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Biomedical subjects

P Elsass

Publications and source records attributed to P Elsass.

At least 19 recordsLinked to original sources
PubMed2005

Assessing the cost of groundwater pollution: the case of diffuse agricultural pollution in the Upper Rhine valley aquifer.

This paper presents an assessment of the costs of diffuse groundwater pollution by nitrates and pesticides for the industrial and the drinking water sectors in the Upper Rhine valley, France. Pollution costs which occurred between 1988 and 2002 are described and assessed using the avoidance cost method. Geo-statistical methods (kriging) are then used to construct three scenarios of nitrate concentration evolution. The economic consequences of each scenario are then assessed. The estimates obtained are compared with the results of a contingent valuation study carried out in the same study area ten years earlier.

Agriculture↗
PubMed1999

Health education pamphlets about smoking--their benefit to smokers and non-smokers.

The aim of this present study was to compare the use by smokers and non-smokers of pamphlets about smoking as delivered from different settings. The study was a nation-wide cross-sectional survey of 1924 randomly selected, Danish men and women, aged 14-77 y, who had answered a mailed questionnaire in 1994. Of these 71% also participated in a telephone interview enquiring about the use of health education material, smoking status and socio-demographic variables, 39% of readers of household-delivered anti-smoking pamphlets reported having gained information from them and 22% reported having made changes in their own smoking behaviour such as avoiding smoking in the presence of non-smokers. In general practice settings, these percentages were higher among smokers. Smokers who were thinking of stopping smoking in the near future were in addition more likely to take and to read smoking related health education materials from other places. Non-smokers received (3 49%) and read pamphlets about smoking as frequently as did smokers who did not intend to quit. In conclusion, written health education material was well received by readers, but, when distributed in a more open setting it needs to be targeted towards smokers who are considering stopping smoking. In general practice, smokers not thinking of stopping were open to health education, and pamphlets used in this setting should also target this group. Non-smokers contribute indirectly to smokers quitting by providing support to smokers and pamphlets for non-smokers need to be more targeted towards this social role.

Adolescent↗
PubMed1997

[The health-psychological consultation. An introduction to the humanistic health research on physician-patient relationship].

The descriptions of the so-called healing relationship used in general practice may appear vague and rhetorical, as long as only limited systematic research has been carried out within the area. Health Psychology is introduced as a discipline that qualifies the psychological aspects of the patient-physician relationship. Historical data are given showing that patient-oriented medicine was a well-developed subject even at the beginning of this century. Currently, the new forms of democracy in society influence the patient-physician relationship and cause abuse of power. Concepts like health and autonomy are often used to analyze the consultation process, but these conceptions have a seductive dimension and need to be made convete in practice. Disciplines such as narratology and practice research may supplement an academic scientific analysis.

Behavioral Medicine↗
PubMed1994

[Greenlanders in hospital. An interview study of communication between patients and therapists, satisfaction and therapeutic preferences].

In four hospitals in Greenland, 50 Greenlandic patients and their Danish therapist (18 doctors, 26 nurses and six other staff) have been interviewed about the same topics. The interviews were semistructured with open ended questions on the following subjects: Language difficulties, perception of diagnosis and therapy, patients' satisfaction and points of criticism. Several of the patients had not understood the most important medical information about diagnosis and treatment. But most of the patients did not consider the information problem to be serious and patients were satisfied with most of the consultations. Language difficulties and insufficient communications do not correspond to patients' satisfaction but have to be analysed in the wider cultural context. There was a tendency towards the elder patients being more satisfied than the younger.

Adult↗
PubMed1994

[Greenlanders' attitudes towards health and disease. A comparative interview study of patients' and therapists' attitude to disease and health].

In four hospitals in Greenland, 50 Greenlandic patients and their Danish therapists (18 doctors, 26 nurses and six other staff) have been interviewed about their perceptions of disease and treatment and experiences of health in general. The Greenlandic patients' experiences of health were different and sometimes more articulate than those of their Danish therapists. Most of the Greenlandic patients expressed a trusting relationship towards the therapists, but most of the Danish professionals experienced that attitude as being authoritarian and dependent. It does not seem to be necessary in order to achieve a good treatment result that the patients and their therapists speak the same language and share the same concepts of health and disease. In those cases where the foreign health service's offers of treatment can be contained, and are not experienced as a threat to culturally related concepts of disease, the consultation presumably results in the best patient satisfaction.

Adult↗
PubMed1994

Greenlanders in hospital; lack of language understanding is not always a hindrance to intercultural communication. Comparison of interviews of Greenlandic patients and their Danish therapists with respect to concepts of communication, patient satisfaction, disease, and health.

In four hospitals in Greenland, 50 Greenlandic patients and their Danish therapists have been interviewed about the same topics. The interviews were semistructured with open ended questions on the following subjects: Language difficulties, perception of diagnosis, patients satisfaction and points of criticism, perception of disease and treatment, and experience of health in general. In spite of language difficulties and insufficient communication, patient satisfaction occurred in most of the consultations. There was a tendency towards the elder patients being more satisfied than the younger. It does not seem to be a necessity to achieve a good treatment-result that the patients and the therapists speak the same language and share the same concepts of health and disease. Where the foreign health service can be limited so that it is not viewed as a menace to culturally related concept of disease, the consultations give rise to the best patient-satisfaction.

Attitude to Health↗
PubMed1990

The psychological effect of three different forms of patient information.

The psychological effects of different forms of preanesthetic information have been measured in four groups of patients (total N = 207) with the same questionnaires and rating scales. The emotional support of a contact-person was found to be most effective in reducing anxiety compared to routinely given information. Tranquilizing with diazepam showed a slightly lesser degree of anxiety reduction. A detailed information had least effect and even increased anxiety for some patients. Even the results were characterized by a large inter- and intraindividual variation, the emotional-supportive aspects of the information given were more important for anxiety reduction than the cognitive-informative aspects. The patients who had been hospitalized before were less influenced by the degree of information given, and had a higher increase in anxiety compared to the non-experienced patients.

Anxiety↗
PubMed1987

Psychological effect of detailed preanesthetic information.

Eighty-one patients admitted for minor surgery were followed with questionnaires and self-rating scales in the pre- and post-anesthetic period to evaluate the effect of giving either routine or detailed information. The patients were randomly allocated to two groups and received either routinely given information by the anesthetist for about 5 min or more detailed information for at least 20 min. The patients' experience of the effect of the preanesthetic visit was tranquillizing and adequate in both groups. The most significant difference with detailed information was a smaller number of side-effects like slow cerebration, nausea and a general feeling of discomfort compared to the routinely informed patients. Repetitive ratings on Spielberger's State of Anxiety Scale showed that the patients who had had previous anesthetic experience were less influenced by the degree of information given. In view of the considerable numbers of parameters investigated, there were relatively few significant differences between the groups, and it was concluded that there was no convincing benefit from expanding routine to detailed information.

Adult↗
PubMed1987

The psychological effects of having a contact-person from the anesthetic staff.

Seventy-four patients admitted for elective surgery completed identical questionnaires and rating scales pre- and postoperatively. The course of anxiety was compared between patients who were either routinely informed or had contact with an anesthetic nurse available for support during the 30-min anesthesia and surgery preparation. Comparing the results with our three other studies, it is concluded that emotional support given by a "contact-person" is more effective than either detailed information or a tranquillizer.

Adolescent↗
PubMed1986

Continuous reaction times in cerebral dysfunction.

The Continuous Reaction Times (CRT) method was used to examine pharmacological, psychiatric, medical and neurological problems in clinical practice where a detailed neuropsychological examination with a test battery was not possible. Either 100 visual or 150 auditory stimuli were given within a period of 6 1/2 or 10 min respectively, and the patients were instructed to react as quickly as possible to every stimulus. The same CRT method was applied to heterogeneous groups of patients with cerebral dysfunction and control subjects. The results demonstrated that it was useful as a screening test for the presence of cerebral dysfunction and was especially sensitive to progressive diseases. Its discriminative power was equivalent to more sophisticated and complex psychological tests. Even if CRT is a valid and reliable method of testing cerebral affection, the neural background for the reaction time process is still unknown and the test did not distinguish between patients with right- or left-hemisphere lesions and was not influenced by the etiology of the disease. CRT is therefore considered a provisional method, suggestive only for the actual diagnostic procedures. Only when the patients have a well-defined diagnosis e.g. a diffuse cerebral affection caused by a drug or a metabolic disorder can CRT be recommended as a measure of the degree of lowered consciousness.

Acoustic Stimulation↗
PubMed1985

Reaction time and brain disease: relations to location, etiology and progression of cerebral dysfunction.

Using the results from 485 patients with various forms of cerebral dysfunctions and from 60 hospitalized controls, it was shown that measurement of continuous reaction times (CRT) is sensitive to cerebral lesions. Reaction times were more impaired by progressive than by non-progressive brain diseases. The test did not distinguish between patients with right- or left-hemisphere lesions and was not influenced either by etiology, chronicity, age or sex. Our conclusion is that CRT is useful as a "screening" test for the presence of cerebral dysfunction and is especially sensitive to progressive diseases. Its discrimination power is equivalent to more sophisticated and complex psychological tests.

Adolescent↗
PubMed1985

Discrimination between organic and hepatic encephalopathy by means of continuous reaction times.

Measurement of continuous reaction times (CRT) was applied to 105 hospitalized controls, 65 patients with brain damage and 47 patients with hepatic encephalopathy. One hundred and fifty reaction times were measured in every patient. The best discrimination between controls and patients with organic brain damage was obtained with the 10 percentile of the reaction time distribution (86% correct classification). The 90 percentile discriminated best between controls and patients with hepatic encephalopathy (86% correct classification). Furthermore, the ratio between the 50 percentile and the difference between the 10 and 90 percentile made it possible to discriminate between the two groups of patients (91% correct classification), which indicates that the CRT test is suitable as a screening device for discrimination between organic brain damage and hepatic encephalopathy.

Adult↗
PubMed1984

Reaction time course during weaning from respirator treatment.

Ten patients who developed disturbed mental function during respirator weaning were studied. They were investigated during respirator treatment and 1 h after start of spontaneous ventilation with continuous reaction time measurements and clinical ratings. During the spontaneous ventilation the reaction times increased and the patients experienced fatigue. PaCO2 was higher and PaO2 was lower than during respirator treatment. A significant correlation was found between individual differences of reaction times and arterial blood gas levels in the two conditions, whereas no general correlation between reaction times and arterial blood gas levels could be established. The findings must be considered tentative, but the results of this study indicate the value of continuous reaction time measurements for quantitative assessment of mental status during respirator treatment.

Adult↗
PubMed1984

Number connection test and continuous reaction times in assessment of organic and metabolic encephalopathy: a comparative study.

Number Connection Test (NCT) and Continuous Reaction Times (CRT) have been used for assessment of encephalopathy in groups of 105 controls, 65 brain damaged patients and 22 patients with hepatic encephalopathy. With the use of NCT, 65% of the patients with cerebral damage could be correctly classified with regard to presence versus absence of brain disease, whereas the use of CRT gave 85% correct classification. With regard to hepatic encephalopathy the CRT was better for classification than NCT; respectively 86% and 64% were correctly classified. The NCT could not separate the patient with brain damage from the patients with hepatic encephalopathy, whereas CRT could classify respectively 95% and 86% correctly. When the tests were performed on five successive days, the NCT scores showed a learning effect, whereas the CRT gave stable measures. This means that the CRT was superior to the NCT for classification purposes.

Adult↗
PubMed1984

Acute cerebral dysfunction after open-heart surgery. A reaction-time study.

A sensitive measure of subtle CNS dysfunction, the continuous reaction time (CRT), was used in 19 patients to quantify the immediate effects of open-heart surgery and extracorporeal circulation (ECC) on the CNS. The control group comprised 17 patients undergoing thoracic surgical procedures without ECC. The reaction time was significantly prolonged after surgery both in the ECC patients and in the controls. CRT was unrelated to the duration of anaesthesia in both groups, but in the ECC group deterioration of CRT showed positive correlation with (a) the duration of ECC, (b) the duration of perfusion pressure below 50 mmHg during ECC and (c) the PCO2 during ECC. These three factors may be of pathogenetic significance in the development of CNS dysfunction following open-heart surgery. The acute changes in reaction time resolved within a week of surgery, but on questioning two months later half of the ECC patients reported intellectual disturbance, primarily impairment of memory and lability of mood.

Adolescent↗
PubMed1983

Reaction time deficit in multiple sclerosis.

50 multiple sclerosis (MS) patients were evaluated, according to an objective weighting scale measuring neurologic deficit, and investigated with continuous reaction time (CRT). Compared to a group of 105 controls, the reaction times of the MS patients were significantly delayed. The CRT method could correctly classify 80% of the controls and 72% of the patients. The CRT was especially sensitive for patients in the progressive phase of the disease and independent of dyscoordination.

Adult↗