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Results for “list randomization”

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PubMed1996

A home-based exercise program for nondisabled older adults.

OBJECTIVES: This paper describes a videotaped, home-based, strength training program, titled Strong-for-Life and reports on its effectiveness in improving muscle strength, psychological well-being, and health status in a sample of older persons. DESIGN AND SETTING: We enrolled 102 nondisabled, community-dwelling older people aged 66 to 87, identified from the Medicare beneficiary list, into a randomized, controlled trial. MEASUREMENTS: Effectiveness was based on change in isokinetic upper and lower extremity muscle strength, psychologic well-being, and health status. RESULTS: Results revealed several statistically significant short-term benefits after 12 to 15 weeks of exercise, especially for men. Younger older adults demonstrated a 10% improvement in knee extensor strength relative to control subjects. Older male exercisers achieved significant differences relative to controls in perceived anger, tension, and overall social functioning. Male exercisers, in general, achieved significant improvement in perceived vigor. Women did not report psychological benefits following participation in the program. CONCLUSION: Study results reveal that the Strong for Life program, designed to be widely disseminated to the nondisabled older population, has many short-term positive benefits.

Affect↗

PubMed1983

Amount of therapist contact and outcome in a multidimensional depression treatment program.

An 8-week multidimensional program of behavioral management, cognitive restructuring, and assertiveness training was administered to depressed outpatients either individually with a single therapist (n = 12), in two small groups (n = 11), or one large group (n = 11), or as bibliotherapy (n = 12). A randomly assigned waiting list control group was also included (n = 10). Follow-up assessments were conducted at 18 weeks. Principal findings were that 1) there were no significant pretreatment differences among groups, 2) all treated groups including bibliotherapy improved substantially over the course of treatment, 3) the waiting list control group was unchanged during this same period, 4) there were no significant differences among treated groups at termination or at follow-up, nor did these groups change significantly over the period of follow-up. Thus the effectiveness of this multidimensional program was supported, but its efficacy was not systematically influenced by amount of therapist contact.

Adult↗

PubMed1976

Associative and conceptual organization in thought disorder.

Thought disorder has frequently been described either as a disturbance of associative response hierarchies or as an inability to deal with objects or events as representative of classes. The tendency of normal subjects to organize free recall by clustering associatively or conceptually related words suggested the recall task as a means to investigate these views of thought disorder. Two groups of psychiatric patients, one with high scores on Lovibond's version of the OST, one with low (thought-disordered and non-thought-disordered, respectively), were presented with randomly ordered word lists containing pairs related associatively and pairs related taxonomically. Thought-disordered and non-thought-disordered groups were not differentiated by any tendency to cluster more of one kind of pair than another. Rather, the thought-disordered showed a general lack of organization in recall, and significantly less improvement over trials in amount recalled. The results do not support the view that thought disorder is specifically a disorder of concept use or conceptual mediation. Research needs to be addressed to variables which affect the activation or inhibition of mediational links in thinking.

Adult↗

PubMed1986

Common personality features in neurotic disorder.

The personality characteristics of 77 patients seen in general practice with a Catego diagnosis of anxiety state (including phobic state) or depressive neurosis derived from the Present State Examination were compared with those in 77 normal subjects chosen at random from the list of the same general practitioner. Each patient was matched with a normal subject of the same age and sex. The personality characteristics were rated using the Personality Assessment Schedule, an interview schedule designed to elicit the premorbid personality of the subject. The neurotic patients had significantly higher scores for the personality charcteristics of anxiousness, vulnerability, resourcelessness, hypochondriasis and other features commonly described as oral and hysterical. Schizoid features were absent in the neurotic group. The results suggest that there are common personality attributes in neurotic disorder and that these have clinical significance.

Adolescent↗

PubMed1989

Prevalence of symptoms of dyspepsia in the community.

To study the prevalence of dyspepsia in the community a postal questionnaire was sent to 2697 patients who were selected at random from the lists of patients registered in two health centres in Hampshire. A total of 2066 returned questionnaires were suitable for analysis (response rate 77%). It was found that the six month prevalence of dyspepsia was 38%. There was considerable overlap between symptoms of heartburn and upper abdominal pain, with over half of patients with dyspepsia experiencing both. One in four of these patients had consulted their general practitioner during that time. The proportion of patients with dyspepsia who consulted their general practitioner varied widely among the eight doctors who participated in the study, from 17% to 45%. Frequency of symptoms tended to fall with age, particularly in men, while the proportion of patients with dyspepsia who sought medical advice increased with age. Almost one in five of the 2066 patients had been investigated with radiology or endoscopy at some time, and 143 (7%) of them claimed to have had a diagnosis of peptic ulcer.

Adult↗

PubMed1989

General practitioners' continuing medical education within and outside their practice.

To study continuing medical education 96 out of 101 general practitioners chosen at random from the list held by a family practitioner committee were interviewed. The results provided little evidence of regular attendance at local postgraduate centre meetings, though practice based educational meetings were common. Thirty one of the general practitioners worked in practices that held one or more practice based educational meetings each month at which the doctors provided the main educational content. Performance review was undertaken in the practices of 51 of the general practitioners, and 80 of the doctors recognised its value. The general practitioners considered that the most valuable educational activities occurred within the practice, the most valued being contact with partners. They asked for increased contact with hospital doctors. The development of general practitioners' continuing medical education should be based on the content of the individual general practitioner's day to day work and entail contact with his or her professional colleagues.

Clinical Competence↗

PubMed2001

An analysis of calls referred to the emergency 999 service by NHS Direct.

INTRODUCTION: NHS Direct was launched in West Yorkshire in April 1999. A 999 ambulance can be dispatched to the patient as a result of a call to NHS Direct. The aim of this study is to compare cases that had been referred by NHS Direct via the 999 service, with those who had dialled 999 themselves. METHODS: The study was carried out in three accident and emergency (A&E) departments in West Yorkshire, between 1 April 1999 and 21 August 1999. NHS Direct generated 999 calls were identified. The comparison group was selected at random from a list of all other 999 cases attending the three departments. The study involved retrieving basic demographic data, as well as duration of symptoms before dialling 999, triage category on arrival in A&E and disposal of patient. Ethical approval and statistical advice were obtained. RESULTS: 91 NHS Direct generated 999 calls were identified. Of the comparison group (260 cases), 28 were excluded from the study. There were no differences in the triage categories assigned to the two groups on arrival in A&E. There were notable differences in presenting complaint between the two groups and in particular, trauma was less common among the NHS Direct patients (6.6%) compared with those who had self dialled (37.5%). Patients who had first called NHS Direct were younger (p=0.033) and had endured their symptoms for longer (p<0.001); they were less likely to be admitted, and if discharged, were less likely to have follow up arranged (p=0.014). CONCLUSIONS: Both groups received similar triage categories suggesting that severity of illness is equally well assessed by self as by NHS Direct. There are large differences in case mix between the two groups studied and these almost certainly explain the differences in outcome.

Diagnosis-Related Groups↗

PubMed1999

Respiratory symptoms in older people and use of domestic gas appliances.

BACKGROUND: Studies in children and young women have indicated an increased risk of respiratory illness in association with the use of domestic gas appliances, possibly caused by oxides of nitrogen generated when gas is burned. It is not known whether risks are similarly increased in older subjects. METHODS: A questionnaire about respiratory symptoms in the past year and potential risk factors for respiratory disease was mailed to 6000 men and women aged 65 years and older who were selected at random from the lists of general practices in North Bristol, UK. Associations between symptoms and the use of gas appliances were examined by logistic regression with adjustment for age, sex, social class, and smoking habits. RESULTS: Questionnaires were completed by 4792 (80%) of those mailed. The most common symptoms were exercise induced breathlessness, wheeze, or chest tightness (51%); wheeze (27%); morning phlegm (20%); and daytime breathlessness at rest (19%). In an analysis that included all subjects only weak associations were found with use of gas appliances, odds ratios all being 1.2 or less. The risks associated with use of a gas hob tended to be higher in women, with odds ratios of 1.36 (95% CI 1.01 to 1.83) for wheeze and 1.33 (95% CI 0.56 to 3.17) for morning chest tightness, but were lower than had been reported previously in younger women. CONCLUSION: The absence of stronger associations cannot readily be explained by bias or confounding. Gas cookers and fires are unlikely to be an important cause of respiratory illness in the elderly. If they do cause such illness, the largest risks are likely to be in women who use gas hobs.

Aged↗

PubMed1990

Health workers and AIDS: knowledge, attitudes and experiences as determinants of anxiety.

The objective of the study was to measure the level of HIV/AIDS related anxiety among health care workers and identify its determinants. Data were obtained by means of a mailed, anonymous, self-administered questionnaire distributed to 2561 Danish medical doctors, nurses and nursing aides drawn randomly from the lists of members of the respective national associations. The data were analysed on the basis of a pre-study model including 12 variables hypothesizing a hierarchy of causal dependencies with anxiety at the top. 44% of the participants expressed HIV/AIDS related anxiety--hospital workers more than primary care workers, the older less than the younger. Anxiety was significantly associated with negative/restrictive attitudes towards HIV positives and gay men and with low levels of knowledge about HIV transmission and less education about HIV/AIDS. Negative/restrictive attitudes towards HIV positives were associated both with less knowledge regarding HIV transmission and fewer contacts with HIV positives. Similar associations were found regarding gay men. It is suggested that new kinds of training programmes be established which focus much more on attitudes and norms concerning HIV/AIDS--especially among health care workers with only occasional contact with HIV patients.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Prevalence and burden of self-reported blindness and low vision for individuals living in institutions: a nationwide survey.

BACKGROUND: The prevalence of self-reported low vision (LV) and blindness, and their associated disabilities, handicaps and socio-economic consequences for individuals living in institutions are poorly documented. METHODS: 2,075 institutions were selected at random and eight individuals were picked at random from the list of residents. Three groups of individuals were defined: blind, LV, and a control group (CG). These were compared after adjustment for age and co-morbidities. Of the 15,403 individuals, 14,603 interviews (94.9%) were completed. RESULTS: The prevalence of blindness was 1.6% and the LV 13.4%. Blind individuals needed assistance more often (OR: 2.65 to 11.35) than CG members while the assistance required by LV individuals was similar to that for the CG. Blind individuals required institution adaptation (building and furniture changes) more often than the CG. Blind (57.9%) and LV individuals (35.4%) were more often registered for social allowances. Monthly social allowances were EUR 86 higher for blind than LV individuals. Monthly family incomes were found to be similar between the three groups (from EUR 782 to 797). Social and demographic data, institution description, income, handicaps, disabilities, social allowances and details of daily activities were collected interviews. CONCLUSION: The results demonstrate the impact of self-reported blindness and LV on daily life for patients living in institutions.

Activities of Daily Living↗

PubMed2001

The use of e-mail by doctors in the West Midlands.

We surveyed the use of e-mail by doctors in the West Midlands. In addition to 224 questionnaires distributed to doctors at three large hospitals, 300 general practitioners (GPs) selected randomly from a list of 711 were also sent questionnaires. There was a 60% response rate. Overall, 65% of the 314 respondents used e-mail, but 84% of hospital doctors used email compared with 55% of GPs. E-mail was used mainly for communication with friends and family (92%) and work colleagues (61%), with only 7% using e-mail for transmitting clinical data and 3% to send or receive referrals. E-mail usage showed a significant trend with respect to age, being highest in the 20-29-year age group and lowest among those aged over 60 years. Over 60% of respondents felt that e-mail was not secure for the transfer of patient data. However, 90% felt that they would be using e-mail in a clinical setting in five years' time. Despite the relatively high use of e-mail for social communication, work-related use by doctors was low.

Adult↗

PubMed1996

Analysis of dentists' attitudes towards risks in oral radiology.

OBJECTIVES: To develop a method of measuring dentists' attitudes towards radiation hazards and to describe their prevalence among Swedish general dental practitioners. METHODS: A questionnaire was mailed to 2000 randomly selected dentists listed in the register of the Swedish Dental Society, with a response rate of 69.3%. An index for measurements of attitudes towards radiation hazards was constructed. RESULTS: Those dentists who showed high concern at radiation hazards also restricted their use of X-ray examinations. Years in practice and attendance at extended (one-week) courses in oral radiology both had significant associations with risk attitude. Inexperienced dentists showed less concern for radiation hazards compared with those more experienced and were less scrupulous in their choice of radiographic procedures. Gender, working alone, in the public dental health services or in private practice had no significant association with attitude. Dentists who considered regulations laid down by the Swedish National Institute of Radiation Protection as wholly adequate had a high care attitude. CONCLUSIONS: It is possible to study the relationship between attitudes and clinical behaviour by postal survey. Experience and continuing education affect dentists' attitudes towards risk and these attitudes in turn influence their clinical behaviour.

Adult↗

PubMed2006

Mass-casualty events at schools: a national preparedness survey.

OBJECTIVE: Recent school shootings and terrorist events have demonstrated the need for well-coordinated planning for school-based mass-casualty events. The objective of this study was to document the preparedness of public schools in the United States for the prevention of and the response to a mass-casualty event. METHODS: A survey was mailed to 3670 school superintendents of public school districts that were chosen at random from a list of school districts from the National Center for Education Statistics of the US Department of Education in January 2004. A second mailing was sent to nonresponders in May 2004. Descriptive statistics were used for survey variables, and the chi2 test was used to compare urban versus rural preparedness. RESULTS: The response rate was 58.2% (2137 usable surveys returned). Most (86.3%) school superintendents reported having a response plan, but fewer (57.2%) have a plan for prevention. Most (95.6%) have an evacuation plan, but almost one third (30%) had never conducted a drill. Almost one quarter (22.1%) have no disaster plan provisions for children with special health care needs, and one quarter reported having no plans for postdisaster counseling. Almost half (42.8%) had never met with local ambulance officials to discuss emergency planning. Urban school districts were better prepared than rural districts on almost all measures in the survey. CONCLUSIONS: There are important deficiencies in school emergency/disaster planning. Rural districts are less well prepared than urban districts. Disaster/mass-casualty preparedness of schools should be improved through coordination of school officials and local medical and emergency officials.

Child↗

PubMed2000

[Evaluation of the tuberculin reaction in health occupation students] .

A cross-sectional study was done at the University of Antioquia, MedellIn, Colombia, to evaluate the response to a tuberculin skin test among students in undergraduate health programs (medicine, odontology, nursing, and bacteriology) as compared to undergraduate students in nonhealth programs. The study included students from the beginning, middle, and end of the university's academic programs. The sample of 490 students included 273 from health programs and 217 from nonhealth programs. Participants were randomly selected using lists provided by the university registrar, for the second semester of 1998. The presence of a BCG vaccination scar was determined, and all the participants were also questioned about TB-related risk factors. Tuberculin skin test reactivity was evaluated by the size of induration 72 hours after intradermal injection of two tuberculin units of purified protein derivative RT 23. There were no differences in tuberculin reactivity between students from the health programs and from the nonhealth programs, irrespective of the academic level. However, there was a significantly higher proportion of positive skin tests among students with a BCG scar. These results suggest that undergraduate health students do not have extensive contact with TB patients or with clinical samples from such patients. Nevertheless, the results do not rule out TB as an occupational risk for health personnel.

Adult↗

PubMed2002

The general public's perceptions and use of antimicrobials in Trinidad and Tobago.

OBJECTIVE: To determine the general public's perceptions and use of antibiotics in Trinidad and Tobago, a two-island republic in the Caribbean. METHODS: This prospective study surveyed 824 randomly selected households listed in the telephone directory, from November 1998 to January 1999. Through telephone interviews we determined knowledge about antibiotics and beliefs concerning their safety and efficacy. We studied the influence of age, gender, education, and having private health insurance on knowledge, self-medication, storing medication at home for emergency use ("hoarding"), and asking a private doctor to prescribe antibiotics ("demand prescribing"). RESULTS: For the 824 telephone calls that the interviewers completed, 753 of the households agreed to participate (91.4% response rate). Of those 753 participants, 699 of them (93%) knew the term "antibiotic," 29% (206/699) said it was a drug for bacterial infections, and 25% (170/690) had asked a doctor for an antibiotic prescription. Penicillin was correctly identified as an antibiotic across age, gender, and education categories, but 36% of respondents incorrectly said Benadryl (diphenhydramine), a common over-the-counter cough and cold formulation, was an antibiotic. Gender was not significantly associated with knowledge of antibiotic safety, with self-medication, or with hoarding antibiotics. On the other hand, completion of tertiary (university) education was significantly associated with correct knowledge of the safety of antibiotics and whether or not they could cure all infections. Of the various antimicrobials, beta-lactams were the ones that survey respondents had used most frequently in the preceding year, and 20% of antibiotics users had used multiple antibiotics in that period. In comparison to persons with private health insurance, more individuals without private health insurance said that antibiotics are safe and do not have side effects, and more of them also incorrectly called aspirin and Benadryl antibiotics. CONCLUSIONS: In Trinidad and Tobago, inappropriate use of antimicrobials results from self-medication, over-the-counter availability at the community pharmacy, prescribing on demand, and lack of regulatory control. In order to contain antibiotic abuse, both the Drug Inspectorate of the Ministry of Health and the Pharmacy Board should exert stricter control on the dispensing of antibiotics at private pharmacies. Further, education of the general public and of health care professionals on antibiotic misuse and appropriate use must be instituted, along with community-based surveillance of antimicrobial resistance trends.

Adolescent↗

PubMed1989

Predicting child abuse and neglect in New Zealand.

We describe the three stages of our attempt to predict parenting problems and child abuse antenatally. In the first stage, we made an intuitive check list of ten items from 173 risk factors drawn from the literature. The check list was useful in predicting who would relinquish care or have major parenting difficulty in two different samples drawn four years apart and before and after some major sociocultural changes in New Zealand. In the second stage we used statistical techniques rather than intuition to maximise the predictive ability of the checklist and produced a new one of 9 items. In the third stage we validated the new list in a random sample of pregnant mothers. It was effective in predicting parenting difficulty in the 2 years after childbirth. We recommend it for routine use in a New Zealand setting. We do not know how useful the checklist will be in other cultural settings.

Child Abuse↗

PubMed1995

Factors affecting herd milk composition and milk plasmin at four levels of somatic cell counts.

A longitudinal study was carried out on samples of bulk tank milk collected from 200 farms for 12 mo to evaluate SCC, plasmin and plasminogen activities, psychrotrophic bacteria count, and protein quality in milk and to examine the proteolytic effects of plasmin on milk proteins. Herds were selected randomly from client lists of two dairies to create four groups based on milk SCC of the month before the study; herds were reassigned monthly to one of four groups based on SCC for that month. Overall means were 3.73% fat, 3.13% protein by infrared analysis, 3.16% protein by Kjeldahl analysis, 2.42% casein percentage, 4.65% lactose, 5.43 cells/ml of log SCC, 1.13 U of plasmin, 45.6 U of plasminogen, and log 2.86 cfu/ml of psychrotrophic bacteria. The ANOVA showed a significant effect of month on all factors except SCC, which was fixed by the experimental design. Plasmin and plasminogen activities were high from December to May. Plasmin activities and psychrotroph counts were significantly higher for the high SCC group. Casein percentage and number were significantly higher for the low SCC group.

Animals↗

PubMed2002

Part-set cuing of false memories.

Part-set cuing inhibition describes the common finding that re-presenting items from a word list can reduce subjects' overall recall performance for studied items. Do part-set cuing effects occur for false memories as well? In the present experiments, subjects studied lists of words drawn from Roediger and McDermott (1995). After studying each list, subjects completed math problems and then recalled the list items either with or without accompanying list cues. In Experiment 1, the recall cues consisted of items drawn randomly from the original list. In Experiment 2, an additional type of cued recall task was added in which the even numbered list items were used as cues. Taken together, these experiments demonstrate robust part-set cuing effects for critical nonpresented items. In addition, they show that whereas recall of critical words is reduced by the presence of cues at test, retrieval cues do not affect critical words and studied words in exactly the same manner.

Attention↗