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PubMed2001

How do residents prioritize smoking cessation for young "high-risk" women? Factors associated with addressing smoking cessation.

BACKGROUND: Sixty-seven percent of physicians report advising their smoking patients to quit. Primary care residents' priorities for preventive health for a young "high-risk" female are unknown. Factors related to residents addressing smoking also need examining. METHODS: One hundred residents completed a survey about preventive health issues for a woman in her 20s "who leads a high-risk lifestyle." Residents indicated which topics they would address, and the likelihood that they would address each of 12 relevant preventive health topics, their outcome expectancies that the patient would follow their advice on each topic, their confidence that they could address the topic, and perceived barriers for addressing the topic. RESULTS: Residents listed STD prevention most frequently. Drug use and smoking cessation were second and third most frequently listed. Residents who believed that the patient would follow their advice were more likely to list smoking cessation than residents who had lower outcome expectancies for that patient. Higher barriers were negatively related to addressing smoking cessation. CONCLUSIONS: When time is not a barrier, residents are likely to address smoking cessation. Teaching residents how to incorporate this subject into their clinical practice is needed. Raising residents' outcome expectancies may increase their likelihood of addressing smoking cessation.

Adult↗

PubMed1984

A novel system to obtain addresses of out-patients--assessment in routine clinic practice in Madras, S. India.

A novel method of obtaining accurate home addresses from out-patients was introduced as a routine procedure in 6 chest clinics of Madras City, following highly satisfactory results under study conditions. In this method, the patient is given a card (the address card), and asked to get his exact address entered on it by any knowledgeable person of his choice such as a landlord or neighbour. An assessment of the system was undertaken after it had been in operation for about 8 months. A complete and legible address was available for 82% of 3956 patients, the range in the 6 clinics being 74% to 91%. The main causes for failure were: not giving address card to patient (7%), patient not reattending the clinic (6%), and patient reattending but not returning the address card (3%). Corrective measures have now been introduced, and a re-assessment will be undertaken in due course.

Ambulatory Care Facilities↗

PubMed1994

Do doctors address the concerns of patients with diabetes?

Diabetes has an impact on people at both a biomedical and a holistic level. Furthermore there is a legitimate and substantial 'medical agenda' which doctors must address. But does this mean that they fail to deal with the concerns of their patients? A questionnaire study of diabetic patients attending the Manchester Diabetes Centre found that not all the patients' concerns were addressed in 25.5% of consultations. 220 (98%) patients were recruited from 225 approached. Not surprisingly, those who expressed three or more concerns were significantly less likely to have all their concerns addressed compared with those who had only one or two concerns (p = 0.001). The probability of having an individual concern addressed was 0.82. It was also found that Black-Caribbeans were significantly less likely to have their concerns addressed than Whites especially if they were over 60 years old (p = 0.03). This study concludes that doctors should be particularly aware of the needs of patients who express many concerns, and especially if they are Black-Caribbeans. Further research should develop strategies for improving the ability of doctors to identify and address the concerns of their patients.

Black or African American↗

PubMed1984

Age-sex registers as a screening tool for general practice: size of the wrong address problem.

Age-sex registers were compiled and updated for the east London general practices participating in a screening study for hypertension. Of 1435 addresses in the registers of two practices that were checked, 228 (16%) were incorrect, according to the return by the post office of the screening invitations and checking the addresses of the non-responders using telephone directories and the medical records. The non-responders to the screening invitation for whom a new address was not found, were visited at the address as recorded on the age-sex register. This showed that the true address error rate from the original age-sex registers was 26% and thus substantially greater than that calculated from returned letters. It is concluded that the non-acceptance rate of screening in general practice might be exaggerated as a result of the lack of a correct address for a substantial proportion of the patients on a general practice list.

Age Factors↗

PubMed2000

To what extent does South African mental health and substance abuse research address priority issues?

OBJECTIVE: To investigate the extent to which South African mental health research addresses priority issues. DESIGN: Cross-sectional survey of conference presentations. SETTING: The most recent conferences of the following professional societies: the Epidemiological Society of Southern Africa, the Psychological Society of South Africa, the Society of Psychiatrists of South Africa, and the South African Association for Child and Adolescent Psychiatry and Allied Disciplines. MAIN OUTCOME MEASURES: Whether the presentations addressed priority areas as defined in the list 'Selected priority areas of research' compiled by the Mental Health and Substance Abuse Thrust of the Medical Research Council, and if so which priority areas were addressed. RESULTS: There were 627 presentations, with 267 (43%) on mental health or substance abuse. Seventy-eight papers (29%) reported original research in a priority area identified by the Medical Research Council. Of these, 73 (94%) were on mental health and 5 (6%) were on substance abuse. Of the 73 papers on mental health, 33 (45%) addressed topics in health problem research, 7 (10%) aetiology research, 22 (30%) intervention research, and 11 (15%) operational and health systems research. CONCLUSION: Much South African mental health research does not address priority issues. There is a particular dearth of research addressing substance abuse research priorities. Funding mechanisms and research capacity development initiatives could help to rectify the situation.

Cross-Sectional Studies↗

PubMed1988

[Highly effective complementary addressed laser modification (cleavage) of oligodeoxynucleotides].

Complementary addressed nonlinear photomodification of oligodeoxynucleotide dAGAGTATTGACTTA ("target") has been carried out by means of fluorescent derivatives of oligonucleotide dpAATACTCT ("addressed chromophore"). Three different ethidium derivatives were used as a chromophore. The photomodification was induced by nitrogen laser radiation (337 nm, 15 MW/cm2), which led to the target cleavage in the addressation region with the yield of the main fragment (8 bases long) about 10%, formation of specific covalent adduct target-addressed chromophore with the yield 20-70%, "hidden" (not revealed by gel electrophoresis) target damages with 7-27% yield (for different chromophores). The total yield of specific (i. e. localized in the vicinity of the addressation site) modification was 50-80%. The target cleavage and hidden damage generation are optically nonlinear processes. Piperidine treatment of the irradiated samples caused addressed cleavage of the target with up to 40% yield. All kinds of observed modification are not effected by high concentrations of free radical scavengers, 1,3 M t-BuOH or 10 mM cystamine. The bulk of the data is in agreement with the mechanism of nonlinear photomodification (the cleavage and hidden damage generation) based on the transfer of two-photon excitation energy from the chromophore to the target.

Base Sequence↗

PubMed1992

Standardization of network addressing in picture archiving and communications systems utilizing the ISO OSI protocols.

The establishment of a communications network requires the definition of addressing schemes to identify systems attached to the network. When it is anticipated that such a network will interconnect to, or communicate with, other similar networks it is beneficial to define standardized addressing schemes. This paper discusses the need for the standardization of network service access point (NSAP) addresses in picture archiving and communications systems (PACS) which use the open systems interconnect (OSI) communications protocols. Possible methods for establishing the necessary hierarchy of address registration authorities are discussed, along with the corresponding address formats.

Computer Communication Networks↗

PubMed1990

Design of peptidomimetic delta opioid receptor antagonists using the message-address concept.

Highly selective nonpeptide ligands with potent delta opioid receptor antagonist activity have been developed using the message-address concept. This approach envisaged the delta opioid receptor to contain two major recognition subsites; a message subsite which recognizes the pharmacophore, and an address subsite that is unique for the delta receptor type and confers selectivity. The message and address components of the delta-selective enkephalins were postulated to be Tyr1 and Phe4, respectively, with Gly2-Gly3 functioning as a spacer. The message component of the target compounds in this study was derived from naltrexone and related structures. An indole system was fused to the C ring of naltrexone as a mimic of the address component. The benzene moiety of indole was viewed as the delta address component, mimicking the phenyl group of Phe4, and the pyrrole portion was used as a rigid spacer. Members of the series (1-23) were evaluated for opioid antagonist activity on the guinea pig ileum (GPI) and mouse vas deferens (MVD) preparations. Naltrindole (NTI, 1) was the most potent member of the series, with Ke values of approximately 0.1 nM at delta receptors. The antagonism by NTI was approximately 220- and 350-fold greater at delta than at mu and kappa opioid receptors. The binding of NTI and selected members of the series to guinea pig brain membranes was qualitatively consistent with their pharmacologic antagonist activity profiles in the MVD and GPI, but the Ki values were not in the same rank order. The selectivity of NTI arises mainly as a consequence of increased affinity at delta receptors. Thus, the Ke and Ki values of NTI were 1/530 and 1/90 that of the delta antagonist enkephalin analogue, ICI 174864. In contrast to NTI, ICI174864 derives its selectivity through greatly decreased recognition at mu and kappa receptors. The implications of the high affinity and selectivity of NTI as a consequence of its conformational rigidity are discussed. It is suggested that any attempt to model a receptor-bound conformation of an opioid peptide should consider affinity and potency at multiple receptor sites rather than selectivity alone.

Animals↗

PubMed2001

Ergonomics of electronic mail address systems: related literature review and survey of users.

The paper reviews the cognitive ergonomics literature related to electronic mail (e-mail) address design. Based on this information, a survey of 160 users of current e-mail address system was conducted. The aim was to obtain information on likes, dislikes and difficulties associated with e-mail address and to obtain users' suggestions and input for improving the current e-mail address system. The survey results indicated that users want an improved e-mail address system with regard to shorter length, useful information and appropriate presentation of information.

Computer Communication Networks↗

PubMed2001

Ergonomics guidelines for designing electronic mail addresses.

The aim was to design a human-centred electronic mail (e-mail) address system based on networking technology and cognitive ergonomics. Based on the background literature and the results of users' survey, a conceptual model is developed for designing e-mail addresses. This model consists of e-mail address components of formats, domain length, meaningfulness, orientation and information type pertaining to recall, information association and categorization. Five hypotheses were proposed to test the conceptual model, and four experiments were conducted with 85 participants to test the hypotheses. The dependent variables were performance time, error rate and degree of satisfaction, and the independent variables were components of the e-mail addresses. The main results indicate that for a recall task, significantly lower total performance time (26.2%) and error rate (75%) were found for the hybrid formats (digits and letters) than for the letter format, and up to four characters was the best single domain length. For an information association task, embedding both geographical and organizational information significantly decreased the response time (10.9%) in comparison with only embedding organizational information. For a categorization task, embedding both geographical information and organizational information significantly decreased response time (40.7%) in comparison with only embedding organizational information. This research demonstrates the importance of human-centred design and provides guidelines in effectively designing e-mail addresses.

Computer Communication Networks↗

PubMed1996

Terms of address: implications for nursing.

Nurses are in a position of power over their clients. Power is reflected by status and clients, like all other people, have status relative to their social situation. Terms of address are one of the ways that status and solidarity are demonstrated. They are selected on the basis of the perceived status of the nurse and client, and the solidarity of the relationship. There is a tension between solidarity and status that can cause nurses to select inappropriate terms of address or referring pronouns. The nurse may choose terms of address to increase solidarity in the relationship, for example, to show empathy with the client's apparent vulnerable condition. By increasing solidarity the client's status may seem to be diminished. Clients may have to submit to many invasive, painful, embarrassing or humiliating experiences at the nurse's request. Many of these situations are beyond ordinary acceptable behaviour outside the clinical context. Distress to clients is minimized if they retain as much control as possible and one way keeping a certain amount of control is by maintaining their status. In making a selection of terms of address and pronouns, the nurse must consider the delicate nuances of the options available so that the status of the client is not compromised. This paper discusses the options available in selecting terms of address and referring pronouns, and the sociological implications of those choices.

Age Factors↗

PubMed1997

Spouses with identical residential addresses before marriage: an indicator of pre-marital cohabitation.

This article analyses new data on identical address marriages in England and Wales during 1994. It outlines previous background research which has provided good evidence that identical address marriages are likely to be ones in which the couple premaritally cohabited. Recent evidence, based on results from the General Household Survey, is also presented. The article analyses the number and characteristics of identical address marriages, both to provide new (proxy) information on pre-marital cohabitation, and also to announce the publication of a new set of tables on identical address marriages which will be included in the Marriage and Divorce Statistics annual reference volume in future years. Overall, six in every 10 couples marrying in 1994 gave identical addresses. The pattern of variation of this proportion among different subgroups of couples who married in 1994 is analysed--according to: age at marriage; the previous marital status of the partners before marriage; the manner of solemnisation of the marriage, and, for religious weddings, by denomination; by day of the week; month of the year, and by the county in which the wedding took place.

Adult↗

PubMed2000

Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care.

Socioeconomic and racial/ethnic disparities in health care quality have been extensively documented. Recently, the elimination of disparities in health care has become the focus of a national initiative. Yet, there is little effort to monitor and address disparities in health care through organizational quality improvement. After reviewing literature on disparities in health care, we discuss the limitations in existing quality assessment for identifying and addressing these disparities. We propose 5 principles to address these disparities through modifications in quality performance measures: disparities represent a significant quality problem; current data collection efforts are inadequate to identify and address disparities; clinical performance measures should be stratified by race/ethnicity and socioeconomic position for public reporting; population-wide monitoring should incorporate adjustment for race/ethnicity and socioeconomic position; and strategies to adjust payment for race/ethnicity and socioeconomic position should be considered to reflect the known effects of both on morbidity. JAMA. 2000;283:2579-2584

Empirical Research↗

PubMed1996

Use of participatory ergonomics teams to address musculoskeletal hazards in the red meat packing industry.

Participatory ergonomics teams from two departments of a pork slaughtering plant analyzed musculoskeletal hazards and proposed ergonomics solutions for several jobs in the plant. The jobs were targeted based on association with a large number of injuries, one or more particularly severe injuries, high workers' compensation expenses, and/or high turnover plus absence of obvious solutions to abate the hazards. The teams used a structured problem-solving method that was generally derived from principles associated with quality improvement processes. Workers performing the targeted jobs were involved in the problem-solving process, even if they were not members of the team. The effectiveness of each team was assessed and compared in terms of the number of problem jobs addressed and feedback from team members. One team addressed all nine of its targeted jobs; the other team addressed eight of 12 targeted jobs. Feedback from team members regarding their teams' methods and performance was generally favorable. The major obstacle to effective team functioning in this project was the scheduling of meetings. There were also some obstacles related to team leadership. Overall, this project demonstrated that the use of participatory ergonomics teams that rely on structured problem-solving methods are able to work effectively to address musculoskeletal hazards, especially related to the upper extremities, in the red meat packing industry.

Animals↗

PubMed1994

Addressing alcohol use among primary care patients: differences between family medicine and internal medicine residents.

OBJECTIVES: To determine whether rates of addressing alcohol use differed between family medicine and internal medicine residents, and to determine whether attitudes, confidence, and perceptions affected these relationships. SETTING: Two university outpatient clinics, one staffed by family medicine and the other by primary care and categorical internal medicine residents. DESIGN: Cross-sectional study of consecutive patients who had been followed by second- and third-year residents for at least one year. MEASUREMENTS: Alcohol abuse was determined using the Michigan Alcoholism Screening Test (MAST), with a score > or = 5 considered positive. Rates of addressing alcohol use in the preceding year were determined by patient report and chart review. Attitudes were assessed using the Substance Abuse Attitude Survey (SAAS). RESULTS: 334 patients of 49 residents completed the MAST. Rates of alcoholism among the patient groups were: family medicine, 8.3%; primary care, 29.1%; and categorical medicine, 18.0% (p < 0.001). Screening behavior varied by type of residency: 47% of the family medicine, 71% of the primary care, and 65% of the categorical residents' patients reported being asked about alcohol use in the preceding year (p < 0.001); chart documentation was present for 15% of the family medicine, 38% of the primary care, and 24% of the categorical residents' patients (p < 0.001). Perceived prevalence of alcohol abuse, confidence in intervening, and several scales on the SAAS were related to residency type and to addressing alcohol use, but controlling for these variables did not affect the association between residency type and either patient report or chart documentation of screening. CONCLUSION: Rates of addressing alcohol use differed for internal medicine and family medicine residents, but were not due to differences in resident perceptions and attitudes.

Alcoholism↗

PubMed1979

An investigation of the accuracy of the home address given by patients in an urban community in South India.

Studies were undertaken in three tuberculosis clinics in Madras, a large Indian city with a good civic organization, to assess the accuracy of address recorded routinely by registry clerks at the patient's first clinic attendance. The accuracy was poor, with 20% to 30% of the letters posted not reaching the patients. It was appreciably improved, by 10% to 20%, by supplementing the clerk's efforts with questioning by a motivated, experienced health visitor. An address card, a card on which the patient's address was recorded by the local postman or a literate neighbour, relative or friend, was returned by 90% to 94% of the patients, and the accuracy of addresses was found to be at least as good as that obtained with the health visitor. Even when all three sources of information were considered, the patient's home could not be traced in 3% of cases and was found with difficulty in 4%.

Community Health Nursing↗

PubMed1999

Addressing global warming and biodiversity through forest restoration and coastal wetlands creation

The Climate Challenge is a partnership between the Department of Energy and the electric utility industry to reduce, avoid, and sequester greenhouse gases. A portion of the initiative, the sequestration of greenhouse gases, is the focus of this presentation. Over 4 million acres of bottomland hardwood forests were cleared for agriculture in the Mississippi River Valley in the 1970s. Reestablishing these forests would improve depleted wildlife habitats, serve as wildlife corridors, increase biodiversity, and decrease soil erosion. Louisiana is losing coastal wetlands at a rate of approximately 25 square miles/year. This coastal erosion is due to a number of factors and many efforts are currently underway to address the matter. One such effort is the use of material generated in the dredging of navigational canals; however, this material is low in nutrient value, making the regeneration of marsh grasses more difficult. In addition, bottomland hardwood forests and coastal wetland grasses are excellent 'carbon sinks' because they take carbon dioxide out of the atmosphere and store it in living plant tissue. Entergy Services, Inc. is an electric utility with a service territory that comprises portions of both the Lower Mississippi River Valley and the Gulf of Mexico coastline. This provides an opportunity to positively address both habitat losses noted above while at the same time addressing global warming, forest fragmentation, and biodiversity. Entergy, through its affiliation with the UtiliTree Carbon Company, is participating in projects that will investigate the feasibility of using bottomland hardwood reforestation on cleared marginal farmlands now managed by the Louisiana Department of Wildlife and Fisheries and the US Fish and Wildlife Service. Entergy has also begun a research project with the Environmental Protection Agency and the State of Louisiana. The research is a compost demonstration project that will utilize wood waste generated through our tree-trimming program as a compost material that will be mixed with low nutrient dredge material to create new coastal wetlands. Taken together, Entergy's initiatives will be able to address global warming through carbon sequestration, restore fragmented forest habitats, reduce coastal erosion and improve the quality of a vital coastal aquatic nursery habitat. Efforts will be made to manage the created habitats for biodiversity. Pulling all these ideas together creates an effect in which the whole is greater than the sum of the parts. In such a synergy of ideas, there are no losers and the winners are both industry participants and the environment.

Journal Article↗

PubMed1991

Role of spacer and address components in peptidomimetic delta opioid receptor antagonists related to naltrindole.

A series of heterocyclic analogues 2-5 related to naltrindole (1) (NTI) and 6-arylnaltrexone derivatives 6-8 were synthesized in order to determine the role of the spacer and the address moieties in conferring delta opioid receptor antagonist activity. The benzofuran (NTB), quinoxaline, and quinoline analogues (2, 3, and 4, respectively) were delta-selective opioid antagonists in vitro and bound selectively to delta receptors. The tetrahydroindole derivative 5, while delta-selective, was considerably less potent than its indole analogue 13. The data for 2-4 indicate that heterocycles other than pyrrole can serve as a spacer for the delta address moiety. Moreover, the lower delta antagonist potency of 5 illustrates the importance of the aromatic address component. Molecular dynamics simulations of enkephalin using a zipper binding model are consistent with a delta address subsite that may accommodate the benzene moiety of NTI or the Phe4 phenyl group of leucine enkephalin. The considerably lower delta opioid receptor antagonist potencies of the 6-aryl derivatives 6-8 are consistent with the conformational mobility of the aryl group and its location in the molecule.

Animals↗