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PubMed1984

Acute hemodynamic effects of acebutolol and propranolol.

The acute hemodynamic effects of intravenous acebutolol, 50 mg, and propranolol, 10 mg, were evaluated in 12 patients undergoing diagnostic cardiac catheterization. Each patient received acebutolol or propranolol according to a list of randomization. Both acebutolol and propranolol depressed left ventricular function. There was a significant increase in left ventricular end-diastolic pressure at rest and after isometric exercise, with a concomitant decrease in cardiac index. Systemic vascular resistance was increased by both drugs. The increment after patients received acebutolol was not statistically significant; however, with propranolol it was statistically significant. The overall hemodynamic effects of acebutolol and propranolol are similar, but a quantitative difference exists in their effect on systemic vascular resistance. Acebutolol, a cardioselective agent, produces less of a peripheral vascular beta 2-blockade than does propranolol.

Acebutolol↗

PubMedDate not supplied

Personal contact from friends to increase mammography usage.

To increase the use of mammography among women 40 years of age and older, the American Cancer Society (ACS) designed a telephone intervention strategy (the "Tell A Friend" program) that relied on ACS volunteers. During a half-day training session, each volunteer provided a list of 10 women she was willing to contact over a 6-month period and encourage to have a mammogram. Each list was randomized, and five names were returned to each volunteer for inclusion in the intervention. The other women served as controls and were not contacted by the volunteers. All women were subsequently interviewed at the end of the intervention period. Forty-nine percent of the women in the intervention group (n = 289) had received their most recent mammogram since the start of the intervention period, whereas 34% of control women (n = 305) received mammograms during the same time period (p < or = .001, rate ratio = 1.4, 95% confidence interval = 1.2, 1.7). The effectiveness of the intervention remained after controlling for demographic characteristics. The strategy was effective for both black and white women of all ages, but principally among women with annual household incomes of less than $40,000. We conclude that a telephone intervention strategy of personal contacts between acquainted women can significantly increase mammography use, particularly among women with low-to-moderate income.

Adult↗

PubMed1994

Breast cancer: causes of patients' distress identified by qualitative analysis.

BACKGROUND: Previous investigations of the psychological consequences of having breast cancer have usually involved quantitative analysis within medical models. AIM: This qualitative study set out to identify key events which had caused distress to women with breast cancer and to compare the frequency of these events with doctors' beliefs about their relative frequency. METHOD: The causes of distress in 26 women with breast cancer were identified by qualitative analysis of unstructured interviews. Subsequently, all hospital doctors and general practitioners in the Exeter health district were sent a list in random order of the eight events which had most commonly caused distress and were asked to rank them in order of frequency for patients with breast cancer. RESULTS: The responses suggest a mismatch between the doctors' expectations and the experience of the patients. CONCLUSION: Patients may suffer distress in areas of management doctors do not suspect are important; qualitative analysis can identify these areas.

Breast Neoplasms↗

PubMed1976

Transfer of categorial clustering set in mildly retarded adolescents.

The relative effectiveness of instructions to adopt an organizational strategy vs. exposure to category labels was investigated. Twenty-four retarded adolescents were assigned to each of three conditions (blocking plus instructions, blocking plus labels, and blocking) for pretraining and training. Immediately after training, all subjects received a transfer task consisting of a new randomly organized list containing words from the same (training) categories for one-half of the subjects and from different categories for the other half. When exposure to category labels accompanied blocking, results indicated increased clustering and recall during the training phase and a trend toward increased clustering during the transfer phase.

Adolescent↗

PubMed2000

Development of a random response scale for the multiple affect adjective check list-revised.

A scale was constructed to identify random responses on the Multiple Affect Adjective Check List-Revised. Items chosen were the 14 least frequently checked items and 14 most frequently checked items, plus the seven most frequently checked negative items and the seven least frequently checked positive items (total=42). The Random Response Scale successfully differentiated random protocols from those produced by 420 college students, and scores on the scale were significantly higher for the college students than for the random sample. In addition, correlations between scores on the Random Response Scale and the Communality Scale (Adjective Check List) and the NEO-FFI Conscientiousness Scale suggest its usefulness as a measure of "conscientiousness" or "dependableness."

Affect↗

PubMed2002

An entry-level MS degree in clinical laboratory science: is it time?

OBJECTIVE: The study was undertaken to address the following questions: 1) Does the scope of practice of the clinical laboratory scientist require an entry-level master's (MS) degree? 2) How would a change to an entry-level MS degree in clinical laboratory science (CLS) affect educational programs, the practice field, and students? and 3) Based on this study, what recommendations can be made to CLS educators? DESIGN: Surveys were developed to assess the opinions of educators, managers, and practitioners on the need for an entry-level MS degree in CLS. Surveys were also sent to students to assess their interest in an entry-level MS degree and their perceptions of the advantages and disadvantages of this type of program. Surveys sent to educators included questions addressing the effect of a change to an entry-level MS degree in CLS on enrollment and program viability. Managers were asked questions concerning job expectations and compensation for graduates with an entry-level MS degree and practitioners were asked about their interest in this type of program. PARTICIPANTS: The sample for the survey included 280 directors of National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) educational programs, 600 managers randomly selected from the Clinical Laboratory Management Association (CLMA) mailing list, 600 practitioners randomly selected from the American Society for Clinical Laboratory Science (ASCLS) mailing list, and 1400 CLS students selected by program directors. MAIN OUTCOME MEASURES: Educators, managers, and practitioners were asked to read 12 statements related to educational preparation for entry into CLS and indicate their level of agreement on a five point scale. Mean responses to these questions were compared for educators, managers, and practitioners, for educators in hospital-based and university-based programs, and for managers with BS and advanced degrees. Responses to demographic and other forced-choice type questions related to entry-level MS programs were counted and reported. RESULTS: Response rates of 58% (educators), 28% (practitioners), 39% (managers), and 40% (students) were obtained. Educators, managers, and practitioners all agreed that the scope of practice of CLS does not require an entry-level MS degree and that the MS degree is appropriate for those practitioners who wish to further their education. There were no major differences in educators', managers', and practitioners' responses to questions on the need for an MS in CLS. Students indicated that they would be interested in an entry-level MS program if the additional education would give them higher salaries and more job opportunities. Students who entered their CLS program with a baccalaureate (BS) degree were more interested in the entry-level MS option than students who entered with an associate degree or high school diploma. Managers indicated that they would not pay a graduate with an entry-level MS degree more than a graduate with a baccalaureate degree. CONCLUSION: There is currently no support for an overall change from the BS degree to the MS degree as the entry-level requirement for CLS practitioners. Entry-level MS programs in CLS may be attractive to students who already have BS degrees.

Data Collection↗

PubMed1991

[Which controls should be chosen in a case-control study? Survey of bladder cancer in Hérault].

A case-control investigation about bladder cancer was carried out in Herault department with 219 incident cases from January 1987 to May 1989 and two control groups: 196 hospital controls randomized from hospital admission lists and 794 population controls randomized from census data. According to the comparison for those two groups, there are few socio-demographic differences; but hospital controls are more exposed to smoking, coffee, alcohol, artificial sweetners. So, the odds ratios with those hospital controls are under-estimated. We can evaluate the resulting biais.

Aged↗

PubMed2005

A trial of neuropsychologic rehabilitation in mild-spectrum traumatic brain injury.

OBJECTIVE: To test the effectiveness of a neuropsychologic rehabilitation program consisting of psychotherapy and cognitive remediation in the treatment of the affective and neuropsychologic sequelae of mild-spectrum traumatic brain injury (TBI). DESIGN: Single-blind randomized, wait-listed controlled trial, with repeated measures and multiple baselines. SETTING: Outpatient clinic in northern New Jersey. PARTICIPANTS: Twenty persons with persisting complaints after mild and moderate TBI (11 in treatment group, 9 controls). INTERVENTIONS: The experimental group received both 50 minutes of individual cognitive-behavioral psychotherapy and 50 minutes of individual cognitive remediation, 3 times a week for 11 weeks. The control group was wait-listed and received treatment after conclusion of follow-up. MAIN OUTCOME MEASURES: Symptom Check List-90R General Symptom Index, plus scales of depression, anxiety, coping, attention, and neuropsychologic functioning. RESULTS: Compared with the control group, the treatment group showed significantly improved emotional functioning, including lessened anxiety and depression. Most significant improvements in emotional distress were noted at 1 month and 3 months posttreatment. Performance on a measure of divided auditory attention also improved, but no changes were noted in community integration scores. CONCLUSIONS: Cognitive behavioral psychotherapy and cognitive remediation appear to diminish psychologic distress and improve cognitive functioning among community-living persons with mild and moderate TBI.

Adult↗

PubMed2003

Correlation among academic performance, recurrent abdominal pain and other factors in Year-6 urban primary-school children in Malaysia.

OBJECTIVE: The present study aimed to investigate the extent to which recurrent abdominal pain and other factors were associated with academic achievement among Year-6 (12 years of age) schoolchildren. METHODS: The present study was a cross-sectional survey conducted from September to November 2001. Schoolchildren were recruited from primary schools that were selected randomly from a list of all primary schools in Petaling Jaya, Malaysia, using random sampling numbers. Information concerning recurrent abdominal pain, socio-economic status, life events, demographic and other details was obtained using a combination of questionnaires and interviews. Academic achievement was assessed using a score based on the Malaysian Primary School Achievement Examination. An overall score at or above the mean was taken to indicate high academic achievement while a score below the mean indicated poor academic achievement. RESULTS: A total of 1971 children were studied (958 boys and 1013 girls: 1047 Malays, 513 Chinese and 411 Indians). Of these children, 456 (23.1%) fulfilled the criteria for recurrent abdominal pain. Using the method of binary logistic regression analysis, the following factors were found to be independently associated with poor academic performance: a low socio-economic status (odds ratio (OR) 1.30; 95% confidence interval (CI) 1.25-1.35); male sex (OR 1.61; 95% CI 1.26-2.05); the death of a close relative (OR 2.22; 95% CI 1.73-2.85); the divorce or separation of parents (OR 3.05; 95% CI 1.73-5.40); the commencement of work by the mother (OR 1.34; 95% CI 1.02-1.76); hospitalization of the child in the 12 months prior to the study (OR 1.83; 95% CI 1.12-3.01); lack of health-care consultation (OR 1.80; 95% CI 1.36-2.36); missing breakfast (OR 1.47; 95% CI 1.07-2.02); and lack of kindergarten education (OR 1.35; 95% CI 1.04-1.75). CONCLUSIONS: Many factors, such as socio-economic status and recent life events, were associated with poor academic performance. Recurrent abdominal pain did not correlate directly to academic performance. Stress may be a means by which various factors cause children to struggle academically.

Abdominal Pain↗

PubMed2001

Is physical activity protective against hip fracture in frail older people?

BACKGROUND: there is limited evidence of a protective effect of physical activity in preventing hip fractures among older people living in institutions and in those aged 80 or over. OBJECTIVE: to examine the relationship between physical activity and risk of hip fracture in frail older people. DESIGN: a case-control study. SETTING: Auckland, New Zealand. SUBJECTS: a random sample of individuals hospitalized with a fracture of the femoral neck (n=911) and 910 randomly selected age- and sex-matched individuals from the lists of a random sample of general practitioners. METHODS: we sought information on physical activity and other potential risk factors for hip fracture from cases and controls, using a standardized interviewer-administered questionnaire. We conducted multivariate analyses, separately for those living in private homes and residential institutions. RESULTS: increasing hours of physical activity per week protected against the risk of hip fracture among individuals living in private homes, including those who are over 80. However, among individuals living in institutions, physical activity levels were extremely low (<15% participated in >/=2 h per week) and there was limited evidence of a protective effect. CONCLUSIONS: efforts to prevent hip fractures in individuals living in care homes and institutions should focus on passive interventions which are known to be effective.

Activities of Daily Living↗

PubMed1994

Quality evaluation in the management of child sponsorship programmes.

Programme evaluation tactics for child sponsorship programmes have historically concentrated on quantitative analysis of service units, amount of money invested, number of countries served, the number of projects, and number of children in each project. While these are valuable measures of programme variables, they do not assess the impact of programmes on the lives of the children sponsored. Outcome measures designed to assess programme impact add greatly to the information available to child welfare professionals. This study collected data about the impact of the programme on the lives of the children. The Child Welfare League's Child Well-Being Scales (CWBS) were used to assess programme impact. Twelve scales were chosen as directly related in type to the programmes administered by Children International, a traditional and well established child sponsorship organization located in Kansas City, Missouri. A thirteenth scale was suggested by field workers in India as particularly relevant to Third World populations. The scales were translated into languages appropriate to each population in the programme countries. Social workers in each country were trained to administer and score them. This analysis used the emerging data technology becoming available to programmes in Third World countries. The system enables administrators in the Third World to evaluate, enhance and summarize their programmes in a way understandable across borders. Epi Info (Dean et al., 1990) was customized to provide the framework for the analysis. The population for this study was selected by a 5% random sampling of children currently enrolled as sponsored children (180,000+ worldwide). These were compared with a waiting-list control group selected randomly from lists of children who have applied for sponsorship but have not yet been receiving services (n = 50 from each project).(ABSTRACT TRUNCATED AT 250 WORDS)

Charities↗

PubMed2000

Reamed versus nonreamed intramedullary nailing of lower extremity long bone fractures: a systematic overview and meta-analysis.

OBJECTIVE: To determine the effect of reamed versus nonreamed intramedullary (IM) nailing of lower extremity long bone fractures on the rates of nonunion, implant failure, malunion, compartment syndrome, pulmonary embolus, and infection. DESIGN: Quantitative systematic review of prospective, randomized controlled trials. DATA IDENTIFICATION: MEDLINE and SCISEARCH computer searches provided lists of published randomized clinical trials from 1969 to 1998. Extensive hand searches of major orthopaedic journals, bibliographies of major orthopaedic texts, and personal files identified additional studies. STUDY SELECTION AND DATA EXTRACTION: Of 676 citations initially identified, sixty proved potentially eligible, of which four published and five unpublished randomized trials met all eligibility criteria. Each of three investigators assessed study quality and abstracted relevant data. RESULTS: The pooled relative risk of reamed versus nonreamed nails (nine trials, n = 646 patients) was 0.33 [95% confidence interval (CI), 0.16 to 0.68; p = 0.004]. The absolute risk difference in nonunion rates with reamed IM nailing was 7.0 percent (95% CI, 1 to 11 percent). Thus, one nonunion could be prevented for every fourteen patients treated with reamed IM nailing [number needed to treat (NNT) = 14.28]. The risk ratios for secondary outcome measures were: implant failure, 0.30 (95% CI, 0.16 to 0.58; p < 0.001); malunion, 1.06 (95% CI, 0.32 to 3.57); pulmonary embolus, 1.10 (95% CI, 0.26 to 4.76); compartment syndrome, 0.45 (95% CI, 0.13 to 1.56); and infection, 0.98 (95% CI, 0.21 to 4.76). Sensitivity analyses suggested that reported rates of nonunion and implant failure were higher in studies of lower quality. The type of long bone fractured (tibia or femur), the degree of soft tissue injury (open or closed), study quality, and whether a study was published or unpublished did not significantly alter the relative risk of nonunion between reamed and nonreamed IM nailing. CONCLUSIONS: There is evidence from a pooled analysis of randomized trials that reamed IM nailing of lower extremity long bone fractures significantly reduces rates of nonunion and implant failure in comparison with nonreamed nailing.

Bone Nails↗

PubMed1997

Evaluation of bias and logistics in a survey of adults at increased risk for oral health decrements.

OBJECTIVES: Designing research to include sufficient respondents in groups at highest risk for oral health decrements can present unique challenges. Our purpose was to evaluate bias and logistics in this survey of adults at increased risk for oral health decrements. METHODS: We used a telephone survey methodology that employed both listed numbers and random digit dialing to identify dentate persons 45 years old or older and to oversample blacks, poor persons, and residents of nonmetropolitan counties. At a second stage, a subsample of the respondents to the initial telephone screening was selected for further study, which consisted of a baseline in-person interview and a clinical examination. We assessed bias due to: (1) limiting the sample to households with telephones, (2) using predominantly listed numbers instead of random digit dialing, and (3) nonresponse at two stages of data collection. RESULTS: While this approach apparently created some biases in the sample, they were small in magnitude. Specifically, limiting the sample to households with telephones biased the sample overall toward more females, larger households, and fewer functionally impaired persons. Using predominantly listed numbers led to a modest bias toward selection of persons more likely to be younger, healthier, female, have had a recent dental visit, and reside in smaller households. Blacks who were selected randomly at a second stage were more likely to participate in baseline data gathering than their white counterparts. Comparisons of the data obtained in this survey with those from recent national surveys suggest that this methodology for sampling high-risk groups did not substantively bias the sample with respect to two important dental parameters, prevalence of edentulousness and dental care use, nor were conclusions about multivariate associations with dental care recency substantively affected. CONCLUSIONS: This method of sampling persons at high risk for oral health decrements resulted in only modest bias with respect to the population of interest.

Adult↗

PubMed1993

Randomized trial of the effect of calcium supplementation on fecal risk factors for colorectal cancer.

Newmark et al. (J Natl Cancer Inst 1984; 72:1323-8) hypothesized that supplementation with calcium would decrease the concentration of bile acids in aqueous phase feces and that such a reduction would reduce the risk of malignant disease in the bowel. A randomized trial was therefore undertaken to examine the effects of calcium supplementation on fecal biochemistry. A total of 68 men between 40 and 60 years of age volunteered to participate after having been selected randomly from population lists in Scarborough, a city in the Toronto area, Ontario, Canada. Participants were randomly assigned to receive a daily supplement of 3 g of calcium carbonate or a sucrose placebo for a period of 1 week. Fecal samples were collected for 2 days prior to supplementation and for the last 2 days of supplementation. Records of all foods consumed were kept throughout the study period. The average concentration of total soluble bile acids fell in the placebo group (-11.2 g/ml) but increased slightly in the calcium group (1.4 g/ml). Similar patterns of change were observed for deoxycholic acid (placebo, -3.0 g/ml; calcium, 4.5 g/ml). The distribution of changes in total bile acids and deoxycholic acid differed between randomization groups at the 10 percent level of significance in univariate analysis. After adjustment for initial stool chemistry and initial levels and changes in nutrient intake, no reduction in fecal bile acid levels was observed in association with calcium supplementation. In fact, a statistically significant (p = 0.05) increase in deoxycholic acid concentration remained in the calcium supplemental group. Thus, this study was unable to support the hypothesis that calcium supplementation alters aqueous phase bile acids in the manner hypothesized to be consistent with protection from colorectal cancer.

Adult↗

PubMed2006

Tadalafil and modifications in peak systolic velocity (Doppler spectrum dynamic analysis) in the cavernosal arteries of patients with type 2 diabetes after continuous tadalafil treatment.

AIM: In this study peak systolic velocity (PSV) was measured by penile duplex Doppler spectrum dynamic analysis in diabetic patients with erectile dysfunction (ED) administered continuous treatment with tadalafil for 3 months in a weekly regimen (Monday-Wednesday-Friday). Responses to the Structured Interview on Erectile Dysfunction (SIEDY) questionnaire and hormonal blood levels (LH, testosterone, prolactin) were studied before and after treatment. METHODS: The study sample was 20 diabetic patients (mean age 60 years; range 55-65) with organic vascular arterial ED at enrollment into the study. All patients were eligible for receiving tadalafil. Patients were randomly assigned to 2 different treatment groups according to a computer-generated list. The first random set of numbers was assigned to group A, the second to group B. Group A (n=10) received tadalafil 20 mg per os on demand for 3 months (Cialis, Lilly ICOS; London, UK). Group B (n=10) received tadalafil 20 mg per os on weekly fixed days (Monday-Wednesday-Friday) for 3 months. All patients underwent duplex penile sonographic dynamic evaluation after intracavernosal injection of alprostadil 20 microg (Caverject, Pharmacia SpA; Milan, Italy); SIEDY questionnaire responses and changes in blood hormonal levels (LH, testosterone, prolactin) before and after treatment were compared. RESULTS: Increased PSV at 10 min and 20 min after alprostadil administration was found in 30% of Group A patients and in 60% of Group B patients. In 40% of Group B patients, the increase in PSV was so significant as to justify reclassification to a less severe diagnostic category (Benson classification) in vascular profile. No changes in hormonal levels after treatment were found in either group. Analysis of the questionnaires showed a more marked reduction in the global total scores in Group B, with a greater frequency and a clearer improvement in global scores. CONCLUSIONS: This study on a group of 20 patients with organic vascular arterial ED disclosed at least 2 basic aspects: 1) a higher percentage of Group B patients (fixed-day treatment regimen) showed a greater improvement in PSV than the controls; 40% of these patients were reclassified according to the Benson classification; 2) within the context of a clinical study, monitoring and supportive care to increase the frequency and quality of sexual intercourse led to a resumption of and a greater interest in sexual activity. This finding cannot be explained by changes in hormonal levels; instead, there appeared a sort of effect placebo that the continuous therapy, like conventional treatment for other health reasons, had on the patient.

Aged↗

PubMedDate not supplied

A home study-based spirituality education program decreases emotional distress and increases quality of life--a randomized, controlled trial.

CONTEXT: Although epidemiological studies have reported protective effects of religion and spirituality on mental health, it is unknown whether spirituality can be used as an intervention to improve psychological well-being. OBJECTIVE: To evaluate the efficacy of a home study-based spirituality program on mood disturbance in emotionally distressed patients. DESIGN, SETTING, AND PARTICIPANTS: A non-blinded, randomized, wait list-controlled trial of 165 individuals with mood disturbance [score of >40 on the Profile of Mood States (POMS)] were recruited from primary care clinics in a Canadian city between August 2000 and March 2001. INTERVENTIONS: Participants were randomized to a spirituality group (an 8-week audiotaped spirituality home-study program), a mindfulness meditation-based stress reduction group (attendance at facilitated classes for 8 weeks), or a wait-list control group (no intervention for 12 weeks). MAIN OUTCOME MEASURES: Primary outcomes were mood disturbance, measured using POMS, and quality of life, measured using the SF-36, a short-form health survey with 36 questions. The POMS and the SF-36 were completed at baseline, at 8 weeks, and at 12 weeks. RESULTS: At the end of the 8-week intervention period, the mean POMS score improvement was -43.1 (-45.7%) for the spirituality group, -22.6 (-26.3%) for the meditation group, and -10.3 (11.3%) for the control group (P<.001 for spirituality vs control group; P=.034 for spirituality vs meditation group). Mean improvement in the SF-36 mental component summary score was 14.4 (48.6%) for the spirituality group, 7.1 (22.3%) for the meditation group, and 4.7 (16.1%) for the control group (P<.001 for spirituality vs control group; P=.029 for spirituality vs meditation group). At 12 weeks, POMS and SF-36 scores remained significantly different from baseline for the spirituality group.

Adult↗

PubMed1995

Patient empowerment. Results of a randomized controlled trial.

OBJECTIVE: The purpose of this study was to determine if participation in a patient empowerment program would result in improved psychosocial self-efficacy and attitudes toward diabetes, as well as a reduction in blood glucose levels. RESEARCH DESIGN AND METHODS: This study was conducted as a randomized, wait-listed control group trial. The intervention group received a six-session (one session per week) patient empowerment education program; the control group was assigned to a wait-list. At the end of 6 weeks, the control group completed the six-session empowerment program. Six weeks after the program, both groups provided follow-up data. RESULTS: The intervention group showed gains over the control group on four of the eight self-efficacy subscales and two of the five diabetes attitude subscales. Also, the intervention group showed a significant reduction in glycated hemoglobin levels. Within groups, analysis of data from all program participants showed sustained improvements in all of the self-efficacy areas and two of the five diabetes attitude subscales and a modest improvement in blood glucose levels. CONCLUSIONS: This study indicated that patient empowerment is an effective approach to developing educational interventions for addressing the psychosocial aspects of living with diabetes. Furthermore, patient empowerment is conducive to improving blood glucose control. In an ideal setting, patient education would address equally blood glucose management and the psychosocial challenges of living with diabetes.

Adaptation, Psychological↗

PubMed2005

Analyzing protein lists with large networks: edge-count probabilities in random graphs with given expected degrees.

We present an analytical framework to analyze lists of proteins with large undirected graphs representing their known functional relationships. We consider edge-count variables such as the number of interactions between a protein and a list, the size of a subgraph induced by a list, and the number of interactions bridging two lists. We derive approximate analytical expressions for the probability distributions of these variables in a model of a random graph with given expected degrees. Probabilities obtained with the analytical expressions are used to mine a protein interaction network for functional modules, characterize the connectedness of protein functional categories, and measure the strength of relations between modules.

Algorithms↗