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PubMed2004

Psychometric properties of the Medical Outcomes Study Sleep measure.

BACKGROUND AND PURPOSE: Sleep is an active and highly organized biological process that is an important component of life. Self-report measures of sleep provide information that can be useful for characterizing the quality of sleep in subgroups of the population. A 12-item self-report sleep measure, the Medical Outcomes Study Sleep measure, was developed and evaluated previously in a sample of 3445 individuals with chronic illness. PATIENTS AND METHODS: In this study, we evaluate the psychometric properties of the MOS Sleep measure in a nationally representative sample of 1011 US adults aged 18 and older and in a sample of 173 adults with neuropathic pain participating in a clinical drug trial. RESULTS: The average age of the general population sample was 46; 51% were female and 81% were white. The average age of the sample of adults with neuropathic pain was 72; 53% were female and 95% were white. Internal consistency reliability estimates for the MOS Sleep scales were 0.73 or higher, with the exception of the daytime somnolence scale in the US general population, which was 0.63. At baseline of the clinical trial, the neuropathic pain patients reported significantly more sleep disturbance and daytime somnolence, as well as less quantity and adequacy of sleep than patients in the general US population. The MOS Sleep scales were found to be responsive to change in the clinical trial with statistically significant improvements observed after administration of pregabalin for sleep disturbance (standardized response mean, SRM=-0.76, P=0.0007), shortness of breath (SRM=-0.20, P=0.0302), sleep adequacy (SRM=0.57, P=0.0014), sleep quantity (SRM=0.55, P=0.0086), and sleep problems (SRM=-0.62, P=0.0036). CONCLUSIONS: This study provides further support for the reliability and validity of the MOS Sleep measure. The instrument can be used to assess important aspects of sleep perceived by adults in the general population or participating in clinical studies.

Adult↗
PubMed2003

Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding (STOP-DUB): design and methods.

The Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding (STOP-DUB) was a multicenter, randomized clinical trial that assessed the efficacy and effectiveness of hysterectomy versus endometrial ablation (EA) for dysfunctional uterine bleeding (DUB) in women for whom medical management has not provided relief. Resource centers included a coordinating center, a chair's office, the American College of Obstetricians and Gynecologists, the Agency for Healthcare Research and Quality Project Office and 33 clinical centers in the United States and Canada. STOP-DUB enrolled: (1) eligible patients for whom medical treatment had not been successful and who were randomized to either hysterectomy or EA and (2) an observational cohort of patients who were "provisionally ineligible" or who were eligible but did not wish to be randomized. Enrollment began in October 1997 and ended in June 2001. The primary outcome addressed by the randomized trial was the impact of surgery on bleeding, pain, fatigue, and the major problem (symptom) that led the woman to seek treatment for her condition, measured 1 year following surgery. Additional outcomes included the impact of surgery at time points after 1 year; changes in quality of life, activity limitation, sexual functioning, and urinary incontinence; surgical complications; additional surgery; and resource utilization. The costs and the relative cost-effectiveness of the two surgeries were calculated. The main scientific objective for the observational study was to examine changes over time in terms of treatment selected, DUB-related symptoms, and quality of life.

Female↗
PubMed2003

A qualitative exploration of rural feeding and weaning practices, knowledge and attitudes on nutrition.

AIM: An exploratory qualitative investigation was done to determine the feeding and weaning practices, knowledge and attitudes towards nutrition of mothers/caregivers of children up to 3 years old attending baby clinics in the Moretele district (South Africa). METHODOLOGY: Qualitative data collection on six relevant nutrition topics was done using focus group interviews. Trained moderators, using a pre-tested, structured interview schedule, interviewed participants in six age groups. Focus group interviews were taped, transcribed and translated. Content analysis produced systematic data descriptions and ethnography provided descriptive data. RESULTS: Breast-feeding was the choice feed and bottle-feeding was only given when breast-feeding was impossible. Solid food was introduced early (at 2-3 months) and a mixed family diet at 7-9 months. Milk feeds were stopped completely from 18-24 months. Weaning diets were compromised due to poor food choices, preparation practices and limited variety. The participant's nutrition knowledge regarding specific foods, their functions and recommended quantities was poor. The women adhered to their cultural beliefs regarding food choices and preparation practices. CONCLUSION: The data analysis revealed that inadequate nutrition knowledge and adherence to cultural practices lead to poor-quality feeding practices. Cultural factors and taboos have a powerful influence on feeding practices and eating patterns. Young mothers often find it impossible to ignore their ill-informed elders or peer group. Nutrition knowledge needs to be changed in a first step towards implementing improved feeding practices. Facilitated group discussions could focus on possible solutions for the identified nutrition-related problems.

Bottle Feeding↗
PubMedDate not supplied

A qualitative study of the physical, social and attitudinal environments influencing the participation of children with cerebral palsy in northeast England.

PURPOSE: The social model of disability considers participation to be determined by the social, attitudinal and physical environments experienced by an individual. This study aims to ascertain from families of children with cerebral palsy the features of such environments which facilitate or restrict participation. METHOD: Thirteen in-depth interviews using a topic guide were conducted with the parents of children with cerebral palsy. Interviews were tape-recorded, transcribed and analysed with NVivo software. RESULTS: The main themes emerging from the interviews were the importance of mobility, transport, support by and to parents and attitudes of individuals and institutions towards children. Most parents did not raise the policies and legislation determining participation barriers, although these are also likely to be influential. CONCLUSIONS: This study confirms the importance of the environment for the participation of children with cerebral palsy. Statutory agencies need to attend the attitudes and policies in their organization in order to plan the inclusive environments which parents report will facilitate their child's participation. This study also contributes to the development of a tool to quantify the environment to allow the development of models to determine the environments which maximize children's participation.

Activities of Daily Living↗
PubMed1996

Pediatric AIDS and advanced directives: a three-year prospective study in New York State.

Most HIV-infected families currently receive their care in an ambulatory setting. Ambulatory care provides greater means of medical care, and planning for the infected family members. Advanced Directives (AD) and Do Not Resuscitate (DNR) for adults are now discussed in an ambulatory setting rather than under the duress of a hospital admission. We felt it is important to examine the practice of discussing AD/DNR with the families of pediatric AIDS patients in an out patient setting. Twenty-one and 26 AIDS-designated centers in New York State and five major hospitals in New York City were contacted through a telephone survey in 1991 and 1994, respectively. Questions were designed to obtain demographics of the hospital, pediatric AIDS population, and their DNR/AD policies. In 1991 and 1994, the survey was conducted with the pediatric unit of hospitals with pediatric AIDS. In 1991, only 12 (75%) hospitals had an existing policy on pediatric DNR. No hospital had admitted a patient with AD/DNR obtained as an outpatient, nor were there guidelines at any hospital to approach the issue in an outpatient setting. In 1994, 20 (95%) hospitals had a DNR policy for pediatric patients. We found that even though six patients were admitted with AD obtained as outpatients, no outpatient guidelines existed for AD/DNR for pediatrics. The number of cases of pediatric AIDS in New York State increased by 29.7% for the 1991-1994 period. While pediatric DNR existed in 1991/1994, we found there were presently no guidelines for obtaining AD/DNR for pediatric AIDS patients in an ambulatory setting. Families infected with HIV should have a caring atmosphere to help them address pediatric AD/DNR with their primary care providers. However, we believe that guidelines should be developed to address this issue.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Willingness to participate in clinical treatment research among older African Americans and Whites.

PURPOSE: Using a health services utilization conceptual framework, the purpose of this analysis was to examine race differences in factors predictive of the behavioral intention of older persons to participate in a clinical treatment trial should they have a diagnosis of cancer. In addition, the analysis sought to determine if older African Americans were less likely than Whites to express willingness to participate, given knowledge of the Tuskegee syphilis study and greater fatalistic cancer beliefs. DESIGN AND METHODS: Data were drawn from a community-based telephone survey of 216 African Americans and 222 Whites, 50 years of age and older. RESULTS: Findings show that willingness to participate was significantly higher among males, persons of younger age, higher incomes, and with nonfatalistic cancer beliefs. Race differences were only apparent for the two significant interactions of race with age and high income. Neither knowledge of the Tuskegee study nor fatalistic cancer beliefs were more important for African Americans than for Whites. IMPLICATIONS: Study findings suggest that recruitment strategies need to be tailored to racial differences in factors affecting willingness to participate, particularly those related to age and income level.

Black or African American↗
PubMed1985

Criteria for selection of future physicians.

Academic achievement correlates poorly with clinical performance of physicians, so it is probably more important to select college students for medical school admission who will be superior physicians than to select those who will be excellent medical students. Before such selection criteria can be developed, a valid description of a superior physician must be determined. The relative importance of 87 characteristics of a superior physician, based on a previously published list, was determined by asking medical school faculty members to rate them. The resulting description of a superior physician is valid, because it correlated very highly (r = 0.87, p less than 0.001) with the published ratings of the same characteristics from decades earlier in another part of the country, and because it was constant across many subgroups. The faculty was also asked to rate how easily each characteristic could be taught, and those ratings were validated by high correlations across several subgroups. The importance and the teachability ratings were combined into a nonteachable-important index (NTII) that provides a rank order of traits that are important but cannot be taught easily. These are the characteristics that should be used in selecting future physicians.

Character↗
PubMed1994

Getting research into practice: facing the issues.

The translation of research into practice is currently a high-profile issue in the NHS. A number of regions have undertaken work in this area. Reports on a project that is part of the Anglia and Oxford Regions's "getting Research into Practice" (GRiP) initiative. The work focuses on the use of steroids in pre-term delivery, a procedure that medical evidence suggests can reduce neo-natal mortality and morbidity. Presents a number of findings which suggest that getting research into practice does not merely rest on the availability of well-researched evidence.

Attitude of Health Personnel↗
PubMed1981

Evaluation of teaching on interpersonal interactions.

In 1978, the second-year pre-clinical Behavioural Sciences course at Monash University Medical School was restructured to improve monitoring of, and feedback on, the development of interpersonal relationships between individual students and individual old age pensioners they were studying. Results indicate that integration of lecture, discussion, and practical experience with a carefully defined, multistage project appears to help students in learning about interpersonal relationships, and helps staff to evaluate both student performance and teaching.

Australia↗
PubMed1993

Reliability in headache diagnosis.

The reliability of headache diagnosis using the criteria of the International Headache Society (IHS) has not been well studied. One definition of reliability refers to the reproducibility of diagnoses assigned to the same individual at different times. Reproducibility of diagnosis should be assessed using different clinicians at different times, with or without specific diagnostic instruments. A diagnosis may be unreliable because of variability in diagnostic criteria, in the clinical information used to assign diagnoses, or in the interpretation and application of clinical information to a given set of diagnostic criteria. Reliable diagnostic methods are essential to the development of valid diagnostic methods, as well as for the identification of headache risk factors, biological markers, and effective treatments. An approach to studying the reliability of the International Headache Society criteria is outlined, modeled after the extensive studies conducted in the area of psychiatric diagnosis.

Evaluation Studies as Topic↗
PubMed2004

Design of a case management approach to enhance cancer screening trial retention among older African American men.

PURPOSE: The purpose of this study was to enhance retention among African American men enrolled in a cancer screening trial. DESIGN: A telephone-based, randomized trial design was used. The intervention group included 352 African American men aged 55+. Case managers contacted participants at least monthly and provided information and referral services to participants and their relatives. RESULTS: The mean age of participants was 65.7 years. A total of 14,978 calls were made resulting in 780 referrals. The 10 most frequent referrals were for scheduling medical appointments, health information, insurance information, legal aid, transportation, cancer screening information, information technology/computer information, employment, housekeeping/chore services, and food programs. CONCLUSIONS: The case managers served as links between participants and community-based resources. The types of referrals made could be associated with the age-related needs of the participants.

Black or African American↗
PubMed1992

Strategic marketing for charitable organizations.

A new marketing strategy unites major for-profit corporations with charitable organizations in such a way that both benefit. Most major charitable organizations are finding cause related marketing a new strategy for fund raising. The largest charities in the country including the Red Cross, Special Olympics and the American Heart Association have all become involved with cause related marketing and have all realized its benefits. With these benefits come some risks. The decade of the 1990s should include increased awareness and participation among charitable organizations regarding cause related marketing.

Charities↗
PubMed1996

[Perception of blockage or facilitation of communication: an experiment].

Based on the reference work of FORREST (1983), we conducted an experiment in order to determine how interviewees (6th semester nursing undergraduate course) perceive a dialogue, taking into consideration 12 items of evaluation (opening, interest, changing subject, directed questions, disapproval of the subject, tranquility, tension, counseling, recognizing feelings, reflection about the topics, approval, and flight from the topics). Treatment consisted of interviews with different proportions of categories of facilitating (F) and blocking (B) communication: Group A-55% F category and 45% B category; Group B-75% B category and 25% F category. There was no statistical difference between groups in terms of any of the proposed evaluation items. We emphasize the fact that the interviewer was known by interviewees. The topic was easy to approach and the level of relationship was of the horizontal type.

Attitude↗
PubMedDate not supplied

Evaluation of the Australian Medical Association drink-driving campaign in Wollongong.

A pilot public education campaign against drink-driving directed towards 18-24-year-old men in Wollongong in 1982 is described. Analysis suggested significant behavioural change in the target group. This was shown by a reduction in traffic accidents and by some reduction in drink-driving convictions. While a comparative assessment of the knowledge and attitudes of the community before and after the campaign showed a marked awareness of the campaign, attitudinal changes to drink-driving were equivocal.

Accidents, Traffic↗
PubMed1990

Workplace flexibility.

Whether your organization is in a growth pattern or downsizing, you are probably facing change. To gain some insight into your options, here is an in-depth look at the problems and benefits of some flexible work arrangements from a just published study by Catalyst.

Employment↗
PubMed1991

Securing your assets.

Explore the source record for details and available documents.

Evaluation Studies as Topic↗
PubMed1991

Hospital agenda to prioritize. Interview by Donald E. Johnson..

How does a teaching hospital balance the needs of patient care with its educational mission? What changes in focus must the CEO make to accommodate reductions in federal funding while maintaining academic excellence? In the following interview with Health Care Strategic Management's Donald E. L. Johnson, John D. Forsyth, executive director of the University of Michigan Hospitals, discusses the challenges facing his institution. The interview focuses on many topics including setting priorities, funding researchers and countering any "anti-science" perceptions.

Health Priorities↗