Biomedical subjects

Isabelle Côté

Publications and source records attributed to Isabelle Côté.

11 recordsLinked to original sources

PubMed2006

The effect of a hearing aid noise reduction algorithm on the acquisition of novel speech contrasts.

Audiologists are reluctant to prescribe digital hearing aids with active digital noise reduction (DNR) to pre-verbal children due to their potential for an adverse effect on the acquisition of language. The present study investigated the relation between DNR and language acquisition by modeling pre-verbal language acquisition using adult listeners presented with a non-native speech contrast. Two groups of normal-hearing, monolingual Anglophone subjects were trained over four testing sessions to discriminate novel, difficult to discriminate, non-native Hindi speech contrasts in continuous noise, where one group listened to both speech items and noise processed with DNR, and where the other group listened to unprocessed speech in noise. Results did not reveal a significant difference in performance between groups across testing sessions. A significant learning effect was noted for both groups between the first and second testing sessions only. Overall, DNR does not appear to enhance or impair the acquisition of novel speech contrasts by adult listeners.

Adult↗

PubMed2005

A cohort study found the RAND-12 and Health Utilities Index Mark 3 demonstrated construct validity in high-risk primary care patients.

OBJECTIVE: The Short Form 12 (SF-12) is widely used in primary care settings. The RAND-12 Health Status Inventory (HSI) and the Health Utilities Index Mark 3 (HUI3) have not been as widely used in such settings. The objective of this study was to examine the construct validity of the RAND-12 and HUI3 in the context of high-risk primary care patients. STUDY DESIGN AND SETTING: The SF-12, HUI2, and HUI3 were administered to a cohort of high-risk primary care patients. RAND-12 summary scores for physical and mental health were generated. Single-attribute utility scores for each dimension of health status and overall health in HUI3 were computed. A priori hypotheses were specified. RESULTS: In general, the relationships among RAND-12 and HUI3 scores were consistent with construct validity. Twelve of 24 a priori predictions were confirmed. However, predictions about the correlations between the number of medical conditions and the number of medications and the measures of health-related quality of life were, in general, not confirmed. CONCLUSIONS: The RAND-12 and HUI3 seem to be useful among primary care patients with diverse chronic conditions. Further investigation is warranted.

Cohort Studies↗

PubMed2004

Quality of life in hypertension: the SF-12 compared to the SF-36.

BACKGROUND: The SF-36 has frequently been used to measure health related quality of life (HRQOL) in hypertension. Recently, the SF-12, a shorter form of the SF-36, has been proposed. However, the validity of the SF-12 in hypertension has not yet been assessed. OBJECTIVES: To determine the extent to which the SF-12 provides similar measurements of HRQOL to those of the SF-36 in hypertensive individuals. METHODS: A study assessing the impact of a pharmacy-based intervention program on hypertensive individuals served as background for this study. One hundred and twelve individuals participated in this study. We compared the SF-36 with the SF-12 on item scores and summary measures using intraclass correlation coefficients (ICC), Pearson correlation coefficients and linear regression. RESULTS: The concordance between the SF-12 and the SF-36 on both physical (ICC=0.88) and mental (ICC=0.92) component summary scores (PCS and MCS respectively) is high and the relationship is linear and positive. Most of the variance in the SF-36 PCS (R2=0.78) and MCS (R2=0.85) can be explained by their SF-12 counterparts. The SF-12 PCS and MCS are the only significant predictor variables for the corresponding measure of the SF-36. CONCLUSIONS: The SF-12 appears to be a valid alternative to the SF-36 for clinical practice or research purposes when studying hypertensive individuals and their treatment.

Adolescent↗

PubMed2004

Comparing short form and RAND physical and mental health summary scores: results from total hip arthroplasty and high-risk primary-care patients.

OBJECTIVES: Summary physical health scores for the Short Form (SF) measures are computing using positive weights for physical items and negative weights for mental health items. Mental health summary scores use positive weights for mental items and negative weights for physical. The RAND Health Status Inventory (HSI) measures do not use negative weights. Do these different approaches to scoring matter? The objective was to compare summary scores using both the SF and RAND-HSI. METHODS: SF-36 and the Health Utilities Index Mark 3 (HUI3) were administered to a cohort of patients waiting for elective total hip arthroplasty (THA). SF-12 and HUI3 were administered to a cohort of high-risk primary-care patients. Summary scores were generated and compared. Single-attribute utility scores for emotion in HUI3 were also computed. Canadian and US norms for SF, RAND-HSI, and HUI3 were used to interpret results. RESULTS: For THA patients, mean physical health scores were 28 and 36 for SF and RAND-HSI. Mean mental health scores were 55 and 42. For the primary-care patients, the scores were 34 and 36 for physical and 46 and 40 for mental health. CONCLUSIONS: SF and RAND-HSI provided somewhat similar summary scores in the THA study. However, SF and RAND-HSI mental health scores differed in the primary-care patient cohort and results from HUI3 corroborate the mental health deficits identified by the RAND-HSI. It may be wise for investigators to use both SF and RAND-HSI scoring systems.

Arthroplasty, Replacement, Hip↗

PubMed2004

Enhancing primary care for complex patients. Demonstration project using multidisciplinary teams.

PROBLEM BEING ADDRESSED: Communication between community-based providers is often sporadic and problem-focused. OBJECTIVE OF PROGRAM: To implement collaborative community-based care among providers distant from one another and to improve or maintain the health of high-risk community-dwelling patients, with a focus on medication use. PROGRAM DESCRIPTION: Six primary health care teams were formed of a family physician, a pharmacist, and a home care case manager (nurse). Three of these teams also had a family physician's office nurse. Teams received training and decided on processes of care that included a home visit, medication history, and weekly 1.5-hour face-to-face team meetings. In 151 team conferences, 705 medication or health issues were identified for 182 patients over 6 months. Medication adherence was improved at 3 and 6 months. After 6 months, all providers had a greater understanding of the roles of the other providers. CONCLUSION: Primary health care teams developed in this study require few structural changes to existing health care systems, but will require more reimbursement options.

Aged↗

PubMed2003

Efficacy of selected oral chemotherapeutants against Ichthyophthirius multifiliis (Ciliophora: Ophyroglenidae) infecting rainbow trout Oncorhynchus mykiss.

The chemotherapeutic efficacy of 6 in-feed compounds against Ichthyophthirius multifiliis Fouquet, 1876 was assessed using experimental infections of rainbow trout Oncorhynchus mykiss (Walbaum) fingerlings. Trial doses of 104 ppm amprolium hydrochloride or 65 ppm clopidol fed to fish for 10 d prior to infection significantly reduced the number of trophonts establishing in trout fingerlings by 62.0 and 35.2% respectively. In-feed treatments of infected trout with either 63 or 75 ppm amprolium hydrochloride, 92 ppm clopidol, or 38, 43 or 47 ppm salinomycin sodium for 10 d also significantly reduced the number of surviving trophonts by 77.6 and 32.2% for amprolium, 20.1% for clopidol and 80.2, 71.9 and 93.3% respectively for salinomycin sodium.

Administration, Oral↗

PubMed2003

Is adherence to drug treatment correlated with health-related quality of life?

BACKGROUND: Adherence to drug treatment and health-related quality of life (HRQL) are two distinct concepts. Generally one would expect a positive relationship between the two. OBJECTIVES: The purpose of this study was to assess the relationship between adherence and HRQL. METHODS: HRQL was measured using the physical and mental summary measures of the RAND-12 (PHC-12, MHC-12), the SF-12 (PCS-12, MCS-12), HUI-2 and HUI-3. Adherence was assessed using Morisky's instrument. Three longitudinal datasets were used. One dataset included 100 hypertensive patients. Another dataset covered 199 high risk community-dwelling individuals. The third dataset consisted of 365 elderly patients. Spearman's correlation coefficients were used to assess association. Subgroup analyses by type of medication and inter-temporal analyses were also performed. RESULTS: Correlation between adherence and PHC-12 ranged from 0.08 (p = 0.26) to 0.22 (p < 0.01). Correlations between adherence and MHC-12 ranged from 0.11 (p = 0.11) to 0.15 (p < 0.01). Similar results were observed using HUI-2, HUI-3, and SF-12 as well as by type of medication and in the lagged analyses. CONCLUSIONS: Correlations between HRQL and adherence were positive but typically weak or negligible in magnitude.

Aged↗

PubMed2003

Use of health services associated with increased menstrual loss in the United States.

OBJECTIVE: The study was conducted to estimate the effect of abnormal uterine bleeding on health care use. STUDY DESIGN: Data were taken from the National Health Interview Survey 1999, a nationwide representative sample of the civilian noninstitutionalized population of the United States. The participants who were eligible for the study were 3133 women aged between 18 and 64 years who reported having a natural menstrual period in the last 12 months and in the last 3 months, never having taken medication containing estrogen (except past use of oral contraceptives), and never been told they had reproductive cancer. From these, 328 women were excluded-5 women because they were more than 64 years old and 323 because of the imprecision of their answers related to their menstrual flow. Analysis was performed with the data from 2805 women: 373 having self-described heavy flow and 2432 having normal flow. RESULTS: Age, family size, insurance coverage, perception of health, and flow of menstrual periods are associated with the majority of questions used to measure health care use (P < or =.05). The odds ratios related to the flow of menstrual periods were all equal to or higher than 1.45 (P < or =.05), which indicates that women who have a heavier flow are at least 1.45 times as likely to use health care as are women who have a lighter or normal flow. CONCLUSION: Women having heavy flow of menstrual bleeding are more likely to use health care than women having a normal flow.

Adult↗

PubMed2003

A pharmacy-based health promotion programme in hypertension: cost-benefit analysis.

OBJECTIVE: To weigh the costs and benefits of a pharmacy-based health promotion programme implemented in four pharmacies of the Quebec City area, Canada. This programme was developed to improve blood pressure control through activities aimed at improving the quality of prescribing and the adherence to treatment. DESIGN: Nine pharmacies in Quebec City were included, of which four pharmacies were assigned to the implementation of the health promotion programme. Each time a study participant came to one of these pharmacies to refill his/her antihypertensive medication, the pharmacist would measure and record the participant's blood pressure and assess adherence to drug treatment. The other five pharmacies delivered usual care. The duration of the intervention programme was 9 months. Costs included direct, indirect, and fixed costs, and the costs of pharmacist intervention. Benefits were measured using cost savings induced by pharmacist intervention. Willingness to pay was also considered. A bootstrap method was used to test the between-group difference. PERSPECTIVE: The study was performed from a societal perspective. STUDY PARTICIPANTS: 100 individuals aged between 34 and 80 years residing in the Quebec City area and taking antihypertensive medication. MAIN OUTCOME MEASURES AND RESULTS: Participants exposed to the programme had a significant decrease in mean direct costs and a significant increase in mean indirect costs compared with non-exposed participants. Pharmacist interventions involved a mean cost of 30.68 Canadian dollars ($ Can) per participant exposed to the programme. On average, exposed participants were willing to pay $ Can 0.54 per month after the intervention period. Benefits were about ten times higher than costs (1998 values). CONCLUSIONS: The implementation of this intervention programme seems promising in the quest to improve blood pressure control in terms of both costs and benefits.

Age Factors↗

PubMed2002

Work loss associated with increased menstrual loss in the United States.

OBJECTIVE: To estimate the effect of increased menstrual flow on the loss of work. METHODS: Heavy or otherwise abnormal menstrual bleeding is a common problem among women in the reproductive age range. Until now, there has been no evidence of its effect on absences from work. We used data from the National Health Interview Survey 1999, a personal interview household survey using a nationwide representative sample of the civilian noninstitutionalized population of the United States. Participants were 3133 women aged between 18 and 64 years who reported having a natural menstrual period in the last 12 months and in the last 3 months, never having taken medication containing estrogen (except past use of oral contraceptives), and never having been told that they had reproductive cancer. Analysis was performed using data from 2805 women, 373 having self-described heavy flow and 2432 having normal flow. The main outcome measure was work loss associated with the degree of menstrual flow. RESULTS: Using binary logistic regression, age, marital status, education, family size, perception of health, and flow of menstrual periods are associated with work losses (P <.05). The odds ratio of 0.72 (95% confidence interval 0.56, 0.92) indicates that women who have a heavier flow are 72% as likely to be working as are women who have a lighter or normal flow. CONCLUSION: Menstrual bleeding has significant economic implications for women in the workplace: work loss from increased blood flow is estimated to be $1692 annually per woman.

Absenteeism↗

PubMed2002

Determinants of discontinuation of new courses of antihypertensive medications.

Discontinuation of medication use constitutes a major barrier to adequate control of high blood pressure. We examined the effect of an array of potential predisposing, enabling and reinforcing factors on the discontinuation of newly prescribed antihypertensive medications. We conducted a prospective cohort study through a network of 173 pharmacies across Canada where were identified individuals newly prescribed an antihypertensive monotherapy. We interviewed participants by telephone four times to obtain information for a minimum duration of 18 months after entry into the cohort. We analyzed data using a multivariate proportional hazard model. Of 682 eligible participants, 43.3% had discontinued their initial medication at the end of the observation period. Individuals more likely to discontinue their initial medication were those who perceived side effects from this medication [Hazard Ratio (HR) = 1.91; 95% Confidence Interval (CI) 1.47-2.47). Individuals with medication insurance coverage were less likely to discontinue (HR = 0.74; 95% CI 0.55-0.99). Persistence with newly prescribed medications could be improved by selecting antihypertensive medications containing fewer side effects and by lifting economic barriers to drug treatment.

Adolescent↗