hiatus hernia, each is of different functional significance. Grouping all abnormalities of the gastroesophageal junction as "hiatus hernia" without detailing the specifics of each case defies logic. Mechanistically, the gastroesophageal junction must protect against reflux both in static and dynamic conditions. During abrupt increases in intra-abdominal pressure, the crural diaphragm normally serves as a "second sphincter," and this mechanism is substantially impaired in individuals with a gaping hiatus. Large, non-reducing hernias also impair the process of esophageal emptying, thereby prolonging acid clearance time following a reflux event (especially while in the supine posture). These anatomically-determined functional impairments of the gastroesophageal junction lead to increased esophageal acid exposure. Thus, although hiatus hernia may or may not be an initiating factor at the inception of reflux disease, it clearly can act as a sustaining factor accounting for the frequently observed chronicity of the disease. PMID:10780571

  6. Have You Heard of GERD? (For Kids)

    MedlinePlus

    ... ketchup and other tomato products mustard and vinegar citrus fruits and juices previous continue What Will the ... for a short time because they can cause side effects and might not control the problem for very ...

  7. Pediatric GERD (Gastro-Esophageal Reflux Disease)

    MedlinePlus

    ... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources ... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources ...

  8. The Subject of Policy

    ERIC Educational Resources Information Center

    Bansel, Peter

    2015-01-01

    I work selectively with poststructuralist theories in order to give an account of the subject of policy as a constitutive relationship between social policy and the embodied human subject. Drawing on theories of subjectivity, narrative and governmentality, I articulate possibilities for analysing narrated accounts of experience as a mode of…

  9. Gendered Subjectivities of Spacetimematter

    ERIC Educational Resources Information Center

    Juelskjaer, Malou

    2013-01-01

    This paper investigates enactments of human subjectivities with a focus on how subjectivities may be studied if spatiality and temporality are taken up as constituting forces in the production of subjectivities. By reading poststructuralist feminist theorising, agential realism and empirical material diffractively through each other I re-situate…

  10. Gendered Subjectivities of Spacetimematter

    ERIC Educational Resources Information Center

    Juelskjaer, Malou

    2013-01-01

    This paper investigates enactments of human subjectivities with a focus on how subjectivities may be studied if spatiality and temporality are taken up as constituting forces in the production of subjectivities. By reading poststructuralist feminist theorising, agential realism and empirical material diffractively through each other I re-situate…

  11. The Subject of Policy

    ERIC Educational Resources Information Center

    Bansel, Peter

    2015-01-01

    I work selectively with poststructuralist theories in order to give an account of the subject of policy as a constitutive relationship between social policy and the embodied human subject. Drawing on theories of subjectivity, narrative and governmentality, I articulate possibilities for analysing narrated accounts of experience as a mode of…

  12. A subjective scheduler for subjective dedicated networks

    NASA Astrophysics Data System (ADS)

    Suherman; Fakhrizal, Said Reza; Al-Akaidi, Marwan

    2017-09-01

    Multiple access technique is one of important techniques within medium access layer in TCP/IP protocol stack. Each network technology implements the selected access method. Priority can be implemented in those methods to differentiate services. Some internet networks are dedicated for specific purpose. Education browsing or tutorial video accesses are preferred in a library hotspot, while entertainment and sport contents could be subjects of limitation. Current solution may use IP address filter or access list. This paper proposes subjective properties of users or applications are used for priority determination in multiple access techniques. The NS-2 simulator is employed to evaluate the method. A video surveillance network using WiMAX is chosen as the object. Subjective priority is implemented on WiMAX scheduler based on traffic properties. Three different traffic sources from monitoring video: palace, park, and market are evaluated. The proposed subjective scheduler prioritizes palace monitoring video that results better quality, xx dB than the later monitoring spots.

  13. Validity of Short and Long Self-Administered Food Frequency Questionnaires in Ranking Dietary Intake in Middle-Aged and Elderly Japanese in the Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) Protocol Area

    PubMed Central

    Yokoyama, Yuta; Takachi, Ribeka; Ishihara, Junko; Ishii, Yuri; Sasazuki, Shizuka; Sawada, Norie; Shinozawa, Yurie; Tanaka, Junta; Kato, Erika; Kitamura, Kaori; Nakamura, Kazutoshi; Tsugane, Shoichiro

    2016-01-01

    Background Longitudinal epidemiological studies require both the periodic update of intake information via repeated dietary survey and the minimization of subject burden in responding to questionnaires. We developed a 66-item Food Frequency Questionnaire (short-FFQ) for the Japan Public Health Center-based prospective Study for the Next Generation (JPHC-NEXT) follow-up survey using major foods from the FFQ developed for the original JPHC Study. For the JPHC-NEXT baseline survey, we used a larger 172-item FFQ (long-FFQ), which was also derived from the JPHC-FFQ. We compared the validity of ranking individuals by levels of dietary consumption by these FFQs among residents of selected JPHC-NEXT study areas. Methods From 2012 to 2013, 240 men and women aged 40–74 years from five areas in the JPHC-NEXT protocol were asked to respond to the long-FFQ and provide 12-day weighed food records (WFR) as reference; 228 also completed the short-FFQ. Spearman’s correlation coefficients (CCs) between estimates from the FFQs and WFR were calculated and corrected for intra-individual variation of the WFR. Results Median CC values for energy and 53 nutrients for the short-FFQ for men and women were 0.46 and 0.44, respectively. Respective values for the long-FFQ were 0.50 and 0.43. Compared with the long-FFQ, cross-classification into exact plus adjacent quintiles with the short-FFQ ranged from 68% to 91% in men and 58% to 85% in women. Conclusions Similar to the long-FFQ, the short-FFQ provided reasonably valid measures for ranking middle-aged and elderly Japanese for many nutrients and food groups. The short-FFQ can be used in follow-up surveys in prospective cohort studies aimed at updating diet rank information. PMID:27064130

  14. Tolerability, usability and acceptability of dissolving microneedle patch administration in human subjects.

    PubMed

    Arya, Jaya; Henry, Sebastien; Kalluri, Haripriya; McAllister, Devin V; Pewin, Winston P; Prausnitz, Mark R

    2017-03-02

    To support translation of microneedle patches from pre-clinical development into clinical trials, this study examined the effect of microneedle patch application on local skin reactions, reliability of use and acceptability to patients. Placebo patches containing dissolving microneedles were administered to fifteen human participants. Microneedle patches were well tolerated in the skin with no pain or swelling and only mild erythema localized to the site of patch administration that resolved fully within seven days. Microneedle patches could be administered by hand without the need of an applicator and delivery efficiencies were similar for investigator-administration and self-administration. Microneedle patch administration was not considered painful and the large majority of subjects were somewhat or fully confident that they self-administered patches correctly. Microneedle patches were overwhelmingly preferred over conventional needle and syringe injection. Altogether, these results demonstrate that dissolving microneedle patches were well tolerated, easily usable and strongly accepted by human subjects, which will facilitate further clinical translation of this technology.

  15. Teaching of subject matter.

    PubMed

    Mayer, Richard E

    2004-01-01

    Psychology of subject matter refers to the scientific study of learning and instruction within school subjects. The growing research literature on teaching and learning of school subjects represents one of educational psychology's most productive accomplishments of the past two decades. The purpose of this chapter is to examine representative advances in the psychology of subject matter, including how people learn to read words, comprehend printed passages, write compositions, solve arithmetic word problems, and understand how scientific systems work. The introduction provides a historical overview of how to promote transfer and is followed by reviews of representative research in learning and teaching of reading fluency, reading comprehension, writing, mathematics, and science.

  16. The Eppelsheimer Subject Catalog

    ERIC Educational Resources Information Center

    Stevenson, Gordon

    1971-01-01

    Since 1945, a method of catalog classification, originally devised by H.W. Eppelsheimer for the Mainz City Library, has found wide acceptance. It is a complex of catalogs which combines features of both subject classification and alphabetical subject indexing. (25 references) (Author/NH)

  17. Body as subject1

    PubMed Central

    MEIR, IRIT; PADDEN, CAROL A.; ARONOFF, MARK; SANDLER, WENDY

    2011-01-01

    The notion of subject in human language has a privileged status relative to other arguments. This special status is manifested in the behavior of subjects at the morphological, syntactic, semantic and discourse levels. Here we bring evidence that subjects have privileged status at the lexical level as well, by analyzing lexicalization patterns of verbs in three different sign languages. Our analysis shows that the sublexical structure of iconic signs denoting state of affairs in these languages manifests an inherent pattern of form–meaning correspondence: the signer’s body consistently represents one argument of the verb, the subject. The hands, moving in relation to the body, represent all other components of the event – including all other arguments. This analysis shows that sign languages provide novel evidence in support of the centrality of the notion of subject in human language. It also solves a typological puzzle about the apparent primacy of object in sign language verb agreement, a primacy not usually found in spoken languages, in which subject agreement ranks higher. Our analysis suggests that the subject argument is represented by the body and is part of the lexical structure of the verb. Because it is always inherently represented in the structure of the sign, the subject is more basic than the object, and tolerates the omission of agreement morphology. PMID:23066169

  18. A randomized phase I clinical study of cis-urocanic acid eye drops in healthy adult subjects.

    PubMed

    Jauhonen, Hanna-Mari; Kari, Eeva; Pylkkänen, Liisa; Poutanen, Jutta; Laihia, Jarmo; Kaarniranta, Kai; Leino, Lasse

    2015-06-01

    To evaluate safety, ocular tolerability and pharmacokinetics of 0.5% and 2.5% cis-urocanic acid (cis-UCA) eye drops. In this phase I, double-blinded, placebo-controlled trial, 37 healthy volunteers were randomized to three treatment arms: 0.5% cis-UCA (12 subjects), 2.5% cis-UCA (12 subjects) and placebo eye drops (13 subjects). In the first part, the subjects were dosed topically on a randomized eye with one drop three times at 7 ± 1 hr intervals during 1 day. In the second part, the subjects self-administered three daily drops at 7 ± 1 hr intervals on both eyes for 14 days. Physical examination of the eyes was performed seven times during the study. Tolerability of cis-UCA was assessed by ocular comfort rating questionnaire. Pharmacokinetic blood and urine samples were analysed under good laboratory practice (GLP). All subjects completed both parts of the study. There were no significant adverse events (AEs). The most common treatment-related ocular AE was eye irritation (62.2% of subjects). Cis-UCA concentrations in plasma remained below the limit of quantification (0.195 μg/ml) in all but two subjects. The fraction of the administered drug excreted into urine over the total collection period ranged from 3.2% to 61.6% of the last dose and from 1.1% to 20.5% of the daily dose. Topical ocular administration of cis-UCA solution is safe and apart from mild- and short-lasting eye irritation after administration well tolerated in healthy adult subjects. Topical ocular dosing leads to transient systemic exposure to cis-UCA that does not cause systemic AEs. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. [Subjective sensitivity to noise].

    PubMed

    Belojević, G

    1991-01-01

    It is likely that individual variations in subjectively estimated noise sensitivity influence different social and psychophysiological reactions of people exposed to noise. Subjective noise sensitivity might be a relatively stable personal characteristic. A correlation have been found between high sensitiveness to noise and some medical symptoms (sleep disturbance, nervousness, depression), and worse work performance in noisy environments. An introvert person with neurotic symptoms is more frequently found in people highly sensitive to noise. Testing for subjective sensitivity to noise might be helpful in professional selection and orientation for noisy work-places as well as in housing advising.

  20. Wireless data collection of self-administered surveys using tablet computers.

    PubMed

    Singleton, Kyle W; Lan, Mars; Arnold, Corey; Vahidi, Mani; Arangua, Lisa; Gelberg, Lillian; Bui, Alex A T

    2011-01-01

    The accurate and expeditious collection of survey data by coordinators in the field is critical in the support of research studies. Early methods that used paper documentation have slowly evolved into electronic capture systems. Indeed, tools such as REDCap and others illustrate this transition. However, many current systems are tailored web-browsers running on desktop/laptop computers, requiring keyboard and mouse input. We present a system that utilizes a touch screen interface running on a tablet PC with consideration for portability, limited screen space, wireless connectivity, and potentially inexperienced and low literacy users. The system was developed using C#, ASP.net, and SQL Server by multiple programmers over the course of a year. The system was developed in coordination with UCLA Family Medicine and is currently deployed for the collection of data in a group of Los Angeles area clinics of community health centers for a study on drug addiction and intervention.

  1. An Online Self-Administered Social Skills Training for Young Adults: Results from a Pilot Study

    ERIC Educational Resources Information Center

    Lehenbauer, Mario; Kothgassner, Oswald D.; Kryspin-Exner, Ilse; Stetina, Birgit U.

    2013-01-01

    Up to 95% of teens and young adults in western societies are online, and research shows striking evidence that users suffering from social fears use the Internet more frequently. Social phobia (SP) is one of the most common anxiety disorders, characterized by early onset and more frequent histories of childhood and adolescent shyness. SP is often…

  2. Measuring individuals' response quality in self-administered psychological tests: an introduction to Gendre's functional method

    PubMed Central

    Dupuis, Marc; Meier, Emanuele; Capel, Roland; Gendre, Francis

    2015-01-01

    The functional method is a new test theory using a new scoring method that assumes complexity in test structure, and thus takes into account every correlation between factors and items. The main specificity of the functional method is to model test scores by multiple regression instead of estimating them by using simplistic sums of points. In order to proceed, the functional method requires the creation of hyperspherical measurement space, in which item responses are expressed by their correlation with orthogonal factors. This method has three main qualities. First, measures are expressed in the absolute metric of correlations; therefore, items, scales and persons are expressed in the same measurement space using the same single metric. Second, factors are systematically orthogonal and without errors, which is optimal in order to predict other outcomes. Such predictions can be performed to estimate how one would answer to other tests, or even to model one's response strategy if it was perfectly coherent. Third, the functional method provides measures of individuals' response validity (i.e., control indices). Herein, we propose a standard procedure in order to identify whether test results are interpretable and to exclude invalid results caused by various response biases based on control indices. PMID:26136693

  3. Handheld computers for self-administered sensitive data collection: A comparative study in Peru

    PubMed Central

    Bernabe-Ortiz, Antonio; Curioso, Walter H; Gonzales, Marco A; Evangelista, Wilfredo; Castagnetto, Jesus M; Carcamo, Cesar P; Hughes, James P; Garcia, Patricia J; Garnett, Geoffrey P; Holmes, King K

    2008-01-01

    Background Low-cost handheld computers (PDA) potentially represent an efficient tool for collecting sensitive data in surveys. The goal of this study is to evaluate the quality of sexual behavior data collected with handheld computers in comparison with paper-based questionnaires. Methods A PDA-based program for data collection was developed using Open-Source tools. In two cross-sectional studies, we compared data concerning sexual behavior collected with paper forms to data collected with PDA-based forms in Ancon (Lima). Results The first study enrolled 200 participants (18–29 years). General agreement between data collected with paper format and handheld computers was 86%. Categorical variables agreement was between 70.5% and 98.5% (Kappa: 0.43–0.86) while numeric variables agreement was between 57.1% and 79.8% (Spearman: 0.76–0.95). Agreement and correlation were higher in those who had completed at least high school than those with less education. The second study enrolled 198 participants. Rates of responses to sensitive questions were similar between both kinds of questionnaires. However, the number of inconsistencies (p = 0.0001) and missing values (p = 0.001) were significantly higher in paper questionnaires. Conclusion This study showed the value of the use of handheld computers for collecting sensitive data, since a high level of agreement between paper and PDA responses was reached. In addition, a lower number of inconsistencies and missing values were found with the PDA-based system. This study has demonstrated that it is feasible to develop a low-cost application for handheld computers, and that PDAs are feasible alternatives for collecting field data in a developing country. PMID:18366687

  4. Singling out Self-Administered Behavior Therapies for Professional Overview. A Comment on Rosen

    ERIC Educational Resources Information Center

    Goldiamond, Israel

    1976-01-01

    Notes that Rosen's concern with consumer effects produced by behavior therapy self-help programs is to be lauded, but that some problems are best left to the judgment of the public, rather than of those who would look after it. (Author/AM)

  5. Wireless Data Collection of Self-administered Surveys using Tablet Computers

    PubMed Central

    Singleton, Kyle W.; Lan, Mars; Arnold, Corey; Vahidi, Mani; Arangua, Lisa; Gelberg, Lillian; Bui, Alex A.T.

    2011-01-01

    The accurate and expeditious collection of survey data by coordinators in the field is critical in the support of research studies. Early methods that used paper documentation have slowly evolved into electronic capture systems. Indeed, tools such as REDCap and others illustrate this transition. However, many current systems are tailored web-browsers running on desktop/laptop computers, requiring keyboard and mouse input. We present a system that utilizes a touch screen interface running on a tablet PC with consideration for portability, limited screen space, wireless connectivity, and potentially inexperienced and low literacy users. The system was developed using C#, ASP.net, and SQL Server by multiple programmers over the course of a year. The system was developed in coordination with UCLA Family Medicine and is currently deployed for the collection of data in a group of Los Angeles area clinics of community health centers for a study on drug addiction and intervention. PMID:22195187

  6. Evaluation of web-based, self-administered, graphical food frequency questionnaire.

    PubMed

    Kristal, Alan R; Kolar, Ann S; Fisher, James L; Plascak, Jesse J; Stumbo, Phyllis J; Weiss, Rick; Paskett, Electra D

    2014-04-01

    Computer-administered food frequency questionnaires (FFQs) can address limitations inherent in paper questionnaires by allowing very complex skip patterns, portion size estimation based on food pictures, and real-time error checking. We evaluated a web-based FFQ, the Graphical Food Frequency System (GraFFS). Participants completed the GraFFS, six telephone-administered 24-hour dietary recalls over the next 12 weeks, followed by a second GraFFS. Participants were 40 men and 34 women, aged 18 to 69 years, living in the Columbus, OH, area. Intakes of energy, macronutrients, and 17 micronutrients/food components were estimated from the GraFFS and the mean of all recalls. Bias (second GraFFS minus recalls) was -9%, -5%, +4%, and -4% for energy and percentages of energy from fat, carbohydrate, and protein, respectively. De-attenuated, energy-adjusted correlations (intermethod reliability) between the recalls and the second GraFFS for fat, carbohydrate, protein, and alcohol were 0.82, 0.79, 0.67, and 0.90, respectively; for micronutrients/food components the median was 0.61 and ranged from 0.40 for zinc to 0.92 for beta carotene. The correlations between the two administrations of the GraFFS (test-retest reliability) for fat, carbohydrate, protein, and alcohol were 0.60, 0.63, 0.73, and 0.87, respectively; among micronutrients/food components the median was 0.67 and ranged from 0.49 for vitamin B-12 to 0.82 for fiber. The measurement characteristics of the GraFFS were at least as good as those reported for most paper FFQs, and its high intermethod reliability suggests that further development of computer-administered FFQs is warranted.

  7. Reliability and validity of two frequently used self-administered physical activity questionnaires in adolescents

    PubMed Central

    Rangul, Vegar; Holmen, Turid Lingaas; Kurtze, Nanna; Cuypers, Koenraad; Midthjell, Kristian

    2008-01-01

    Background To create and find accurate and reliable instruments for the measurement of physical activity has been a challenge in epidemiological studies. We investigated the reliability and validity of two different physical activity questionnaires in 71 adolescents aged 13–18 years; the WHO, Health Behaviour in Schoolchildren (HBSC) questionnaire, and the International Physical Activity Questionnaire (IPAQ, short version). Methods The questionnaires were administered twice (8–12 days apart) to measure reliability. Validity was assessed by comparing answers from the questionnaires with a cardiorespiratory fitness test (VO2peak) and seven days activity monitoring with the ActiReg, an instrument measuring physical activity level (PAL) and total energy expenditure (TEE). Results Intraclass correlation coefficients for reliability for the WHO HBSC questionnaire were 0.71 for frequency and 0.73 for duration. For the frequency question, there was a significant difference between genders; 0.87 for girls and 0.59 for boys (p < 0.05). The intraclass correlation coefficients the IPAQ varied between 0.10 and 0.62 for the reliability. Spearman correlation coefficients for validity for both the WHO HBSC questionnaire and the IPAQ (recoded into low, moderate and high activity) measured against VO2peak were fair, ranging between 0.29 – 0.39. The WHO HBSC questionnaire measured against VO2peak for girls were acceptable, ranging between 0.30 – 0.55. Both questionnaires, except the walking question in IPAQ, showed a low correlation with PAL and TEE, ranging between 0.01 and 0.29. Conclusion These data indicate that the WHO HBSC questionnaire had substantial reliability and were acceptable instrument for measuring cardiorespiratory fitness, especially among girls. None of the questionnaires however seemed to be a valid instrument for measuring physical activity compared to TEE and PAL in adolescents. PMID:18627632

  8. Adolescent Rats Self-Administer Less Nicotine Than Adults at Low Doses.

    PubMed

    Schassburger, Rachel L; Pitzer, Emily M; Smith, Tracy T; Rupprecht, Laura E; Thiels, Edda; Donny, Eric C; Sved, Alan F

    2016-09-01

    Although nearly 90% of current smokers initiated tobacco use during adolescence, little is known about reinforcement by nicotine in adolescents. Researchers are currently investigating whether a potential public health policy setting a tobacco product standard with very low nicotine levels would improve public health, and it is essential to understand whether data generated in adults translates to adolescents, particularly as it relates to the threshold dose of nicotine required to support smoking. The present study compared self-administration of low doses of nicotine between adolescent and adult rats. Adolescent (postnatal day [P] 30) and adult (P90) male and female rats were allowed to nosepoke to receive intravenous infusions of nicotine (3-100 μg/kg/infusion) during 16 daily 1-hour sessions. At 10 μg/kg/infusion nicotine, adolescent rats earned significantly fewer infusions than adults. When responding for 30 μg/kg/infusion nicotine, rats of both ages earned a similar number of infusions; however, there were subtle differences in the distribution of infusions across the 1-hour session. No sex differences were apparent in either age group at any dose. These results demonstrate that adolescent rats are less sensitive than adults to the primary reinforcing effects of nicotine. However, at nicotine doses that support self-administration in both age groups, adolescent and adult rats do not differ in acquisition or number of infusions earned. These results suggest that reducing nicotine levels in cigarettes to a level that does not support smoking in adults may be sufficient to reduce the acquisition of smoking in adolescents. The results of the present studies demonstrate that adolescent rats are less sensitive than adults to the primary reinforcing effects of nicotine. These results suggest that reducing nicotine levels in cigarettes to a level that does not support smoking in adults will be sufficient to reduce the acquisition of smoking in adolescents. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Overexpression of CREB in the nucleus accumbens shell increases cocaine reinforcement in self-administering rats.

    PubMed

    Larson, Erin B; Graham, Danielle L; Arzaga, Rose R; Buzin, Nicole; Webb, Joseph; Green, Thomas A; Bass, Caroline E; Neve, Rachael L; Terwilliger, Ernest F; Nestler, Eric J; Self, David W

    2011-11-09

    Chronic exposure to addictive drugs enhances cAMP response element binding protein (CREB)-regulated gene expression in nucleus accumbens (NAc), and these effects are thought to reduce the positive hedonic effects of passive cocaine administration. Here, we used viral-mediated gene transfer to produce short- and long-term regulation of CREB activity in NAc shell of rats engaging in volitional cocaine self-administration. Increasing CREB expression in NAc shell markedly enhanced cocaine reinforcement of self-administration behavior, as indicated by leftward (long-term) and upward (short-term) shifts in fixed ratio dose-response curves. CREB also increased the effort exerted by rats to obtain cocaine on more demanding progressive ratio schedules, an effect highly correlated with viral-induced modulation of BDNF protein in the NAc shell. CREB enhanced cocaine reinforcement when expressed either throughout acquisition of self-administration or when expression was limited to postacquisition tests, indicating a direct effect of CREB independent of reinforcement-related learning. Downregulating endogenous CREB in NAc shell by expressing a short hairpin RNA reduced cocaine reinforcement in similar tests, while overexpression of a dominant-negative CREB(S133A) mutant had no significant effect on cocaine self-administration. Finally, increasing CREB expression after withdrawal from self-administration enhanced cocaine-primed relapse, while reducing CREB levels facilitated extinction of cocaine seeking, but neither altered relapse induced by cocaine cues or footshock stress. Together, these findings indicate that CREB activity in NAc shell increases the motivation for cocaine during active self-administration or after withdrawal from cocaine. Our results also highlight that volitional and passive drug administration can lead to substantially different behavioral outcomes.

  10. Self-administered behavior modification to reduce nail biting: incorporating simple technology to ensure treatment integrity.

    PubMed

    Craig, Andrew R

    2010-01-01

    Habitual behaviors, such as problematic nail biting, are a common target for self-managed behavior-modification programs. The current self-experiment used self-monitoring in conjunction with a self-managed differential-reinforcement procedure for the treatment of problematic nail biting. A simple picture-comparison procedure allowed an independent observer to assist in monitoring treatment progress and outcomes and to ensure treatment integrity. Results provide support that the overall treatment package was successful in decreasing the occurrence of nail biting. Moreover, the treatment-integrity procedure enabled full-day monitoring to take place with limited requirement of a secondary observer.

  11. Self administered cognitive behavior therapy for moderate to severe IBS: Clinical efficacy, tolerability, feasibility

    PubMed Central

    Lackner, Jeffrey M.; Jaccard, James; Krasner, Susan S.; Katz, Leonard A.; Gudleski, Gregory D.; Holroyd, Kenneth

    2009-01-01

    Background and Aims Given the limitations of conventional therapies and restrictions imposed on newer pharmacological agents, there is an urgent need to develop efficacious and efficient treatments that teach patients behavioral self management skills for relieving irritable bowel syndrome (IBS) symptoms and associated problems. Method 75 Rome II diagnosed IBS patients (86% female) without comorbid GI disease were recruited from local physicians and the community and randomized to either 2 versions of cognitive behavior therapy (10 session, therapist administered CBT vs. 4 session, patient administered CBT) or a wait list comparison (WLC) that controlled for threats to internal validity Final assessment occurred two weeks after the 10 week treatment phase ends. Outcome measures included adequate relief from pain and bowel symptoms; global improvement of IBS symptoms (CGI-Improvement Scale); IBS symptom severity (IBS SSS); quality of life (IBSQOL); psychological distress (Brief Symptom Inventory); patient satisfaction (Client Satisfaction Scale). Results At week 12, both CBT versions were significantly (p < .0001) superior to WLC in the percentage of participants reporting adequate relief (e.g., MC-CBT = 72%, S-CBT = 60.9%, WLC = 7.4%) and improvement of symptoms. CBT treated patients reported significantly improved quality of life and IBS symptom severity but not psychological distress than WL patients (p < .0001) Conclusions Data from this pilot study lend preliminary empirical support to a brief patient administered CBT regimen capable of providing short term relief from IBS symptoms largely unresponsive to conventional therapies. PMID:18524691

  12. Diet Measurement in Vietnamese Youth: Concurrent Reliability of a Self-Administered Food Frequency Questionnaire.

    ERIC Educational Resources Information Center

    Wiecha, John M.; And Others

    1994-01-01

    Vietnamese high school students completed a food frequency questionnaire (FFQ) and completed daily diet reports for seven weeks. Data from the FFQ were compared to the food reports. The results indicated a few simple FFQ items, particularly for indicator foods such as rice, were reliable for dietary assessment for that population. (SM)

  13. Testing the Question-Behavior Effect of Self-Administered Surveys Measuring Youth Drug Use.

    PubMed

    Briney, John S; Brown, Eric C; Kuklinski, Margaret R; Oesterle, Sabrina; Hawkins, J David

    2017-09-29

    Concern that asking about a specific behavior could elicit that behavior is often cited as a reason that communities and schools should not administer surveys about youth drug use. In this study, we investigated if this question-behavior effect exists related to substance use. We examined if simply asking a student about their current drug use leads to an increase in drug use 1 year later. This study tests the validity of the question-behavior effect on youth drug use in a longitudinal panel of 2,002 elementary school students. The sample of students was drawn from the Community Youth Development Study, a community-randomized test of the Communities That Care prevention system. If the prevalence of self-reported drug use in sixth grade in a sample surveyed in fifth and sixth grades was higher than in an accretion sample surveyed only in sixth grade, the difference could indicate a question-behavior effect. Results from logistic regression analyses did not provide any evidence of a question-behavior effect on 30-day or lifetime prevalence of alcohol, tobacco, inhalant, or marijuana use reported in sixth grade. Asking youth about drug use in a survey did not increase the rates of self-reported drug use measured 1 year later. The absence of evidence of a question-behavior effect should ease concerns of communities and schools when administering surveys asking youth about their drug use. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. Fitting portion sizes in a self-administered food frequency questionnaire.

    PubMed

    Nöthlings, Ute; Hoffmann, Kurt; Bergmann, Manuela M; Boeing, Heiner

    2007-12-01

    For epidemiological studies, a simple semiquantitative FFQ was developed to assess the frequency of intake of food items demonstrated with graphically displayed portion sizes. As a validation study, a random sample of 393 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study completed 2 unannounced 24-h dietary recalls (24HDR) and the FFQ during 1 y. To calculate food and nutrient intakes, we compared the use of fitted portion sizes with the use of predefined portion sizes. Fitted portion sizes were calculated by summing food intakes over the 2 24HDR and dividing the sum by the frequency of intake reported in the FFQ for each FFQ food item, leading to similar mean intakes for FFQ and 24HDR. As predefined portion sizes, amounts that had been used in previous dietary assessments in EPIC-Potsdam were used. Mean intake of 12 food groups was 102% for men or women with fitted portion sizes and 79% for men and 95% for women with predefined portion sizes of intake measured with 2 24HDR. However, deattenuated, energy-adjusted correlation coefficients between FFQ and 24HDR were not better for 19 nutrients by the use of fitted portion sizes, with a mean correlation coefficient of 0.53 for men and 0.56 for women. Mean correlation coefficients for food groups also were similar for fitted and predefined portion sizes. Fitting portion sizes using recent reference data from a random sample of study participants improved the quantitative assessment of food and nutrient intake, but not ranking of study participants, compared with predefining portion sizes based on prior knowledge.

  15. Using a Self-Administered Visual Basic Software Tool To Teach Psychological Concepts.

    ERIC Educational Resources Information Center

    Strang, Harold R.; Sullivan, Amie K.; Schoeny, Zahrl G.

    2002-01-01

    Introduces LearningLinks, a Visual Basic software tool that allows teachers to create individualized learning modules that use constructivist and behavioral learning principles. Describes field testing of undergraduates at the University of Virginia that tested a module designed to improve understanding of the psychological concepts of…

  16. Adolescent Rats Self-Administer Less Nicotine Than Adults at Low Doses

    PubMed Central

    Schassburger, Rachel L.; Pitzer, Emily M.; Smith, Tracy T.; Rupprecht, Laura E.; Thiels, Edda; Donny, Eric C.

    2016-01-01

    Introduction: Although nearly 90% of current smokers initiated tobacco use during adolescence, little is known about reinforcement by nicotine in adolescents. Researchers are currently investigating whether a potential public health policy setting a tobacco product standard with very low nicotine levels would improve public health, and it is essential to understand whether data generated in adults translates to adolescents, particularly as it relates to the threshold dose of nicotine required to support smoking. The present study compared self-administration of low doses of nicotine between adolescent and adult rats. Methods: Adolescent (postnatal day [P] 30) and adult (P90) male and female rats were allowed to nosepoke to receive intravenous infusions of nicotine (3–100 μg/kg/infusion) during 16 daily 1-hour sessions. Results: At 10 μg/kg/infusion nicotine, adolescent rats earned significantly fewer infusions than adults. When responding for 30 μg/kg/infusion nicotine, rats of both ages earned a similar number of infusions; however, there were subtle differences in the distribution of infusions across the 1-hour session. No sex differences were apparent in either age group at any dose. Conclusions: These results demonstrate that adolescent rats are less sensitive than adults to the primary reinforcing effects of nicotine. However, at nicotine doses that support self-administration in both age groups, adolescent and adult rats do not differ in acquisition or number of infusions earned. These results suggest that reducing nicotine levels in cigarettes to a level that does not support smoking in adults may be sufficient to reduce the acquisition of smoking in adolescents. Implications: The results of the present studies demonstrate that adolescent rats are less sensitive than adults to the primary reinforcing effects of nicotine. These results suggest that reducing nicotine levels in cigarettes to a level that does not support smoking in adults will be sufficient to reduce the acquisition of smoking in adolescents. PMID:26764255

  17. Acetaminophen self-administered in the drinking water increases the pain threshold of rats (Rattus norvegicus).

    PubMed

    Mickley, G Andrew; Hoxha, Zana; Biada, Jaclyn M; Kenmuir, Cynthia L; Bacik, Stephanie E

    2006-09-01

    Previous studies have suggested that the addition of flavored acetaminophen suspension (for example, Children's Tylenol) in the drinking water of rats may not be effective in producing postoperative analgesia because of low levels of consumption. However, these investigations neither measured analgesia nor compared the consumption by rats that had undergone surgery with that by unmanipulated rats. The present study reports that although unmanipulated rats naive to the taste of flavored acetaminophen do indeed drink significantly less of this liquid than tap water, they drank sufficient amounts of the acetaminophen-containing solution to significantly raise pain thresholds, as measured by the hot-plate test. Moreover, rats that had undergone surgery drank significantly more acetaminophen solution than did those that had no surgery. These data suggest that oral self-administration of flavored acetaminophen by rats may be an appropriate means to reduce pain.

  18. Validation of a self-administered computerized system to detect cognitive impairment in older adults.

    PubMed

    Brinkman, Samuel D; Reese, Robert J; Norsworthy, Larry A; Dellaria, Donna K; Kinkade, Jacob W; Benge, Jared; Brown, Kimberly; Ratka, Anna; Simpkins, James W

    2014-12-01

    There is increasing interest in the development of economical and accurate approaches to identifying persons in the community who have mild, undetected cognitive impairments. Computerized assessment systems have been suggested as a viable approach to identifying these persons. The validity of a computerized assessment system for identification of memory and executive deficits in older individuals was evaluated in the current study. Volunteers (N = 235) completed a 3-hr battery of neuropsychological tests and a computerized cognitive assessment system. Participants were classified as impaired (n = 78) or unimpaired (n = 157) on the basis of the Mini Mental State Exam, Wechsler Memory Scale-III and the Trail Making Test (TMT), Part B. All six variables (three memory variables and three executive variables) derived from the computerized assessment differed significantly between groups in the expected direction. There was also evidence of temporal stability and concurrent validity. Application of computerized assessment systems for clinical practice and for identification of research participants is discussed in this article. © The Author(s) 2012.

  19. Formative research of a quick list for an automated self-administered 24-Hour dietary recall

    USDA-ARS?s Scientific Manuscript database

    Twenty-four-hour dietary recalls are used to collect high-quality dietary data. Because they require highly trained interviewers, recalls are expensive and impractical for large-scale nutrition research, leading to the use of food frequency questionnaires. We are developing a computer-based, self-ad...

  20. How to engage children in self-administered dietary assessment programmes

    PubMed Central

    Lu, Amy Shirong; Baranowski, J.; Islam, N.; Baranowski, T.

    2013-01-01

    Effectively assessing children’s dietary intake is essential for understanding the complex relationships among dietary behaviours and obesity. Dietary assessment accuracy decreases when children are unable or unmotivated to complete accurate self-reports. Technology-based assessment instruments for children’s self-report of diet can be enhanced in light of developments in media psychology and communication science. To motivate children to complete a dietary assessment, researchers could use animated, customisable agents; embed the assessment process into a video game; or add narratives to encourage self-reporting behaviour. To improve accuracy, the intake environment could be recreated virtually; training sessions could be interspersed to improve portion estimation; and implicit attitudinal measures could be incorporated as a control or to increase validity. Research is needed to evaluate possible methods of enhancing children’s self-reporting motivation and accuracy. The main challenge remains how to engage children without biasing their reporting. PMID:22594618

  1. Wheel running exercise attenuates vulnerability to self-administer nicotine in rats

    PubMed Central

    Sanchez, Victoria; Lycas, Matthew D; Lynch, Wendy J; Brunzell, Darlene H

    2015-01-01

    Background Preventing or postponing tobacco use initiation could greatly reduce the number of tobacco-related deaths. While evidence suggests that exercise is a promising treatment for tobacco addiction, it is not clear whether exercise could prevent initial vulnerability to tobacco use. Thus, using an animal model, we examined whether exercise attenuates vulnerability to the use and reinforcing effects of nicotine, the primary addictive chemical in tobacco. Methods Initial vulnerability was assessed using an acquisition procedure wherein exercising (unlocked running wheel, n = 10) and sedentary (locked or no wheel, n = 12) male adolescent rats had access to nicotine infusions (0.01-mg/kg) during daily 21.5-hr sessions beginning on postnatal day 30. Exercise/sedentary sessions (2-hr/day) were conducted prior to each of the acquisition sessions. The effects of exercise on nicotine’s reinforcing effects were further assessed in separate groups of exercising (unlocked wheel, n = 7) and sedentary (no wheel, n = 5) rats responding for nicotine under a progressive-ratio schedule with exercise/sedentary sessions (2-hr/day) conducted before the daily progressive-ratio sessions. Results While high rates of acquisition of nicotine self-administration were observed among both groups of sedentary controls, acquisition was robustly attenuated in the exercise group with only 20% of exercising rats meeting the acquisition criterion within the 16-day testing period as compared to 67% of the sedentary controls. Exercise also decreased progressive-ratio responding for nicotine as compared to baseline and to sedentary controls. Conclusions Exercise may effectively prevent the initiation of nicotine use in adolescents by reducing the reinforcing effects of nicotine. PMID:26433561

  2. How to engage children in self-administered dietary assessment programmes

    USDA-ARS?s Scientific Manuscript database

    Effectively assessing children's dietary intake is essential for understanding the complex relationships among dietary behaviors and obesity. Dietary assessment accuracy decreases when children are unable or unmotivated to complete accurate self-reports. Technology-based assessment instruments for c...

  3. Dopamine Signaling in the Nucleus Accumbens of Animals Self-Administering Drugs of Abuse

    PubMed Central

    Willuhn, Ingo; Wanat, Matthew J.; Clark, Jeremy J.; Phillips, Paul E. M.

    2013-01-01

    Abuse of psychoactive substances can lead to drug addiction. In animals, addiction is best modeled by drug self-administration paradigms. It has been proposed that the crucial common denominator for the development of drug addiction is the ability of drugs of abuse to increase extracellular concentrations of dopamine in the nucleus accumbens (NAcc). Studies using in vivo microdialysis and chronoamperometry in the behaving animal have demonstrated that drugs of abuse increase tonic dopamine concentrations in the NAcc. However, it is known that dopamine neurons respond to reward-related stimuli on a subsecond timescale. Thus, it is necessary to collect neurochemical information with this level of temporal resolution, as achieved with in vivo fast-scan cyclic voltammetry (FSCV), to fully understand the role of phasic dopamine release in normal behavior and drug addiction. We review studies that investigated the effects of drugs of abuse on NAcc dopamine levels in freely-moving animals using in vivo microdialysis, chronoamperometry and FSCV. After a brief introduction of dopamine anatomy and signal transduction, and a section on current theories of dopamine in natural goal-directed behavior, a discussion of techniques for the in vivo assessment of extracellular dopamine behaving animals is presented. Then, we review studies using these techniques to investigate changes in phasic and tonic dopamine signaling in the NAcc during 1) response-dependent and –independent administration of abused drugs, 2) drug-conditioned stimuli and operant behavior in self-administration paradigms, 3) drug withdrawal, and 4) cue-induced reinstatement of drug seeking. These results are then integrated with current ideas on the role of dopamine in addiction with an emphasis on a model illustrating phasic and tonic NAcc dopamine signaling during different stages of drug addiction. This model predicts that phasic dopamine release in response to drug-related stimuli will be enhanced over stimuli associated with natural reinforcers, which may result in aberrant goal-directed behaviors contributing to drug addiction. PMID:21161749

  4. A Self-Administered Parent Training Program Based upon the Principles of Applied Behavior Analysis

    ERIC Educational Resources Information Center

    Maguire, Heather M.

    2012-01-01

    Parents often respond to challenging behavior exhibited by their children in such a way that unintentionally strengthens it. Applied behavior analysis (ABA) is a research-based science that has been proven effective in remediating challenging behavior in children. Although many parents could benefit from using strategies from the field of ABA with…

  5. Self-Administered Screening for Mild Cognitive Impairment: Initial Validation of a Computerized Test Battery

    PubMed Central

    Tornatore, Jane B.; Hill, Emory; Laboff, Jo Anne; McGann, Mary E.

    2006-01-01

    The CANS-MCI, a computer administered, scored, and interpreted touch screen battery, was evaluated for its ability to screen for mild cognitive impairment. 310 community-dwelling elders enrolled in an NIA-funded study. One-month test-retest reliability correlations were all significant (p<.05-p<.001). Concurrent validity correlations were all significant (p<.001). A high level of diagnostic validity was attained relative to the WMS-R LMS-II test (p<.001). Confirmatory factor analysis supported a three-factor model indicating the tests measure the intended cognitive dimensions of Memory, Language/Spatial Fluency, and Executive Function/Mental Control. Goodness of fit indicators were strong (Bentler Comparative Fit Index = .99; Root Mean Square Error of Approximation=.055). Initial validation analyses indicate that the CANS-MCI shows promise of being a reliable, valid screening tool to determine whether more intensive testing for early cognitive impairment is warranted. PMID:15746489

  6. Self administered screening for hereditary cancers in conjunction with mammography and ultrasound.

    PubMed

    McDonnell, Charles H; Seidenwurm, David J; McDonnell, Diana E; Bobolis, Kristie A

    2013-12-01

    We evaluated the feasibility of an automated tablet computer application providing a family and personal history based cancer risk assessment for hereditary breast, ovarian, endometrial and colorectal cancers. 1,002 women presenting for screening mammography and 1,000 presenting for ultrasound were offered screening. The application calculated the risk of BRCA mutations using BRCAPRO, Myriad and Tyrer-Cuzick risk assessment models. Lifetime risk of breast and ovarian cancer was assessed with the BRCAPRO, Claus and Tyrer-Cuzick models. Colorectal and endometrial cancer risk was calculated via the MMRpro model. Patients were identified as high-risk based on thresholds 10% or greater risk for carrying genetic mutations or 20% or greater lifetime risk of breast or ovarian cancer. The percent of women found to be high-risk by a single risk assessment tool ranged from 0.5 to 5.3%. Combining assessment tools found 9.3% of women to be high-risk. The risk assessments performed similarly for the mammography and ultrasound cohorts with yields (combining assessment tools) of 9.2 and 9.4% respectively. The average ages of all the high-risk women were 45.8 and 39.6 years for the mammography and ultrasound cohorts respectively. Difficulties encountered included a need for software upgrade, wireless network unreliability and hardware theft. Automated family history screening can identify women probably at high-risk for hereditary cancers efficiently. The number of women identified is increased by employing multiple risk assessment models simultaneously. Surveying women in conjunction with ultrasound identified women at increased risk as effectively and at a younger age than with screening mammography.

  7. An Online Self-Administered Social Skills Training for Young Adults: Results from a Pilot Study

    ERIC Educational Resources Information Center

    Lehenbauer, Mario; Kothgassner, Oswald D.; Kryspin-Exner, Ilse; Stetina, Birgit U.

    2013-01-01

    Up to 95% of teens and young adults in western societies are online, and research shows striking evidence that users suffering from social fears use the Internet more frequently. Social phobia (SP) is one of the most common anxiety disorders, characterized by early onset and more frequent histories of childhood and adolescent shyness. SP is often…

  8. Use assessment of self-administered epinephrine among food-allergic children and pediatricians.

    PubMed

    Sicherer, S H; Forman, J A; Noone, S A

    2000-02-01

    Food allergy is a common cause of anaphylaxis, and early treatment with epinephrine can be life-saving. We sought to determine the ability of families with food allergic children and pediatricians to properly use self-injectable epinephrine. We enrolled families of consecutive, food-allergic pediatric patients newly referred to our allergy practice but previously prescribed epinephrine and a sampling of pediatricians. Parents or teenage patients answered a structured questionnaire concerning use of self-injectable epinephrine and demonstrated the use of devices with which they were familiar. Demonstrations were scored in a standard manner. One hundred one families of food-allergic children (mean age of patients, 6.4 years) were enrolled. Self-injectable epinephrine was prescribed (mean of 2.7 years previously) primarily by pediatricians (n = 46) and allergists (n = 49). Patients were prescribed EpiPen (n = 93), EpiE-Z Pen (n = 11), and Ana-Kit (n = 3). Eighty-six percent of the families responded that they had the device with them "at all times," but only 71% of this group had epinephrine at the visit. Among those with the epinephrine, 10% had devices beyond the labeled expiration date. Thus, only 55% of the 101 families had unexpired epinephrine on-hand at the time of the survey. Among children in school, 77% had the medication available in school, and 81% stated that the school knew the indications for administration. Only 32% of the participants correctly demonstrated the use of the device. Twenty-nine attending pediatricians were enrolled (mean 14 yrs in practice; mean 4 epinephrine prescriptions/year). Familiarity with the devices was as follows: EpiPen (86%), EpiE-Z Pen (17%) and Ana-Kit (7%). Only 24% generally gave patients written materials concerning indications. Overall, 18% were familiar with and able to demonstrate correct use of at least 1 device (21% correctly demonstrated Epi-Pen). Seventeen pediatric residents were enrolled; 65% were familiar with the EpiPen; 36% demonstrated it correctly and only 1 resident was familiar with Ana-Kit. Many parents of severely food-allergic children, and food-allergic teenagers cannot correctly administer their self-injectable epinephrine and may not have the medication readily available. Pediatricians are not familiar with these devices and may fail to review their use with patients. Improved patient and physician education is needed to ensure proper use of this life-saving medication.

  9. Persistent cue-evoked activity of accumbens neurons after prolonged abstinence from self-administered cocaine.

    PubMed

    Ghitza, Udi E; Fabbricatore, Anthony T; Prokopenko, Volodymyr; Pawlak, Anthony P; West, Mark O

    2003-08-13

    Persistent neural processing of information regarding drug-predictive environmental stimuli may be involved in motivating drug abusers to engage in drug seeking after abstinence. The addictive effects of various drugs depend on the mesocorticolimbic dopamine system innervating the nucleus accumbens. We used single-unit recording in rats to test whether accumbens neurons exhibit responses to a discriminative stimulus (SD) tone previously paired with cocaine availability during cocaine self-administration. Presentation of the tone after 3-4 weeks of abstinence resulted in a cue-induced relapse of drug seeking under extinction conditions. Accumbens neurons did not exhibit tone-evoked activity before cocaine self-administration training but exhibited significant SD tone-evoked activity during extinction. Under extinction conditions, shell neurons exhibited significantly greater activity evoked by the SD tone than that evoked by a neutral tone (i.e., never paired with reinforcement). In contrast, core neurons responded indiscriminately to presentations of the SD tone or the neutral tone. Accumbens shell neurons exhibited significantly greater SD tone-evoked activity than did accumbens core neurons. Although the onset of SD tone-evoked activity occurred well before the earliest movements commenced (150 msec), this activity often persisted beyond the onset of tone-evoked movements. These results indicate that accumbens shell neurons exhibit persistent processing of information regarding reward-related stimuli after prolonged drug abstinence. Moreover, the accumbens shell appears to be involved in discriminating the motivational value of reward-related associative stimuli, whereas the accumbens core does not.

  10. Using a Self-Administered Visual Basic Software Tool To Teach Psychological Concepts.

    ERIC Educational Resources Information Center

    Strang, Harold R.; Sullivan, Amie K.; Schoeny, Zahrl G.

    2002-01-01

    Introduces LearningLinks, a Visual Basic software tool that allows teachers to create individualized learning modules that use constructivist and behavioral learning principles. Describes field testing of undergraduates at the University of Virginia that tested a module designed to improve understanding of the psychological concepts of…

  11. The Impact of Schools Self-Administering Substance Abuse Surveys: An Evaluation

    ERIC Educational Resources Information Center

    Van Valey, Thomas L.; Hartmann, David; Post, William

    2005-01-01

    The literature suggests that administering drug surveys to public school students is best done by persons outside of the school system (or at least unfamiliar to the students). This is the approach used by the long-time "Monitoring the Future" project. Because of the increased costs that administration by outside research associates requires (both…

  12. Evaluation of Web-Based, Self-Administered, Graphical Food Frequency Questionnaire

    PubMed Central

    Kristal, Alan R.; Kolar, Ann S.; Fisher, James L.; Plascak, Jesse J.; Stumbo, Phyllis J.; Weiss, Rick; Paskett, Electra D.

    2014-01-01

    Computer-administered food frequency questionnaires (FFQs) can address limitations inherent in paper questionnaires, by allowing very complex skip patterns, portion size estimation based on food pictures and real-time error checking. This manuscript evaluates a web-based FFQ, the Graphical Food Frequency System (GraFFS). Participants completed the GraFFS, six, telephone-administered 24-hr dietary recalls over the next 12 weeks, followed by a second GraFFS. Participants were 40 men and 34 women, ages 18–69, living in the Columbus, OH area. Intakes of energy, macronutrients and 17 micronutrients/food components were estimated from the GraFFS and the mean of all recalls. Bias (recalls minus the second GraFFS) was −9%, −5%, +4% and −4% for energy and percentages of energy from fat, carbohydrate and protein. De-attenuated, energy-adjusted correlations (inter-method reliability) between the recalls and the second GraFFS for fat, carbohydrate, protein and alcohol were 0.82, 0.79, 0.67 and 0.90; for micronutrients/food components the median was 0.61 and ranged from 0.40 for zinc to 0.92 for β-carotene. The correlations between the two administrations of the GraFFS (test-retest reliability) for fat, carbohydrate, protein and alcohol were 0.60, 0.63, 0.73 and 0.87; among micronutrients/food components the median was 0.67 and ranged from 0.49 for vitamin B12 to 0.82 for fiber. The measurement characteristics of the GraFFS were at least as good as those reported for most paper FFQs, and its high inter-method reliability suggests that further development of computer-administered FFQs is warranted. PMID:24462267

  13. Effects of orally self-administered bath salt constituent 3,4-methylenedioxypyrovalerone (MDPV) in mice.

    PubMed

    Gannon, Brenda M; Russell, Lauren N; Modi, Meet S; Rice, Kenner C; Fantegrossi, William E

    2017-10-01

    Synthetic cathinones in bath salts products are psychostimulant drugs of abuse, and 3,4-methylenedioxypyrovalerone (MDPV) is a common constituent of these products. Oral MDPV has been show to stimulate locomotor activity but reinforcing, locomotor and appetitive stimulus effects of oral MDPV are unknown. Choice procedures evaluated preference for 0.03, 0.10, 0.30, and 1.00mg/mL MDPV solutions versus 0.10mg/mL quinine solution or water. To verify that oral MDPV produced pharmacological effects, locomotor activity was monitored during and after consumption of water, quinine, or MDPV solutions. Conditioned place preference (CPP) tested the apparent appetitive effects of a preferred concentration of oral MDPV with locomotor stimulant effects (0.30mg/mL), using water as a control, and compared with results from intraperitoneally-administered MDPV. Consumption of MDPV solutions (0.03-1.00mg/mL) was low when the alternative fluid was water, but a history of MDPV consumption increased MDPV choice. When paired with a quinine control solution, MDPV solutions (0.03-0.30mg/mL) were almost exclusively preferred, and treatment with the catecholamine synthesis inhibitor αMPT decreased MDPV choice. Consumption of MDPV concentrations (0.1-1.0mg/mL) stimulated locomotor activity. Chronic (10day) access to 0.30mg/mL MDPV resulted in escalated consumption, but locomotor effects did not systematically change across the access period. Finally, consumption of 0.30mg/mL MDPV elicited CPP with a magnitude similar to the preference observed following intraperitoneal administration of MDPV. Consistent with human abuse patterns, oral MDPV has reinforcing effects in the mouse which are most likely related to its psychostimulant-like pharmacological profile. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Oral Cannabidiol does not Alter the Subjective, Reinforcing or Cardiovascular Effects of Smoked Cannabis

    PubMed Central

    Haney, Margaret; Malcolm, Robert J; Babalonis, Shanna; Nuzzo, Paul A; Cooper, Ziva D; Bedi, Gillinder; Gray, Kevin M; McRae-Clark, Aimee; Lofwall, Michelle R; Sparenborg, Steven; Walsh, Sharon L

    2016-01-01

    Cannabidiol (CBD), a constituent of cannabis with few psychoactive effects, has been reported in some studies to attenuate certain aspects of Δ9-tetrahydrocannabinol (THC) intoxication. However, most studies have tested only one dose of CBD in combination with one dose of oral THC, making it difficult to assess the nature of this interaction. Further, the effect of oral CBD on smoked cannabis administration is unknown. The objective of this multi-site, randomized, double-blind, within-subject laboratory study was to assess the influence of CBD (0, 200, 400, 800 mg, p.o.) pretreatment on the reinforcing, subjective, cognitive, and physiological effects of smoked cannabis (0.01 (inactive), 5.30–5.80% THC). Non-treatment-seeking, healthy cannabis smokers (n=31; 17M, 14 F) completed eight outpatient sessions. CBD was administered 90 min prior to cannabis administration. The behavioral and cardiovascular effects of cannabis were measured at baseline and repeatedly throughout the session. A subset of participants (n=8) completed an additional session to measure plasma CBD concentrations after administration of the highest CBD dose (800 mg). Under placebo CBD conditions, active cannabis (1) was self-administered by significantly more participants than placebo cannabis and (2) produced significant, time-dependent increases in ratings of ‘High', ‘Good Effect', ratings of the cannabis cigarette (eg, strength, liking), and heart rate relative to inactive cannabis. CBD, which alone produced no significant psychoactive or cardiovascular effects, did not significantly alter any of these outcomes. Cannabis self-administration, subjective effects, and cannabis ratings did not vary as a function of CBD dose relative to placebo capsules. These findings suggest that oral CBD does not reduce the reinforcing, physiological, or positive subjective effects of smoked cannabis. PMID:26708108

  15. Oral Cannabidiol does not Alter the Subjective, Reinforcing or Cardiovascular Effects of Smoked Cannabis.

    PubMed

    Haney, Margaret; Malcolm, Robert J; Babalonis, Shanna; Nuzzo, Paul A; Cooper, Ziva D; Bedi, Gillinder; Gray, Kevin M; McRae-Clark, Aimee; Lofwall, Michelle R; Sparenborg, Steven; Walsh, Sharon L

    2016-07-01

    Cannabidiol (CBD), a constituent of cannabis with few psychoactive effects, has been reported in some studies to attenuate certain aspects of Δ(9)-tetrahydrocannabinol (THC) intoxication. However, most studies have tested only one dose of CBD in combination with one dose of oral THC, making it difficult to assess the nature of this interaction. Further, the effect of oral CBD on smoked cannabis administration is unknown. The objective of this multi-site, randomized, double-blind, within-subject laboratory study was to assess the influence of CBD (0, 200, 400, 800 mg, p.o.) pretreatment on the reinforcing, subjective, cognitive, and physiological effects of smoked cannabis (0.01 (inactive), 5.30-5.80% THC). Non-treatment-seeking, healthy cannabis smokers (n=31; 17M, 14 F) completed eight outpatient sessions. CBD was administered 90 min prior to cannabis administration. The behavioral and cardiovascular effects of cannabis were measured at baseline and repeatedly throughout the session. A subset of participants (n=8) completed an additional session to measure plasma CBD concentrations after administration of the highest CBD dose (800 mg). Under placebo CBD conditions, active cannabis (1) was self-administered by significantly more participants than placebo cannabis and (2) produced significant, time-dependent increases in ratings of 'High', 'Good Effect', ratings of the cannabis cigarette (eg, strength, liking), and heart rate relative to inactive cannabis. CBD, which alone produced no significant psychoactive or cardiovascular effects, did not significantly alter any of these outcomes. Cannabis self-administration, subjective effects, and cannabis ratings did not vary as a function of CBD dose relative to placebo capsules. These findings suggest that oral CBD does not reduce the reinforcing, physiological, or positive subjective effects of smoked cannabis.

  16. The COPD assessment test and St George’s Respiratory Questionnaire: are they equivalent in subjects with COPD?

    PubMed Central

    Morishita-Katsu, Mariko; Nishimura, Koichi; Taniguchi, Hiroyuki; Kimura, Tomoki; Kondoh, Yasuhiro; Kataoka, Kensuke; Ogawa, Tomoya; Watanabe, Fumiko; Arizono, Shinichi; Nishiyama, Osamu; Nakayasu, Kazuhito; Imaizumi, Kazuyoshi; Hasegawa, Yoshinori

    2016-01-01

    Background The chronic obstructive pulmonary disease (COPD) assessment test (CAT) is a short questionnaire that has facilitated health status measurements in subjects with COPD. However, it remains controversial as to whether the CAT can be used as a suitable substitute for the St George’s Respiratory Questionnaire (SGRQ). This study investigated the reliability and score distributions of the CAT and SGRQ and evaluated which factors contributed to health status for each questionnaire. Methods A total of 109 consecutive subjects with stable COPD from a single center were enrolled in this study. Each subject completed pulmonary function tests, exercise tests, and the following self-administered questionnaires: the Baseline Dyspnea Index, the Hospital Anxiety and Depression Scale, the CAT, and SGRQ. Results Internal consistencies of CAT and SGRQ total scores were both excellent (Cronbach’s α coefficients =0.890 and 0.933). Statistically significant correlations were observed between CAT and SGRQ total scores (R=0.668, P<0.001). Correlations of CAT scores with parameters related to pulmonary function, dyspnea, exercise performance, and psychological factors were inferior to correlations with those parameters with SGRQ total scores. Both multiple regression analyses and principal component analyses revealed that there were slight differences between SGRQ total scores and CAT scores. Conclusion The CAT is similar to SGRQ in terms of discriminating health status. However, we demonstrated that what is assessed by the CAT may differ slightly from what is measured by SGRQ. PMID:27462150

  17. The relationship between smartphone use and subjective musculoskeletal symptoms and university students

    PubMed Central

    Kim, Hyo-Jeong; Kim, Jin-Seop

    2015-01-01

    [Purpose] The purpose of this study was to investigate the use of smartphones by university students in selected areas, their musculoskeletal symptoms, and the associated hazard ratio. [Subjects and Methods] This involved the completion of a self-administered questionnaire by dental hygiene students in Seoul, Gyeonggido, and Gyeongsangbukdo. The 292 completed copies of the questionnaire were then analyzed. [Results] The most painful body regions after the use of smartphones were found to be the shoulders and neck. In the musculoskeletal system, back pain was found to have a positive correlation with the size of the smartphone’s liquid crystal display (LCD) screen, and pain in legs and feet were found to have a negative correlation with the length of time that the smartphone was used. As a result, it was revealed that the use of a smartphone was correlated with musculoskeletal symptoms. [Conclusion] Therefore, in today’s environment, where the use of smartphones is on the rise, it is necessary to improve the ways that they are used and to develop a preventive program to alleviate the symptoms of musculoskeletal damage. PMID:25931684

  18. The subjective experience of acute, experimentally-induced Salvia divinorum inebriation.

    PubMed

    Addy, Peter H; Garcia-Romeu, Albert; Metzger, Matthew; Wade, Jenny

    2015-04-01

    This study examined the overall psychological effects of inebriation facilitated by the naturally-occurring plant hallucinogen Salvia divinorum using a double-blind, randomized, placebo-controlled trial. Thirty healthy individuals self-administered Salvia divinorum via combustion and inhalation in a quiet, comfortable research setting. Experimental sessions, post-session interviews, and 8-week follow-up meetings were audio recorded and transcribed to provide the primary qualitative material analyzed here. Additionally, post-session responses to the Hallucinogen Rating Scale provided a quantitative groundwork for mixed-methods discussion. Qualitative data underwent thematic content analysis, being coded independently by three researchers before being collaboratively integrated to provide the final results. Three main themes and 10 subthemes of acute intoxication emerged, encompassing the qualities of the experience, perceptual alterations, and cognitive-affective shifts. The experience was described as having rapid onset and being intense and unique. Participants reported marked changes in auditory, visual, and interoceptive sensory input; losing normal awareness of themselves and their surroundings; and an assortment of delusional phenomena. Additionally, the abuse potential of Salvia divinorum was examined post hoc. These findings are discussed in light of previous research, and provide an initial framework for greater understanding of the subjective effects of Salvia divinorum, an emerging drug of abuse.

  19. Classical subjective expected utility

    PubMed Central

    Cerreia-Vioglio, Simone; Maccheroni, Fabio; Marinacci, Massimo; Montrucchio, Luigi

    2013-01-01

    We consider decision makers who know that payoff-relevant observations are generated by a process that belongs to a given class M, as postulated in Wald [Wald A (1950) Statistical Decision Functions (Wiley, New York)]. We incorporate this Waldean piece of objective information within an otherwise subjective setting à la Savage [Savage LJ (1954) The Foundations of Statistics (Wiley, New York)] and show that this leads to a two-stage subjective expected utility model that accounts for both state and model uncertainty. PMID:23559375

  20. SUBJECTIVE DESCRIPTION OF TRAINEES.

    ERIC Educational Resources Information Center

    PEARCE, FRANK C.

    THIS REPORT GIVES A SUBJECTIVE DESCRIPTION OF THE GENERAL POPULATION FROM WHICH TRAINEES FOR THE MODESTO MULTI-OCCUPATIONAL PROJECT WERE SELECTED. IT INCLUDES AN EXTENSIVE STUDY OF THE SOCIOLOGICAL BACKGROUND OF A GROUP OF WHITE MIGRANTS WHO MOVED FROM THE EASTERN UNITES STATES TO CALIFORNIA. THE AUTHOR ALSO INCLUDED REFERENCES TO THE CHANGING…

  1. Schooling, Work and Subjectivity.

    ERIC Educational Resources Information Center

    Cho, Misook Kim; Apple, Michael W.

    1998-01-01

    Analyzes the ways in which administrators, teachers, and students in two commercial high schools responded to the educational policies and work subjectivities that were articulated by the dominant faction in the Republic of Korea (South Korea) and that resulted from the concern about the lack of manual workers in the country. (CMK)

  2. Curriculum Costs: Vocational Subjects.

    ERIC Educational Resources Information Center

    Cumming, C. E.

    To establish a definition of costs in education, a "concept map" is established to which inevitable questions of inclusion and exclusion can be addressed. A specific case, namely the costs of practical/vocational subjects, is then presented. It also includes a profile of benefits, since with regard to vocational education, much more than…

  3. Database Subject Index

    ERIC Educational Resources Information Center

    Hawkins, Donald T.; Teitelbaum, Henry H.

    1978-01-01

    Broad subject headings which have been assigned to each of the 86 data bases available or announced on the five major on-line search systems--Lockheed, SDC, BRS, NIM, and New York Times Information Bank--are arranged alphabetically followed by the name(s) of the appropriate data base(s). (JPF)

  4. Paying Hypertension Research Subjects

    PubMed Central

    Casarett, David; Karlawish, Jason; Asch, David A

    2002-01-01

    CONTEXT Cash payments are often used to compensate subjects who participate in research. However, ethicists have argued that these payments might constitute an undue inducement. OBJECTIVES To determine whether potential subjects agree with theoretical arguments that a payment could be an undue inducement. DESIGN/SETTING/PARTICIPANTS Survey of 350 prospective jurors. MAIN OUTCOME MEASURES Belief that a $500 payment for research participation would impair their own, and others' ability to think carefully about the risks and benefits of a clinical trial. RESULTS Two hundred sixty-one jurors (74.6%) believed that a $500 payment would impair subjects' ability to think carefully about the risks and benefits of research. Ninety-six of 120 (80%) expressed this concern about subjects with a low income (<$20,000) compared to 92/117 (79%) of those with a middle income ($20,000 to $50,000), and 73/113 (65%) with a high income (>$50,000). In contrast, only 69 (19.7%) of jurors believed that a $500 payment would influence them. Jurors who believed that this payment would influence them reported lower incomes and less education. CONCLUSION Members of the general public share ethical concerns about the influence of payments for research, although they believe that these concerns are more applicable to others than to themselves.

  5. Age, cumulative trauma and stressful life events, and post-traumatic stress symptoms among older adults in prison: do subjective impressions matter?

    PubMed

    Maschi, Tina; Morgen, Keith; Zgoba, Kristen; Courtney, Deborah; Ristow, Jennifer

    2011-10-01

    The aging prison population in the United States presents a significant public health challenge with high rates of trauma and mental health issues that the correctional system alone is ill-prepared to address. The purpose of this study was to examine the relationship of age, objective, and subjective measures of trauma and stressful life events and post-traumatic stress symptoms among older adults in prison. Data were gathered from 334 prisoners (aged 55+) housed in the New Jersey Department of Corrections, as of September 2010. An anonymous self-report, self-administered survey was mailed to the total population of 1,000 prisoners aged 55 years and older. Objective and subjective trauma was measured using the Life Stressors Checklist-Revised (LSC-R), and post-traumatic stress symptoms were measured using the Civilian Version of the Post-traumatic Stress Scale. Results of a path analysis revealed that past year subjective impressions of traumatic and stressful life events had a positive and significant relationship to current post-traumatic stress symptoms. Age was found to have a significant and inverse relationship to subjective traumatic and stressful life events. That is, younger participants reported higher levels of cumulative traumatic and stressful life events and past year subjective ratings of being bothered by these past events. These findings have significance for interdisciplinary/interprofessional practice and appropriate institutional and community care, including reentry planning of older adults in the criminal justice system.

  6. Naltrexone Maintenance Decreases Cannabis Self-Administration and Subjective Effects in Daily Cannabis Smokers.

    PubMed

    Haney, Margaret; Ramesh, Divya; Glass, Andrew; Pavlicova, Martina; Bedi, Gillinder; Cooper, Ziva D

    2015-10-01

    Given that cannabis use is increasing in the United States, pharmacological treatment options to treat cannabis use disorder are needed. Opioid antagonists modulate cannabinoid effects and may offer a potential approach to reducing cannabis use. In this double-blind, placebo-controlled human laboratory study, we assessed the effects of naltrexone maintenance on the reinforcing, subjective, psychomotor, and cardiovascular effects of active and inactive cannabis. Nontreatment-seeking, daily cannabis smokers were randomized to receive naltrexone (50 mg: n=18 M and 5 F) or placebo (0 mg; n=26 M and 2 F) capsules for 16 days. Before, during, and after medication maintenance, participants completed 10 laboratory sessions over 4-6 weeks, assessing cannabis' behavioral and cardiovascular effects. Medication compliance was verified by observed capsule administration, plasma naltrexone, and urinary riboflavin. Relative to placebo, maintenance on naltrexone significantly reduced both active cannabis self-administration and its positive subjective effects ('good effect'). Participants in the placebo group had 7.6 times (95% CI: 1.1-51.8) the odds of self-administering active cannabis compared with the naltrexone group. This attenuation of reinforcing and positive subjective effects also influenced cannabis use in the natural ecology. Naltrexone had intrinsic effects: decreasing ratings of friendliness, food intake, and systolic blood pressure, and increasing spontaneous reports of stomach upset and headache, yet dropout rates were comparable between groups. In summary, we show for the first time that maintenance on naltrexone decreased cannabis self-administration and ratings of 'good effect' in nontreatment-seeking daily cannabis smokers. Clinical studies in patients motivated to reduce their cannabis use are warranted to evaluate naltrexone's efficacy as a treatment for cannabis use disorder.

  7. Naltrexone Maintenance Decreases Cannabis Self-Administration and Subjective Effects in Daily Cannabis Smokers

    PubMed Central

    Haney, Margaret; Ramesh, Divya; Glass, Andrew; Pavlicova, Martina; Bedi, Gillinder; Cooper, Ziva D

    2015-01-01

    Given that cannabis use is increasing in the United States, pharmacological treatment options to treat cannabis use disorder are needed. Opioid antagonists modulate cannabinoid effects and may offer a potential approach to reducing cannabis use. In this double-blind, placebo-controlled human laboratory study, we assessed the effects of naltrexone maintenance on the reinforcing, subjective, psychomotor, and cardiovascular effects of active and inactive cannabis. Nontreatment-seeking, daily cannabis smokers were randomized to receive naltrexone (50 mg: n=18 M and 5 F) or placebo (0 mg; n=26 M and 2 F) capsules for 16 days. Before, during, and after medication maintenance, participants completed 10 laboratory sessions over 4–6 weeks, assessing cannabis' behavioral and cardiovascular effects. Medication compliance was verified by observed capsule administration, plasma naltrexone, and urinary riboflavin. Relative to placebo, maintenance on naltrexone significantly reduced both active cannabis self-administration and its positive subjective effects (‘good effect'). Participants in the placebo group had 7.6 times (95% CI: 1.1–51.8) the odds of self-administering active cannabis compared with the naltrexone group. This attenuation of reinforcing and positive subjective effects also influenced cannabis use in the natural ecology. Naltrexone had intrinsic effects: decreasing ratings of friendliness, food intake, and systolic blood pressure, and increasing spontaneous reports of stomach upset and headache, yet dropout rates were comparable between groups. In summary, we show for the first time that maintenance on naltrexone decreased cannabis self-administration and ratings of ‘good effect' in nontreatment-seeking daily cannabis smokers. Clinical studies in patients motivated to reduce their cannabis use are warranted to evaluate naltrexone's efficacy as a treatment for cannabis use disorder. PMID:25881117

  8. [Subjective cognition in schizophrenia].

    PubMed

    Potvin, S; Aubin, G; Stip, E

    2017-02-01

    Given the extent, magnitude and functional significance of the neurocognitive deficits of schizophrenia, growing attention has been paid recently to patients' self-awareness of their own deficits. Thus far, the literature has shown either that patients fail to recognize their cognitive deficits or that the association between subjective and objective cognition is weak in schizophrenia. The reasons for this lack of consistency remain unexplained but may have to do, among others, with the influence of potential confounding clinical variables and the choice of the scale used to measure self-awareness of cognitive deficits. In the current study, we sought to examine the relationships between subjective and objective cognitive performance in schizophrenia, while controlling for the influence of sociodemographic and psychiatric variables. Eighty-two patients with a schizophrenia-spectrum disorder (DSM-IV criteria) were recruited. Patients' subjective cognitive complaints were evaluated with the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS), the most frequently used scale to measure self-awareness of cognitive deficits in schizophrenia. Neurocognition was evaluated with working memory, planning and visual learning tasks taken from Cambridge Neuropsychological Tests Automated Battery. The Stroop Color-Word test was also administered. Psychiatric symptoms were evaluated with the Positive and Negative Syndrome Scale and the Calgary Depression Scale for Schizophrenia. The relationships between subjective and objective cognition were evaluated with multivariate hierarchic linear regression analyses, taking into consideration potential confounders such as sociodemographic and psychiatric variables. Finally, a factor analysis of the SSTICS was performed. For the SSTICS total score, the regression analysis produced a model including two predictors, namely visual learning and Stoop interference performance, explaining a moderate portion of the variance

  9. Influence of Dietary Sodium and Potassium Intake on the Heart Rate Corrected-QT Interval in Elderly Subjects.

    PubMed

    Michishita, Ryoma; Ishikawa-Takata, Kazuko; Yoshimura, Eiichi; Mihara, Rikako; Ikenaga, Masahiro; Morimura, Kazuhiro; Takeda, Noriko; Yamada, Yosuke; Higaki, Yasuki; Tanaka, Hiroaki; Kiyonaga, Akira

    2015-01-01

    It is well known that imbalances in the dietary electrolytes are associated with a significantly higher incidence of cardiovascular disease (CVD). On the other hand, a prolonged heart rate corrected-QT (QTc) interval is associated with an increased risk of cardiac autonomic nervous system dysfunction, the incidence of CVD and sudden cardiac death. This study was designed to clarify the association between the nutritional status and the QTc interval in elderly subjects. The subjects included 119 elderly subjects (46 males and 73 females, age; 72.9±4.8 y) without a history of CVD, who were taking cardioactive drugs. Resting 12-lead electrocardiography was performed, while the QTc interval was calculated according to Bazett's formula. The nutritional status was assessed using a brief self-administered diet history questionnaire. The subjects were divided into three categories, which were defined as equally trisected distributions of the body mass index (BMI). The QTc interval was significantly longer in both the low and high BMI groups than in the moderate BMI group in both genders (p<0.05, respectively). A stepwise multiple regression analysis showed the QTc interval to be independently associated with the potassium intake in the low BMI group and the sodium intake in the high BMI group in both genders (p<0.05, respectively). These results suggest that the body mass, especially lean body mass and overweight, were associated with a prolonged QTc interval and dietary electrolytes in elderly subjects. Based on our results, we consider that it is necessary to perform dietary counseling, especially focusing on sodium and potassium intake, depending on the body mass.

  10. Factors influencing subjects' comprehension of a set of medicine package inserts.

    PubMed

    Pires, Carla; Vigário, Marina; Cavaco, Afonso

    2016-08-01

    Background Package inserts (PIs) should promote the safe and effective use of medicines. The comprehension of PIs is related to socio-demographic features, such as education. Objectives To evaluate the participants' comprehension of a sample of PIs and to build an explanatory model of subjects' understanding of the content of these documents. Setting The data were collected from municipalities, city halls, firefighters, the military, schools and charities from two Portuguese regions. Methods Cross-sectional descriptive survey: 503 participants, homogeneously distributed by education and gender. The self-administered tool comprised questions on socio-demographic data, literacy tasks and comprehension evaluation of 12 purposively selected PIs. A logistic regression analysis was used. Main outcome measures Scores of numeracy tasks and comprehension. Results The average comprehension score for the PIs was 63 % (±32 %), with 48 % (n = 239) of the participants scoring <75 %. The most important predictors in explaining a comprehension score ≥75 % were having >12 years of education and correctly performing a numeracy task [respectively, OR 49.6 (CI 95 %: 22.8-108) and OR 2.48 (CI 95 %: 1.5-4.2)]. Conclusion An explanatory model of subjects' knowledge about the content of the tested PIs was built. Given that a high level of education and literacy were found to be the most relevant predictors for acceptable comprehension rates, PIs should be clearly written to assure that they are understood by all potential users, including the less educated. The evaluated PIs may thus need to be simplified.

  11. Relevance of a subjective quality of life questionnaire for long-term homeless persons with schizophrenia.

    PubMed

    Girard, V; Tinland, A; Bonin, J P; Olive, F; Poule, J; Lancon, C; Apostolidis, T; Rowe, M; Greacen, T; Simeoni, M C

    2017-02-17

    Increasing numbers of programs are addressing the specific needs of homeless people with schizophrenia in terms of access to housing, healthcare, basic human rights and other domains. Although quality of life scales are being used to evaluate such programs, few instruments have been validated for people with schizophrenia and none for people with schizophrenia who experience major social problems such as homelessness. The aim of the present study was to validate the French version of the S-QoL a self-administered, subjective quality of life questionnaire specific to schizophrenia for people with schizophrenia who are homeless. In a two-step process, the S-QoL was first administered to two independent convenience samples of long-term homeless people with schizophrenia in Marseille, France. The objective of the first step was to analyse the psychometric properties of the S-QoL. The objective of the second step was to examine, through qualitative interviews with members of the population in question, the relevance and acceptability of the principle quality of life indicators used in the S-QoL instrument. Although the psychometric characteristics of the S-QoL were found to be globally satisfactory, from the point of view of the people being interviewed, acceptability was poor. Respondents frequently interrupted participation complaining that questionnaire items did not take into account the specific context of life on the streets. Less intrusive questions, more readily understandable vocabulary and greater relevance to subjects' living conditions are needed to improve the S-QoL questionnaire for this population. A modular questionnaire with context specific sections or specific quality of life instruments for socially excluded populations may well be the way forward.

  12. [The clinics of subjectivity].

    PubMed

    Novella, Enric J

    2016-01-01

    This article reviews the project of capturing, describing and cataloging subjective experiences as the constitutive and founding event of psychiatric knowledge. To substantiate this view, it provides first a look at the origins (and problems) of psychiatric semiology in the pioneering work of Philippe Pinel. Afterwards, it describes some of the resources used by his successors in order to gain access to the madman's inner world, expose the folds of his intimacy and enhance the scope of the psychopathological gaze and the semiological repertoire of psychological medicine. And finally it discusses the contraposition between the practice of the gaze and the practice of listening carried out by psychiatrists as a significant correlate of an epistemic culture obsessed with gaze, but whose very eagerness to take the human being as an object of inquiry in its double physical and moral condition doomed it to cultivate listening.

  13. CT scan screening is associated with increased distress among subjects of the APExS

    PubMed Central

    2010-01-01

    Background The aim of this study was to assess the psychological consequences of HRCT scan screening in retired asbestos-exposed workers. Methods A HRCT-scan screening program for asbestos-related diseases was carried out in four regions of France. At baseline (T1), subjects filled in self-administered occupational questionnaires. In two of the regions, subjects also received a validated psychological scale, namely the psychological consequences questionnaire (PCQ). The physician was required to provide the subject with the results of the HRCT scan at a final visit. A second assessment of psychological consequences was performed 6 months after the HRCT-scan examination (T2). PCQ scores were compared quantitatively (t-test, general linear model) and qualitatively (chi²-test, logistic regression) to screening results. Multivariate analyses were adjusted for gender, age, smoking, asbestos exposure and counseling. Results Among the 832 subjects included in this psychological impact study, HRCT-scan screening was associated with a significant increase of the psychological score 6 months after the examination relative to baseline values (8.31 to 10.08, p < 0.0001, t-test). This increase concerned patients with an abnormal HRCT-scan result, regardless of the abnormalities, but also patients with normal HRCT-scans after adjustment for age, gender, smoking status, asbestos exposure and counseling visit. The greatest increase was observed for pleural plaques (+3.60; 95%CI [+2.15;+5.06]), which are benign lesions. Detection of isolated pulmonary nodules was also associated with a less marked but nevertheless significant increase of distress (+1.88; 95%CI [+0.34;+3.42]). However, analyses based on logistic regressions only showed a close to significant increase of the proportion of subjects with abnormal PCQ scores at T2 for patients with asbestosis (OR = 1.92; 95%CI [0.97-3.81]) or with two or more diseases (OR = 2.04; 95%CI [0.95-4.37]). Conclusion This study suggests that

  14. Naming the Ethological Subject.

    PubMed

    Benson, Etienne S

    2016-03-01

    Argument In recent decades, through the work of Jane Goodall and other ethologists, the practice of giving personal names to nonhuman animals who are the subjects of scientific research has become associated with claims about animal personhood and scientific objectivity. While critics argue that such naming practices predispose the researcher toward anthropomorphism, supporters suggest that it sensitizes the researcher to individual differences and social relations. Both critics and supporters agree that naming tends to be associated with the recognition of individual animal rights. The history of the naming of research animals since the late nineteenth century shows, however, that the practice has served a variety of purposes, most of which have raised few ethical or epistemological concerns. Names have been used to identify research animals who play dual roles as pets, workers, or patients, to enhance their market value, and to facilitate their identification in the field. The multifaceted history of naming suggests both that the use of personal names by Goodall and others is less of a radical break with previous practices than it might first appear to be and that the use of personal names to recognize the individuality, sentience, or rights of nonhuman animals faces inherent limits and contradictions.

  15. DEPRESSION IN HYPERTENSIVE SUBJECTS

    PubMed Central

    Ramachandran, V.; Parikh, G.J.; Srinivasan, V.

    1983-01-01

    SUMMARY 168 patients attending hypertension clinic were randomly selected for the study. They were thoroughly investigated using E.C.G., X-ray chest, Urine analysis, Blood sugar, Blood urea, Serum cholesterol, Serum K, Serum Na, Scrum creatinine and Uric acid level. Detailed psychiatric case history and mental examination was carried out. Beck Rating Scale was used to measure the depression. 25% of hypertensive subjects exhibited depressive features and their mean score in Beck Rating scale is 21.76. The mean score of non-depressives is 4.46. All patients were receiving methyl dopa.25 mg. twice or thrice daily with thiazide diuretic. No significant difference in the incidence of depression with the duration of medication was observed. The hypertension was classified into mild, moderate and severe depending on the diastolic pressure. Depression was more frequent in severe hypertensives but not to the statistically significant level. Further hypertensives were classified into: 1. Hypertension without organ involvement 2. Hypertension with LVH only 3. Hypertension with additional organ involvement 4. Malignant hypertension Depression was significantly more frequent in hypertensives with complications and also hypertensives in whom the B.P. remained uncontrolled. As all the patients were on the same drug, the drug effect is common to all; hence, the higher incidence of depression in hypertensives with complications is due to the limitation and distress caused by the illness. PMID:21847301

  16. Chronic subjective dizziness.

    PubMed

    Odman, Micaela; Maire, Raphaël

    2008-10-01

    Chronic subjective dizziness (CSD) is frequent and affects twice as many women as men. Anxiety is a strong predisposing factor. The pathophysiologic concept of this disorder assumes that balance function and emotion share common neurologic pathways, which might explain that the balance disorder can provoke fear and vice versa, giving rise to a problem in perception of space and motion. In anxious patients this can turn into a space and motion phobia, with avoidance behaviour. CSD is a diagnosis based on the hypothesis of an interaction between the vestibular system and the psychiatric sphere. Patients complain of chronic imbalance, worsened by visual motion stimulation, and frequently suffer from anxiety. Vestibular examination reveals no anomalies. We evaluated the incidence and characteristics of CSD in patients referred to our neuro-otology centre (tertiary hospital outpatient clinic). This was a retrospective study of 1552 consecutive patients presenting with vertigo. CSD was diagnosed in 164 patients (female:male=111:53). CSD represents 10.6% of the dizzy patients in our clinic. Psychiatric disorder, mainly anxiety, was found in 79.3% of the cases. Other frequently associated factors were fear of heights and former vestibular lesion (healed). In all, 79.0% of the patients with CSD had poor balance performance on dynamic posturography testing.

  17. Relationships between self-rated oral health, subjective symptoms, oral health behavior and clinical conditions in Japanese university students: a cross-sectional survey at Okayama University

    PubMed Central

    2013-01-01

    Background Self-rated oral health is a valid and useful summary indicator of overall oral health status and quality of life. However, few studies on perception of oral health have been conducted among Japanese young adults. This study investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated with self-rated oral health in Japanese young adults. Methods This cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at Okayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed. Results In a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT) significantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective symptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly induced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral Hygiene Index-simplified were not related to self-rated oral health. Conclusion Self-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health behavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in routine dental examination to improve self-rated oral health in university students. PMID:24195632

  18. Abilities of Oropharyngeal pH Tests and Salivary Pepsin Analysis to Discriminate Between Asymptomatic Volunteers and Subjects with Symptoms of Laryngeal Irritation

    PubMed Central

    Yadlapati, Rena; Adkins, Christopher; Jaiyeola, Diana-Marie; Lidder, Alcina K.; Gawron, Andrew J.; Tan, Bruce K.; Shabeeb, Nadine; Price, Caroline PE; Agrawal, Neelima; Ellenbogen, Michael; Smith, Stephanie S.; Bove, Michiel; Pandolfino, John E.

    2015-01-01

    Background & Aims It has been a challenge to confirm the association between laryngeal symptoms and physiologic reflux disease. We examined the ability of oropharyngeal pH tests (with the Restech Dx-pH system) and salivary pepsin tests (with Peptest) to discriminate between asymptomatic volunteers (controls) and subjects with a combination of laryngeal and reflux symptoms (laryngeal±reflux). Methods We performed a physician-blinded prospective cohort study of 59 subjects at a single academic institution. Adult volunteers were recruited and separated into 3 groups based on GerdQ and reflux symptom index scores: controls (n=20), laryngeal symptoms (n=20), or laryngeal+reflux symptoms (n=19). Subjects underwent laryngoscopy and oropharyngeal pH tests and submitted saliva samples for analysis of pepsin concentration. Primary outcomes included abnormal acid exposure and composite (RYAN) score for oropharyngeal pH tests and abnormal mean salivary pepsin concentration based on normative data. Results Complete oropharyngeal pH data were available from 53 subjects and complete salivary pepsin data from 35 subjects. We did not observe any significant differences between groups in percent time spent below pH 4.0, 5.0, 5.5, 6.0 or RYAN scores; or percent of subjects with positive results from tests for salivary pepsin (53% vs 40% vs 75%; P=.50, respectively). The laryngeal+reflux group had a significantly higher estimated mean concentration of salivary pepsin (117.9±147.4ng/mL) than the control group (32.4±41.9ng/mL) or laryngeal symptom group (7.5±11.2ng/mL) (P=.01 and P=.04, respectively). Conclusions Using current normative thresholds, oropharyngeal pH testing and salivary pepsin analysis are not able to distinguish between healthy volunteers and subjects with a combination of laryngeal and reflux symptoms. PMID:26689899

  19. Is Piaget's Epistemic Subject Dead?

    ERIC Educational Resources Information Center

    Lawson, Anton E.

    1991-01-01

    Argues that the Piaget's epistemic subject is not supported by evidence and contains weaknesses. Concludes that the epistemic subject is dead and that continued acceptance of this aspect of Piagetian theory would be counterproductive. (PR)

  20. Sneak in Some Core Subjects

    ERIC Educational Resources Information Center

    Clarke, Lynne

    2011-01-01

    Even if students don't have an aversion to core subjects, they may not see the relationship between the core subjects and their career path. In this article, the author outlines a career path project that can be adapted to work in any career and technical education (CTE) class to highlight the relationship between core subjects and the real world.…

  1. Physical activity in elderly subjects with impaired glucose tolerance and newly diagnosed diabetes mellitus.

    PubMed

    Baan, C A; Stolk, R P; Grobbee, D E; Witteman, J C; Feskens, E J

    1999-02-01

    The authors carried out a study to investigate the association between different indicators of physical activity and the prevalence of impaired glucose tolerance (IGT) and newly diagnosed diabetes (nDM) in a population-based cohort of elderly men and women in the Netherlands. A sample of participants of the Rotterdam Study (n = 1,016) aged 55-75 years who were not known to have diabetes mellitus underwent an oral glucose tolerance test. Physical activity was assessed by means of a self-administered questionnaire and expressed as time spent on activities per week. Associations with the prevalence of IGT and nDM were assessed by logistic regression analysis after adjustment for age, body mass index, waist-hip ratio, family history of diabetes, and smoking. A total of 745 subjects had normal glucose tolerance, 153 IGT, and 118 nDM. The total amount of time spent on physical activity decreased with increasing glucose intolerance. Adjusted for main confounders, vigorous activities such as bicycling (men: odds ratio (OR) = 0.26, 95% confidence interval (CI) 0.14-0.49; women: OR = 0.37, 95% CI 0.18-0.78) and sports (men: OR = 0.28, 95% CI 0.11-0.74) showed an inverse association with the presence of nDM. For IGT, the associations pointed in the same direction but did not reach statistical significance. These results indicate that physical inactivity and glucose intolerance are associated among older adults similar to the way they are associated among middle-aged adults.

  2. [Factors affecting subjective satisfaction with verbal communication among the disabled elderly and their family caregivers].

    PubMed

    Miura, Hiroko; Arai, Yumiko; Yamasaki, Kiyoko

    2005-05-01

    The aims of the present study were to investigate satisfaction with verbal communication among the disabled elderly and their family caregivers; and to find the significantly influential factors of satisfaction with verbal communication. The subjects were 85 disabled elderly and 85 family caregivers. For the disabled elderly, satisfaction with verbal communication, demographic, and physical factors were examined using an interview survey. For the caregivers, satisfaction with verbal communication, demographic factors, and some factors related caregiving were examined using a self-administered questionnaire. In the disabled elderly, 82.4% were satisfied with their verbal communication while 55.3% of family caregivers were satisfied. Satisfaction with verbal communication between the disabled elderly and their caregivers showed low agreement (kappa = 0.17). Bivariate analysis revealed that satisfaction with verbal communication of the disabled elderly was significantly related to ADL (p < 0.01), dysphagia risk (p < 0.05), and ability of comprehension (p < 0.05) while satisfaction with verbal communication of caregivers was significantly related to the gender of the disabled elderly and caregivers' burden. Furthermore, multiple regression analysis showed that the factor most related to satisfaction with verbal communication for the disabled elderly was ability of comprehension (p value = 0.032, odds ratio = 2.960), and the most related factor for their caregivers was the burden evaluated by J-ZBI_8 (p value = 0.004, odds ratio = 0.842). These results suggest that satisfaction with verbal communication of the disabled elderly disagrees with that of the family caregivers, and that some related factors for the disabled elderly are different from those in their family caregivers.

  3. Human subjects research handbook: Protecting human research subjects. Second edition

    SciTech Connect

    1996-01-30

    This handbook serves as a guide to understanding and implementing the Federal regulations and US DOE Orders established to protect human research subjects. Material in this handbook is directed towards new and continuing institutional review board (IRB) members, researchers, institutional administrators, DOE officials, and others who may be involved or interested in human subjects research. It offers comprehensive overview of the various requirements, procedures, and issues relating to human subject research today.

  4. Memory and subjective workload assessment

    NASA Technical Reports Server (NTRS)

    Staveland, L.; Hart, S.; Yeh, Y. Y.

    1986-01-01

    Recent research suggested subjective introspection of workload is not based upon specific retrieval of information from long term memory, and only reflects the average workload that is imposed upon the human operator by a particular task. These findings are based upon global ratings of workload for the overall task, suggesting that subjective ratings are limited in ability to retrieve specific details of a task from long term memory. To clarify the limits memory imposes on subjective workload assessment, the difficulty of task segments was varied and the workload of specified segments was retrospectively rated. The ratings were retrospectively collected on the manipulations of three levels of segment difficulty. Subjects were assigned to one of two memory groups. In the Before group, subjects knew before performing a block of trials which segment to rate. In the After group, subjects did not know which segment to rate until after performing the block of trials. The subjective ratings, RTs (reaction times) and MTs (movement times) were compared within group, and between group differences. Performance measures and subjective evaluations of workload reflected the experimental manipulations. Subjects were sensitive to different difficulty levels, and recalled the average workload of task components. Cueing did not appear to help recall, and memory group differences possibly reflected variations in the groups of subjects, or an additional memory task.

  5. The Short-Term Effect of Breathing Tasks Via an Incentive Spirometer on Lung Function Compared With Autogenic Drainage in Subjects With Cystic Fibrosis.

    PubMed

    Sokol, Gil; Vilozni, Daphna; Hakimi, Ran; Lavie, Moran; Sarouk, Ifat; Bat-El Bar; Dagan, Adi; Ofek, Miryam; Efrati, Ori

    2015-12-01

    Forced expiration may assist secretion movement by manipulating airway dynamics in patients with cystic fibrosis (CF). Expiratory resistive breathing via a handheld incentive spirometer has the potential to control the expiratory flow via chosen resistances (1-8 mm) and thereby mobilize secretions and improve lung function. Our objective was to explore the short-term effect of using a resistive-breathing incentive spirometer on lung function in subjects with CF compared with the autogenic drainage technique. This was a retrospective study. Subjects with CF performed 30-45 min of either the resistive-breathing incentive spirometer (n = 40) or autogenic drainage (n = 32) technique on separate days. The spirometer encourages the patient to exhale as long as possible while maintaining a low lung volume. The autogenic drainage technique includes repetitive inspiratory and expiratory maneuvers at various tidal breathing magnitudes while exhalation is performed in a sighing manner. Spirometry was performed before and 20-30 min after the therapy. Use of a resistive-breathing incentive spirometer improved FVC and FEV1 by 5-42% in 26 subjects. The forced expiratory flow during the middle half of the FVC maneuver (FEF25-75%) improved by >20% in 9 (22%) subjects. FVC improved the most in subjects with an FEV1 of 40-60% of predicted. Improvements negatively correlated with baseline percent-of-predicted FVC values provided improvements were above 10% (r(2) = 0.28). Values improved in a single subjects using the autogenic drainage technique. These 2 techniques may allow lower thoracic pressures and assist in the prevention of central airway collapse. The resistive-breathing incentive spirometer is a self-administered simple method that may aid airway clearance and has the potential to improve lung function as measured by FVC, FEV1, and FEF25-75% in patients with CF. Copyright © 2015 by Daedalus Enterprises.

  6. Subjective tinnitus and its association with use of ear phones among students of the College of Medicine, University of Lagos, Nigeria.

    PubMed

    Sunny, Oghu Dibaal; Asoegwu, Chinyere Nkiruka; Abayomi, Somefun Oladapo

    2012-01-01

    The ear can be damaged by excessive noise levels. Noise can arise from variety of occupational/recreational sources causing tinnitus, hearing loss and hyperacusis. The use of different types of ear phones for entertainment has become very common/fashionable among our youths. This research aims to determine the prevalence of use of ear phones for entertainment and the prevalence of subjective tinnitus in students in an urban university setting; and the relationship between the two. This is a descriptive, cross sectional study of students of the college of medicine, University of Lagos, Nigeria from January to April 2012. A total of 388 willing participants (203 males, 185 females) were recruited by stratified random sampling from the 14 student hostel blocks. A self administered questionnaire was used. Data collected was analyzed using SPSS version 17.0.1. The prevalence of earphone use among the students and subjective tinnitus was 95.6% and 20.6% respectively. More than 90% of the ear phone users had duration of ear phone use of duration of 3 to 6 years.

  7. The disease-subject as a subject of literature

    PubMed Central

    Kottow, Andrea R; Kottow, Michael H

    2007-01-01

    Based on the distinction between living body and lived body, we describe the disease-subject as representing the impact of disease on the existential life-project of the subject. Traditionally, an individual's subjectivity experiences disorders of the body and describes ensuing pain, discomfort and unpleasantness. The idea of a disease-subject goes further, representing the lived body suffering existential disruption and the possible limitations that disease most probably will impose. In this limit situation, the disease-subject will have to elaborate a new life-story, a new character or way-of-being-in-the-world, it will become a different subject. Health care professionals need to realize that patients are not mere observers of their body, for they are immersed in a reassesment of values, relationships, priorities, perhaps even life-plans. Becoming acquainted with literature's capacity to create characters, modify narratives and depict life-stories in crisis, might sharpen physicians' hermeneutic acumen and make them more receptive to the quandaries of disease-subjects facing major medical and existential decisions in the wake of disruptive disease. PMID:17603873

  8. Atopic asthmatic subjects but not atopic subjects without ...

    EPA Pesticide Factsheets

    BACKGROUND: Asthma is a known risk factor for acute ozone-associated respiratory disease. Ozone causes an immediate decrease in lung function and increased airway inflammation. The role of atopy and asthma in modulation of ozone-induced inflammation has not been determined. OBJECTIVE: We sought to determine whether atopic status modulates ozone response phenotypes in human subjects. METHODS: Fifty volunteers (25 healthy volunteers, 14 atopic nonasthmatic subjects, and 11 atopic asthmatic subjects not requiring maintenance therapy) underwent a 0.4-ppm ozone exposure protocol. Ozone response was determined based on changes in lung function and induced sputum composition, including airway inflammatory cell concentration, cell-surface markers, and cytokine and hyaluronic acid concentrations. RESULTS: All cohorts experienced similar decreases in lung function after ozone. Atopic and atopic asthmatic subjects had increased sputum neutrophil numbers and IL-8 levels after ozone exposure; values did not significantly change in healthy volunteers. After ozone exposure, atopic asthmatic subjects had significantly increased sputum IL-6 and IL-1beta levels and airway macrophage Toll-like receptor 4, Fc(epsilon)RI, and CD23 expression; values in healthy volunteers and atopic nonasthmatic subjects showed no significant change. Atopic asthmatic subjects had significantly decreased IL-10 levels at baseline compared with healthy volunteers; IL-10 levels did not significa

  9. Socioeconomic Predictors of Subjective Age.

    ERIC Educational Resources Information Center

    Cutler, Neal E.

    While a number of studies have documented a variety of attitudinal correlates of the subjective dimension of age, some writers have suggested that, especially at the older end of the life cycle, subjective age is but a surrogate for measures of disadvantaged social status. Specifically, this alternative view is that only the poor or retired or…

  10. Sensory Information and Subjective Contour

    ERIC Educational Resources Information Center

    Brussell, Edward M.; And Others

    1977-01-01

    The possibility that subjective contours are an artifact of brightness contrast was explored. Concludes that subjective contour and brightness contrast are distinct perceptual phenomena but share a dependency on the processing of edge information transmitted through the achromatic channels of the visual system. (Editor/RK)

  11. Subjective Evaluation of Life Events.

    ERIC Educational Resources Information Center

    Fontana, Alan F.; And Others

    1979-01-01

    Surveyed medical/surgical patients concerning life events during the preceding year. Subjective evaluations of events were obtained for dimensions of desirability, adjustment, anticipation, and control. Psychological impairment was associated with subjective evaluations, specifically desirability and adjustment. Inclusion of anticipation and…

  12. Agreement with Subjects in Lubukusu

    ERIC Educational Resources Information Center

    Diercks, Michael J. K.

    2010-01-01

    This dissertation examines three topics in the morphosyntax of Lubukusu (Bantu, Kenya), all of which are concerned with agreement with subjects: locative inversion, complementizer agreement, and alternative agreement effects in subject extraction. Each topic reports novel Lubukusu data which are both typologically interesting and theoretically…

  13. The Child and Postmodern Subjectivity.

    ERIC Educational Resources Information Center

    Kennedy, David

    2002-01-01

    Examines various views of the child, focusing on postmodern subjectivity, discussing: the child as "valuable stranger" and reason's irrational core; the child and the dialect of western reason; and the child, the postmodern subject, and education. It concludes that school as an adult-child intentional community is potentially a space where…

  14. Sensory Information and Subjective Contour

    ERIC Educational Resources Information Center

    Brussell, Edward M.; And Others

    1977-01-01

    The possibility that subjective contours are an artifact of brightness contrast was explored. Concludes that subjective contour and brightness contrast are distinct perceptual phenomena but share a dependency on the processing of edge information transmitted through the achromatic channels of the visual system. (Editor/RK)

  15. Subjective Cognitive Impairment Subjects in Our Clinical Practice

    PubMed Central

    Garcia-Ptacek, Sara; Cavallin, Lena; Kåreholt, Ingemar; Kramberger, Milica Gregoric; Winblad, Bengt; Jelic, Vesna; Eriksdotter, Maria

    2014-01-01

    Background The clinical challenge in subjective cognitive impairment (SCI) is to identify which individuals will present cognitive decline. We created a statistical model to determine which variables contribute to SCI and mild cognitive impairment (MCI) versus Alzheimer's disease (AD) diagnoses. Methods A total of 993 subjects diagnosed at a memory clinic (2007-2009) were included retrospectively: 433 with SCI, 373 with MCI and 187 with AD. Descriptive statistics were provided. A logistic regression model analyzed the likelihood of SCI and MCI patients being diagnosed with AD, using age, gender, Mini-Mental State Examination score, the ratio of β-amyloid 42 divided by total tau, and phosphorylated tau as independent variables. Results The SCI subjects were younger (57.8 ± 8 years) than the MCI (64.2 ± 10.6 years) and AD subjects (70.1 ± 9.7 years). They were more educated, had less medial temporal lobe atrophy (MTA) and frequently normal cerebrospinal fluid biomarkers. Apolipoprotein E4/E4 homozygotes and apolipoprotein E3/E4 heterozygotes were significantly less frequent in the SCI group (6 and 36%) than in the AD group (28 and 51%). Within the regression model, cardiovascular risk factors, confluent white matter lesions, MTA and central atrophy increased the AD likelihood for SCI subjects. Conclusions SCI patients form a distinct group. In our model, factors suggesting cardiovascular risk, MTA and central atrophy increased the AD likelihood for SCI subjects. PMID:25538726

  16. Subject Responses to Electrochromic Windows

    SciTech Connect

    Clear, Robert; Inkarojrit, Vorapat; Lee, Eleanor

    2006-03-03

    Forty-three subjects worked in a private office with switchable electrochromic windows, manually-operated Venetian blinds, and dimmable fluorescent lights. The electrochromic window had a visible transmittance range of approximately 3-60%. Analysis of subject responses and physical data collected during the work sessions showed that the electrochromic windows reduced the incidence of glare compared to working under a fixed transmittance (60%) condition. Subjects used the Venetian blinds less often and preferred the variable transmittance condition, but used slightly more electric lighting with it than they did when window transmittance was fixed.

  17. Is Piaget's epistemic subject dead?

    NASA Astrophysics Data System (ADS)

    Lawson, Anton E.

    Niaz (1990) presents arguments in favor of the retention of Piaget's epistemic subject as a theoretical construct to guide research and practice in science education and psychology. The intent of this article is to point out the weaknesses of those arguments and to suggest that the weight of evidence argues against the existence of the logical thinker postulated by Piaget. Therefore, contrary to Niaz's conclusion that the acceptance of Piaget's epistemic subject will facilitate the development of cognitive theories with greater explanatory power, the conclusion is reached that Piaget's epistemic subject is dead and that continued acceptance of this aspect of Piagetian theory would be counterproductive.

  18. Subjective perception of body sway

    PubMed Central

    Schieppati, M.; Tacchini, E.; Nardone, A.; Tarantola, J.; Corna, S.

    1999-01-01

    OBJECTIVES AND METHOD—The relation between body sway recorded through a stabilometric platform and the subjective report of steadiness was studied in 20 young and 20 elderly subjects and 20 neuropathic and 20parkinsonian patients standing upright. The trials were performed under two stances (feet apart, feet together) and two visual conditions (eyes open, eyes closed). At the end of each trial, subjects scored their performance on a scale from 10 (complete steadiness) to 0(fall).
RESULTS—In all subjects, independently of the stance conditions, the larger the body sway the smaller the reported score. The function best fitting this relation was linear when sway was expressed on a logarithmic scale. The scoring reproducibility proved high both within and across subjects. Despite the different body sways and scores recorded under the different visual and postural conditions (eyes closed >eyes open, feet together>feet apart) in all groups of subjects and patients, the slopes of the relations between sway and score were broadly superimposable. In the normal subjects, the scores were slightly higher during eyes open than eyes closed trials for corresponding body sways. This was interpreted as a sign of perception of greater stability when vision was allowed. Parkinsonian patients swayed to a similar extent as normal subjects, and their scores were accordingly similar, both with eyes open and eyes closed. Neuropathic patients swayed to a larger extent than normal subjects, and their scores were matched appropriately. Although the slope of their relation with eyes closed was not different from that of normal subjects, with eyes open it was steeper and similar to that with eyes closed, suggesting that these patients did not feel more stable when they could take advantage of vision.
CONCLUSIONS—The subjective evaluation of body sway, irrespective of stance condition, age, neuropathy, and basal ganglia disease, reflects the actual sway, and is inversely proportional

  19. PERSONAL LEADERSHIP PROTECTS RESEARCH SUBJECTS

    USDA-ARS?s Scientific Manuscript database

    Personal leadership promotes the ethical conduct of human research activities. Leadership entails application of one’s cognitive abilities, technical skills, and emotional intelligence during the conduct of research activities, Personal leadership assures human research subject protection....

  20. Gnathological features in growing subjects

    PubMed Central

    Ballanti, Fabiana; Ranieri, Salvatore; Baldini, Alberto; Pavoni, Chiara; Bollero, Patrizio; Cozza, Paola

    2013-01-01

    Summary Aim Aim of this study was to evaluate the prevalence of temporomandibular disorders (TMD) in a sample of consecutive subjects. Materials and methods TMDs were recorded in a sample of 580 subjects (279 M, 301 F; mean age: 13.4y). For each subject a case history was compiled to evaluate the social and demographic parameters. An extraoral exam was effected to point out the face proportions, and an intraoral exam was performed to analyze dental occlusion, mandibular deviation during opening, presence of cross-bites, overjet and overbite. A functional exam was carried out to evaluate mandibular movements and to find joint sounds and myofascial pain. The sample was divided into 6 groups according to the: gender, age (ages 6y–11y and 12y–16y), Angle Dental Class, cross-bite, midline deviation and chewing side. For this investigation latex gloves, a millimeter calipers (precision 0,01 mm) and a phonendoscope were used. The percentages of signs and symptoms were compared using the ?2-test with Yates correction to determine the differences among the groups for the rates of TMDs, reduced opening/lateral/protrusive movements, and myofascial pain. Results The prevalence of TMDs in the total sample was 13,9%. Among 6y–11y subjects the percentage of TMD was 7,3% while it was 16,1% among 12y–16y subjects (?2=1.634;; p=0.201). Females showed a percentage of 16,6% of TMDs while males one of 10,8% (?2=0.556;; p=0.456). According to angle malocclusion, the prevalence was 14% in subjects with Class I malocclusion, 15% in sample with Class II and 9% in patients with Class III (?2=0.540;; p=0.763). According to presence or absence of crossbite, prevalence of TMD signs and symptoms was 13,8% among subjects without crossbite and 14,3% among subjects with crossbite, with no significant difference between the two subgroups (?2= 0,047619;; p=0.050). In relation of midline deviation, prevalence of TMDs was 15% in subjects without deviation, 15,8% in functional deviation

  1. Coherent Assessment of Subjective Probability

    DTIC Science & Technology

    1981-03-01

    known results of de Finetti (1937, 1972, 1974), Smith (1961), and Savage (1971) and some recent results of Lind- ley (1980) concerning the use of...provides the motivation for de Finettis definition of subjective probabilities as coherent bet prices. From the definition of the probability measure...subjective probability, the probability laws which are traditionally stated as axioms or definitions are obtained instead as theorems. (De Finetti F -7

  2. The Perception of Subjective Surfaces,

    DTIC Science & Technology

    1981-11-01

    this article we develop an alternative account of subjective contours that derives from the developing computational theory of vision [see Marr 1982...with iistial agnosia who could not sec subjective contours when thecy were presented monocularly, but who could see thein whenI they were presented...a blob like that shown in (a) with a piece cut ouL Consider figure 29. For this article , the crucial point is that figure 29b appears to be

  3. Long-lasting subjective effects of LSD in normal subjects.

    PubMed

    Schmid, Yasmin; Liechti, Matthias E

    2017-09-16

    Lysergic acid diethylamide (LSD) and other serotonergic hallucinogens can induce profound alterations of consciousness and mystical-type experiences, with reportedly long-lasting effects on subjective well-being and personality. We investigated the lasting effects of a single dose of LSD (200 μg) that was administered in a laboratory setting in 16 healthy participants. The following outcome measures were assessed before and 1 and 12 months after LSD administration: Persisting Effects Questionnaire (PEQ), Mysticism Scale (MS), Death Transcendence Scale (DTS), NEO-Five Factor Inventory (NEO-FFI), and State-Trait Anxiety Inventory (STAI). On the PEQ, positive attitudes about life and/or self, positive mood changes, altruistic/positive social effects, positive behavioral changes, and well-being/life satisfaction significantly increased at 1 and 12 months and were subjectively attributed by the subjects to the LSD experience. Five-Dimensions of Altered States of Consciousness (5D-ASC) total scores, reflecting acutely induced alterations in consciousness, and Mystical Experience Questionnaire (MEQ30) total scores correlated with changes in well-being/life satisfaction 12 months after LSD administration. No changes in negative attitudes, negative mood, antisocial/negative social effects, or negative behavior were attributed to the LSD experience. After 12 months, 10 of 14 participants rated their LSD experience as among the top 10 most meaningful experiences in their lives. Five participants rated the LSD experience among the five most spiritually meaningful experiences in their lives. On the MS and DTS, ratings of mystical experiences significantly increased 1 and 12 months after LSD administration compared with the pre-LSD screening. No relevant changes in personality measures were found. In healthy research subjects, the administration of a single dose of LSD (200 μg) in a safe setting was subjectively considered a personally meaningful experience that had

  4. Professional Success and Gender in Family Medicine: Design of Scales and Examination of Gender Differences in Subjective and Objective Success Among Family Physicians.

    PubMed

    Delgado, Ana; Saletti-Cuesta, Lorena; López-Fernández, Luis Andrés; Toro-Cárdenas, Silvia; Luna del Castillo, Juan de Dios

    2016-03-01

    Two components of professional success have been defined: objective career success (OCS) and subjective career success (SCS). Despite the increasing number of women practicing medicine, gender inequalities persist. The objectives of this descriptive, cross-sectional, and multicenter study were (a) to construct and validate OCS and SCS scales, (b) to determine the relationships between OCS and SCS and between each scale and professional/family characteristics, and (c) to compare these associations between male and female family physicians (FPs). The study sample comprised 250 female and 250 male FPs from urban health centers in Andalusia (Spain). Data were gathered over 6 months on gender, age, care load, professional/family variables, and family-work balance, using a self-administered questionnaire. OSC and SCS scales were examined by using exploratory factorial analysis and Cronbach's α, and scores were compared by gender-stratified bivariate and multiple regression analyses. Intraclass correlation coefficients were calculated using a multilevel analysis. The response rate was 73.6%. We identified three OCS factors and two SCS factors. Lower scores were obtained by female versus male FPs in the OCS dimensions, but there were no gender differences in either SCS dimension.

  5. [Reproducibility of subjective refraction measurement].

    PubMed

    Grein, H-J; Schmidt, O; Ritsche, A

    2014-11-01

    Reproducibility of subjective refraction measurement is limited by various factors. The main factors affecting reproducibility include the characteristics of the measurement method and of the subject and the examiner. This article presents the results of a study on this topic, focusing on the reproducibility of subjective refraction measurement in healthy eyes. The results of previous studies are not all presented in the same way by the respective authors and cannot be fully standardized without consulting the original scientific data. To the extent that they are comparable, the results of our study largely correspond largely with those of previous investigations: During repeated subjective refraction measurement, 95% of the deviation from the mean value was approximately ±0.2 D to ±0.65 D for the spherical equivalent and cylindrical power. The reproducibility of subjective refraction measurement in healthy eyes is limited, even under ideal conditions. Correct assessment of refraction results is only feasible after identifying individual variability. Several measurements are required. Refraction cannot be measured without a tolerance range. The English full-text version of this article is available at SpringerLink (under supplemental).

  6. Subjectivity and Severe Psychiatric Disorders

    PubMed Central

    Strauss, John

    2011-01-01

    To have a complete human science in the mental health field it is essential to give adequate attention to both the objective and the subjective data related to people with psychiatric disorders. The tendency in the past has been to ignore or discount one or the other of these data sources. Subjective data are particularly neglected, sometimes considered (only) part of the “art” of medicine since the usual methodologies of the physical sciences in themselves are not adequate to reflect the nature, elusiveness, and complexity of human subjective experience. The complete experience of hallucinated voices, for instance, often includes not only the voices themselves but also terrible anguish and terrifying inability to concentrate. But even such descriptors fall unnecessarily short of reflecting the data of the experience, thus leaving research, theory, and treatment with incomplete information. To represent adequately the subjective data it is essential to recognize that besides the usual discursive knowledge and methods of traditional physical science, a second kind of knowledge and method is required to reflect the depth of human experience. To accomplish this, we must employ approaches to narrative and the arts that are uniquely capable of capturing the nature of these experiences. Only by attending seriously in our research, training, theory, and practice to the unique nature of subjective data is it possible to have a true human science for our field. PMID:20961994

  7. Subject to Form: Research Interviews, Performative Subjectivity, Professional Development

    ERIC Educational Resources Information Center

    Sarigianides, Sophia Tatiana

    2010-01-01

    In this dissertation, I analyze teacher, literacy coach and researcher subjectivities in a five-year study of on-site professional development with middle-grade Language Arts teachers in a school designated by its district and state as severely underperforming. Interested in the role of research interviews as both research method and cultural…

  8. Assessing Developmental Trajectories of Sexual Minority Youth: Discrepant Findings from a Life History Calendar and a Self-Administered Survey

    ERIC Educational Resources Information Center

    Fisher, Colleen M.

    2012-01-01

    Research suggests that the timing and sequence of sexual identity development milestones impact myriad health and mental health outcomes for sexual minority youth. Because these milestone events are typically assessed retrospectively, traditional data collection approaches are limited by recall bias and lack of precision in the recording of…

  9. Response of 40 and Over Aged Military Personnel to an Unsupervised, Self-Administered Aerobic Training Program,

    DTIC Science & Technology

    1982-01-06

    with a Collins chain- com pens ated gasometer. Body weight (kg) and height (cm) were measured and skinfold thickness (mm) determined at the...Body fat assessed from total body density and its estimation from skinfold thickness ; measurements or, 481 men and women aged from 16 to 72 years...subscapular, triceps, biceps, and suprailiac sites using Harpenden calipers. Age-adjusted regression equations were used to estimate percent body fat (18). A

  10. Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals.

    PubMed

    Rimm, E B; Giovannucci, E L; Stampfer, M J; Colditz, G A; Litin, L B; Willett, W C

    1992-05-15

    The authors assessed the reproducibility and validity of an expanded 131-item semiquantitative food frequency questionnaire used in a prospective study among 51,529 men. The form was administered by mail twice to a sample of 127 participants at a one-year interval. During this interval, men completed two one-week diet records spaced approximately 6 months apart. Mean values for intake of most nutrients assessed by the two methods were similar. Intraclass correlation coefficients for nutrient intakes assessed by questionnaires one year apart ranged from 0.47 for vitamin E without supplements to 0.80 for vitamin C with supplements. Correlation coefficients between the energy-adjusted nutrient intakes measured by diet records and the second questionnaire (which asked about diet during the year encompassing the diet records) ranged from 0.28 for iron without supplements to 0.86 for vitamin C with supplements (mean r = 0.59). These correlations were higher after adjusting for week-to-week variation in diet record intakes (mean r = 0.65). These data indicate that the expanded semiquantitative food frequency questionnaire is reproducible and provides a useful measure of intake for many nutrients over a one-year period.

  11. Therapist-Assisted, Self-Administered Bibliotherapy to Enhance Parental Competence: Short- and Long-Term Effects

    ERIC Educational Resources Information Center

    Hahlweg, Kurt; Heinrichs, Nina; Kuschel, Annett; Feldmann, Marit

    2008-01-01

    The efficacy of bibliotherapy has primarily been investigated in anxiety disorders, depression, or substance dependence. The efficacy of self-help books to increase parenting competence was only investigated in a few studies despite their broad dissemination in public. The aims of the study were to investigate the short- and long-term efficacy of…

  12. Test-retest reliability of a self-administered musculoskeletal symptoms and job factors questionnaire used in ergonomics research.

    PubMed

    Rosecrance, John C; Ketchen, Kelly J; Merlino, Linda A; Anton, Dan C; Cook, Tom M

    2002-09-01

    The purpose of this study was to investigate the test-retest reliability of questionnaire items related to musculoskeletal symptoms and the reliability of specific job factors. The type of questionnaire items described in the present study have been used by several investigators to assess symptoms of musculoskeletal disorders and problematic job factors among workers from a variety of occupations. Employees at a plastics molding facility were asked to complete an initial symptom and jobs factors questionnaire and then complete an identical questionnaire either two or four weeks later. Of the 216 employees participating in the initial round, 99 (45.8%) agreed to participate in the retest portion of the study. The kappa coefficient was used to determine repeatability for categorical outcomes. The majority of the kappa coefficients for the 58 questionnaire items were above 0.50 but ranged between 0.13 and 1.00. The section of the questionnaire having the highest kappa coefficients was the section related to hand symptoms. Interval lengths of two and four weeks between the initial test and retest were found to be equally sufficient in terms of reliability. The results indicated that the symptom and job factors questionnaire is reliable for use in epidemiologic studies. Like all measurement instruments, the reliability of musculoskeletal questionnaires must be established before drawing conclusions from studies that employ the instrument.

  13. Implementation fidelity of self-administered transcutaneous electrical nerve stimulation (TENS) in patients with chronic back pain: an observational study.

    PubMed

    Pallett, Edward J; Rentowl, Patricia; Johnson, Mark I; Watson, Paul J

    2014-03-01

    The efficacy of transcutaneous electrical nerve stimulation (TENS) for pain relief has not been reliably established. Inconclusive findings could be due to inadequate TENS delivery and inappropriate outcome assessment. Electronic monitoring devices were used to determine patient compliance with a TENS intervention and outcome assessment protocol, to record pain scores before, during, and after TENS, and measure electrical output settings. Patients with chronic back pain consented to use TENS daily for 2 weeks and to report pain scores before, during, and after 1-hour treatments. A ≥ 30% reduction in pain scores was used to classify participants as TENS responders. Electronic monitoring devices "TLOG" and "TSCORE" recorded time and duration of TENS use, electrical settings, and pain scores. Forty-two patients consented to participate. One of 35 (3%) patients adhered completely to the TENS use and pain score reporting protocol. Fourteen of 33 (42%) were TENS responders according to electronic pain score data. Analgesia onset occurred within 30 to 60 minutes for 13/14 (93%) responders. It was not possible to correlate TENS amplitude, frequency, or pulse width measurements with therapeutic response. Findings from TENS research studies depend on the timing of outcome assessment; pain should be recorded during stimulation. TENS device sophistication might be an issue and parameter restriction should be considered. Careful protocol design is required to improve adherence and monitoring is necessary to evaluate the validity of findings. This observational study provides objective evidence to support concerns about poor implementation fidelity in TENS research.

  14. A Pilot Study of a Self-Administered Parent Training Intervention for Building Preschoolers' Social-Emotional Competence

    ERIC Educational Resources Information Center

    Thomson, Rebecca N.; Carlson, John S.

    2017-01-01

    Social-emotional skills are equally as crucial for school success as cognitive and academic skills (Webster-Stratton and Reid in "Infants and Young Children" 17:96-113, 2004), yet many young children lack these skills (Lavigne et al. in "Journal of the American Academy of Child and Adolescent Psychiatry" 35:204-214, 1996).…

  15. Studying the Hurdles of Insulin Prescription (SHIP©): development, scoring and initial validation of a new self-administered questionnaire

    PubMed Central

    Martinez, Luc; Consoli, Silla M; Monnier, Louis; Simon, Dominique; Wong, Olivier; Yomtov, Bernard; Guéron, Béatrice; Benmedjahed, Khadra; Guillemin, Isabelle; Arnould, Benoit

    2007-01-01

    Background Although insulin therapy is well-accepted by symptomatic diabetic patients, it is still often delayed in less severe patients, in whom injectable insulin remains under-used. A better understanding of patients' perception of insulin would eventually help physicians to adopt the most appropriate dialogue when having to motivate patients to initiate or to intensify insulin injection. Methods The 'Studying the Hurdles of Insulin Prescription' (SHIP) questionnaire was developed based on a list of concepts derived from three diabetic patients' focus groups, and was included into two cross-sectional studies with similar design: SHIP Oral study and SHIP Premix study. Diabetic patients treated with oral hypoglycaemic agents (OHA; n = 1,494) and patients already treated with insulin (n = 1,150) completed the questionnaire at baseline, 6- and 12 months. Psychometric properties were assessed: 1) structure analysis by Principal Component Analysis (PCA) with Varimax rotation, 2) internal consistency reliability (Cronbach's alpha), and 3) concurrent validity (Spearman correlation coefficients with the Fear of Self-Injecting (FSI) score of the Diabetes Fear of Injecting and Self-testing Questionnaire. Reluctance/motivation towards insulin was assessed. Scores' ability to predict patients' insulin injection reluctance/motivation and initiation/intensification was evaluated with the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC). Results PCA analysis confirmed the structure of the 14 items grouped into 3 dimensions: 'acceptance and motivation', 'fear and constraints', and 'restraints and barriers' towards insulin injection. Internal consistency reliability was excellent (Cronbach's alpha > 0.70); concurrent validity was good. The three scores were significantly predictive of patients' reluctance/motivation towards insulin injection initiation, as they were of patients' actual switch, except for the 'restraints and barriers' dimension. 'Acceptance and motivation' and 'fears and constraints' dimensions were also significantly predictive of patients' reluctance/motivation towards insulin intensification. By the end of the 12-month study, 179 of the initially OHA-treated patients had started insulin injections; 186 of the patients already treated with insulin had increased their injections. Conclusion The SHIP questionnaire provides reliable and valid assessment of diabetic patients' attitude towards insulin and injections. The predictive power of scores for patients' reluctance/motivation and actual treatment decisions demonstrates encouraging potential for further application in clinical practice. PMID:17727695

  16. Therapist-Assisted, Self-Administered Bibliotherapy to Enhance Parental Competence: Short- and Long-Term Effects

    ERIC Educational Resources Information Center

    Hahlweg, Kurt; Heinrichs, Nina; Kuschel, Annett; Feldmann, Marit

    2008-01-01

    The efficacy of bibliotherapy has primarily been investigated in anxiety disorders, depression, or substance dependence. The efficacy of self-help books to increase parenting competence was only investigated in a few studies despite their broad dissemination in public. The aims of the study were to investigate the short- and long-term efficacy of…

  17. Over-Expression of CREB in the Nucleus Accumbens Shell Increases Cocaine Reinforcement in Self-Administering Rats

    PubMed Central

    Larson, Erin B.; Graham, Danielle L.; Arzaga, Rose R.; Buzin, Nicole; Webb, Joseph; Green, Thomas A.; Bass, Caroline E.; Neve, Rachael L.; Terwilliger, Ernest F.; Nestler, Eric J.; Self, David W.

    2011-01-01

    Chronic exposure to addictive drugs enhances cAMP response element binding protein (CREB)-regulated gene expression in nucleus accumbens (NAc), and these effects are thought to reduce the positive hedonic effects of passive cocaine administration. Here, we utilized viral-mediated gene transfer to produce short- and long-term regulation of CREB activity in NAc shell of rats engaging in volitional cocaine self-administration. Increasing CREB expression in NAc shell markedly enhanced cocaine reinforcement of self-administration behavior, as indicated by leftward (long-term) and upward (short-term) shifts in fixed-ratio dose-response curves. CREB also increased the effort exerted by rats to obtain cocaine on more demanding progressive ratio schedules, an effect highly correlated with viral-induced modulation of BDNF protein in the NAc shell. CREB enhanced cocaine reinforcement when expressed either throughout acquisition of self-administration or when expression was limited to post-acquisition tests, indicating a direct effect of CREB independent of reinforcement-related learning. Down-regulating endogenous CREB in NAc shell by expressing an shRNA reduced cocaine reinforcement in similar tests, while over expression of a dominant negative CREBS133A mutant had no significant effect on cocaine self-administration. Finally, increasing CREB expression after withdrawal from self-administration enhanced cocaine-primed relapse, while reducing CREB levels facilitated extinction of cocaine seeking, but neither altered relapse induced by cocaine cues or footshock stress. Together, these findings indicate that CREB activity in NAc shell increases the motivation for cocaine during active self-administration or after withdrawal from cocaine. Our results also highlight that volitional and passive drug administration can lead to substantially different behavioral outcomes. PMID:22072694

  18. Efficacy of a Self-Administered Home-Based Parent Intervention on Parenting Behaviors for Preventing Adolescent Substance Use