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Results for “list randomization”

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PubMedDate not supplied

Protection from sun exposure in US white children ages 6 months to 11 years.

OBJECTIVES: To estimate the prevalence of protection from sun exposure among US white children ages 6 months to 11 years. METHODS: During the summer of 1998, using telephone directory lists supplemented by random-digit dialing, the authors surveyed parents living in the contiguous United States. They calculated weighted prevalence estimates for protection methods and conducted logistic regression analyses to determine parent and child characteristics predictive of protection behaviors. RESULTS: Parents of 1,055 white children were interviewed. Children spent a median of 20 hours per week outdoors during the summer, of which 10 hours were at school. Sunscreen (61.8%, 95% confidence interval [CI] 57%, 66%) and shade (26.5%, 95% CI 22%, 31%) were the most frequently reported protection methods. Parents reported higher rates of protection for younger children and children who sunburn easily. CONCLUSIONS: Parents report that a large proportion of white children is protected from sun exposure by one or more methods. Health care providers and educators might encourage the use of all methods of protection, not just sunscreen use, and educate older children to protect themselves from the sun.

Adult↗

PubMed2003

The prevalence of restless legs syndrome among pregnant women in Japan and the relationship between restless legs syndrome and sleep problems.

STUDY OBJECTIVES: To clarify the prevalence of restless legs syndrome (RLS) in pregnant women living in Japan and to analyze the relationship between sleep problems and RLS, in order to discuss ways for pregnant women to obtain comfortable sleep and to improve the health of both the mother and child. DESIGN: A cross-sectional questionnaire survey. SETTING: 500 clinical institutions with maternity services were randomly sampled from a list of organizations identified in a survey by the Japan Association of Obstetricians and Gynecologists. Of these 500 institutions, 260 participated in the survey. PARTICIPANTS: 16,528 pregnant women living in Japan. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: In this survey of pregnant women, the prevalence of RLS was found to be 19.9%. An analysis was conducted on the relationship between RLS and other factors such as subjective evaluation of sleep, difficulty initiating sleep, difficulty maintaining sleep, early morning awaking, and excessive daytime sleepiness. The result of this analysis suggested that women with these sleep-related problems were more likely to have RLS than those without. In addition, RLS was more prevalent in the later stages of pregnancy. CONCLUSION: In the pregnant women in our survey, the prevalence of RLS was found to be 19.9%, which is higher than the prevalence of RLS that has been found in the general public in a previous study. This suggests that RLS-related sleep problems may be an important public health issue among pregnant women in Japan. This finding may have implications for attempts to improve sleep hygiene in this group.

Adult↗

PubMed2001

Electric blanket or mattress cover use and breast cancer incidence in women 50-79 years of age.

Previous research has demonstrated inconsistent associations between electromagnetic radiation, especially from electric blanket use, and breast cancer. Breast cancer risk according to electric blanket or mattress cover use was examined as part of a multicenter population-based case-control study. Breast cancer patients 50-79 years of age (N = 1949) were identified from statewide tumor registries in Massachusetts, New Hampshire, and Wisconsin from the period June 1994 to July 1995. Women of similar age were randomly selected from population lists as controls. Information regarding electric blanket and mattress cover use and breast cancer risk factors was obtained through telephone interviews. After adjustment for age, body mass index, and other breast cancer risk factors, the risk of breast cancer was similar among ever-users (relative risk = 0.93; 95% confidence interval = 0.82-1.06) and lower among current users than among never-users (relative risk = 0.79; 95% confidence interval = 0.66-0.95). There was no evidence of a dose-response relation with increasing number of months that electric blankets had been used. This study provides evidence against a positive association between electric blanket or mattress cover use and breast cancer.

Aged↗

PubMed2000

Haemostatic factors and risk of varicose veins and chronic venous insufficiency: Edinburgh Vein Study.

Despite much research, the aetiology of venous disease is still poorly understood. Since haemostatic factors are involved in the processes of fibrinolysis and platelet aggregation, it is conceivable that such processes may be implicated in the pathology of varicose veins and chronic venous insufficiency (CVI). The Edinburgh Vein Study examined 1566 men and women aged 18-64 years that were randomly selected from the lists of 12 general practitioners. Each subject completed a questionnaire, underwent a comprehensive clinical examination and had a blood sample taken for the analysis of plasma fibrinogen, tissue plasminogen activator (t-PA) and von Willebrand factor (vWF) antigens. Subjects with trunk varicose veins and those with CVI had higher levels of each haemostatic factor compared with those with no trunk varices and no CVI. Although unit increases in t-PA and vWF were initially associated with a significantly increased risk of CVI in men, and both factors with an elevated risk of trunk varices in women, multiple adjustment for age, smoking status and body mass index reduced the odds ratios to non-significance. However, this does not entirely rule out the possibility of a pathogenic role for haemostatic factors in venous disease, but rather indicates the need for further experimental and epidemiological studies.

Adolescent↗

PubMed1999

Predictors of physician compliance with a published guideline on management of febrile infants.

BACKGROUND: Previous studies have demonstrated clinicians' poor compliance with published management strategies and protocols, but the reasons why physicians often choose to vary their management of the febrile infant from published guidelines are poorly understood. OBJECTIVE: We conducted a study of physicians to learn more about the issues that influence their decisions in the management of febrile infants. METHODS: A survey study of pediatricians, emergency physicians and family physicians randomly selected from a list of licensed physicians in the United States. Chi square and Kruskal-Wallis tests were used to measure differences in responses by specialty. Odds ratios from logistic regression were used to measure differences in compliance with a recently published guideline. RESULTS: We received 193 completed surveys from pediatricians, 177 from emergency physicians and 104 from family physicians. After controlling for other variables, odds for compliance with a recently published guideline were higher for pediatricians [odds ratio (OR) = 9.13] and emergency physicians (OR = 2.5) than for family physicians (P < 0.001). Factors associated with decreased odds of compliance included more years since graduation from medical school (OR = 0.93), a higher proportion of office visits by children < 1 year of age (OR = 0.97) and increased comfort diagnosing serious bacterial illness (OR = 0.35). Factors associated with increased odds of compliance included a higher perceived likelihood of serious bacterial illness in febrile infants (OR = 1.01) and better reported knowledge of the recently published guideline (OR = 2.01). CONCLUSIONS: We found that specialty as well as other factors were associated with physician compliance with a recently published guideline. This information may facilitate guideline development and implementation by providing a better understanding of what motivates physicians in their clinical decision making.

Adult↗

PubMedDate not supplied

Laboratory diagnosis of sexually transmitted diseases in facilities within the United States. Results of a national survey.

BACKGROUND AND OBJECTIVES: The diagnosis of many sexually transmitted diseases (STD) requires laboratory testing. The authors assessed the effects of the introduction of new tests and regulations on STD testing. STUDY DESIGN: A questionnaire survey was mailed to a random sample of facilities listed in the STD Referral Database inquiring about tests offered, changes in testing, and reasons for changes. RESULTS: Responses from 405 facilities were analyzed. Most responding facilities collected specimens for nontreponemal tests for syphilis (352 of 405 [86.9%]). Since each facility's information was last updated, the number reporting testing for Chlamydia trachomatis rose from 160 of 405 (39.5%) to 288 of 405 (71.1%), but testing for gonorrhea and chancroid decreased (365 of 405 [90.1%] to 328 of 405 [81%], and 182 of 405 [44.9%] to 32 of 405 [7.9%], respectively). Of 364 responses to a question on changes in tests performed in the last 2 years, 249 (68.4%) reported no change, 81 (22.3%) reported an increase, and 37 (10.2%) reported a decrease. The most frequently added tests were nonculture tests for C. trachomatis (34 of 81 [42%]) and the most frequent reason for adding tests was targeted funding (25 of 81 [30.9%]). The most frequently discontinued tests were cultures and gram stains for gonorrhea (15 of 37 [40.5%]) and other in-house tests (9 of 37 [24.3%]). Most facilities that discontinued testing cited the Clinical Laboratory Improvement Act as the reason (34 of 37 [91.9%]; 95% confidence interval = 78.1%, 98.3%). CONCLUSIONS: The number of facilities testing for C. trachomatis has increased with funding and with the availability of nonculture tests, but the number of those testing for chancroid and gonorrhea has decreased. Implementation of the Clinical Laboratory Improvement Act may be associated with a decrease in the number of facilities performing tests for STD.

Clinical Laboratory Techniques↗

PubMed2002

Physical exercise, use of Plantago ovata and aspirin, and reduced risk of colon cancer.

To evaluate certain risk and protective factors for colon cancer in our population, we conducted a paired case-control study where cases were all people diagnosed with colon cancer who were registered at the Cancer Data Exchange Systems of the Community of Madrid between January 1995 and December 1996, and controls were randomly taken from electoral lists. The study population consisted of 424 persons. Using SPSS for Windows, variables were adjusted by multiple logistic regression. The results indicate that lack of physical exercise is associated with an increased risk of colon cancer, with an odds ratio (OR) of 2.8 (95% confidence interval (CI) 1.28-6.21) as compared with moderate activity 1-2 days a week. The risk decreases linearly with increasing physical exercise, and this association remains after stratifying the analysis for the existence of constipation. The consumption of is associated with a reduced risk of colon cancer in constipated patients, with an OR of 0.094 (0.014-0.639), as is aspirin use, with an OR of 0.980 (0.898-0.999). These results were obtained after adjusting all the ORs for diet, smoking, alcohol consumption, family history and socio-demographic factors such as marital status and educational level.

Aged↗

PubMed2003

Effect of the CD14 promoter polymorphism on liver function tests and its association with alcohol and obesity.

OBJECTIVE: To investigate the effect of the functional CD14 promoter polymorphism on serum liver function tests and abnormally elevated liver function tests in a general population sample. METHODS: We recruited 310 subjects at random from general practitioner lists in Surrey. A previously validated medical questionnaire was completed and a serum sample provided for estimation of liver function test and genotyping of CD14 promoter polymorphism. RESULTS: The TT polymorphism was associated with significantly reduced serum levels of alanine aminotransferase 0.49 (95% confidence interval 0.26-0.93), gamma-glutamyl transferase 0.49 (95% confidence interval 0.38-0.89) and aspartate aminotransferase 0.48 (95% confidence interval 10.38-0.89). The TT polymorphism was associated with a reduced frequency of liver function test abnormalities, especially gamma-glutamyl transferase (odds ratio 0.113; 0.015-0.851). CONCLUSION: The TT promoter polymorphism was associated with reduced serum levels of alanine aminotransferase, gamma-glutamyl transferase and aspartate aminotransferase in healthy patients, and a low level of liver function test abnormalities. The relationship with gamma-glutamyl transferase stands after correction for age, gender, obesity and alcohol consumption. This raises the possibility that this genotype may offer protection from the development of fatty liver disease.

Aged↗

PubMed2006

Preemptive treatment for cytomegalovirus viremia to prevent cytomegalovirus disease in solid organ transplant recipients.

BACKGROUND: Cytomegalovirus (CMV) is a significant cause of morbidity and mortality in solid organ transplant recipients. Preemptive treatment with antiviral agents of patients with CMV viremia has been widely adopted as an alternative to routine prophylaxis to prevent CMV disease. This study was conducted to evaluate the efficacy of preemptive treatment in preventing symptomatic CMV disease. METHODS: The Cochrane CENTRAL Registry, MEDLINE, EMBASE, and reference lists were searched for randomized trials of preemptive treatment in solid organ transplant recipients. Two authors extracted all data; analysis was with a random effects model and results expressed as relative risk (RR) and 95% confidence intervals (CI). RESULTS: Ten eligible trials (476 patients) were identified, six of preemptive treatment versus placebo or standard care (treatment of CMV when disease occurred), three of preemptive treatment versus antiviral prophylaxis and one of oral versus intravenous preemptive treatment. Compared with placebo or standard care, preemptive treatment significantly reduced the risk of CMV disease (6 trials, 288 patients, RR 0.29, 95% CI 0.11 to 0.80) but not acute rejection (3 trials, 185 patients, RR 1.06, 95% CI 0.64 to 1.76) or all-cause mortality (2 trials, 176 patients, RR 1.23, 95% CI 0.35 to 4.30). Comparative trials of preemptive therapy versus prophylaxis showed no significant difference in the risks of CMV disease (2 trials, 151 patients, RR 0.42, 95% CI 0.07 to 2.65), acute rejection (1 trial, 70 patients, RR 0.94, 95% CI 0.42 to 2.09) or all-cause mortality (3 trials, 151 patients, RR 1.86, 95% CI 0.61 to 5.72). CONCLUSIONS: Few randomized trials have evaluated the effects of preemptive therapy to prevent CMV disease. Preemptive therapy is effective compared with placebo or standard care, but additional head-to-head trials are required to determine the relative benefits and harms of preemptive therapy and prophylaxis to prevent CMV disease in solid organ transplant recipients.

Antiviral Agents↗

PubMed2001

Spin-orbit coupling effects on quantum transport in lateral semiconductor dots.

The effects of interplay between spin-orbit coupling and Zeeman splitting on weak localization and universal conductance fluctuations in lateral semiconductor quantum dots are analyzed: All possible symmetry classes of corresponding random matrix theories are listed and crossovers between them achievable by sweeping magnetic field and changing the dot parameters are described. We also suggest experiments to measure the spin-orbit coupling constants.

Journal Article↗

PubMed2006

Canteen purchasing practices of year 1-6 primary school children and association with SES and weight status.

OBJECTIVE: To identify sources of food eaten during the school day, the types of foods and frequency of purchases from the canteen and association with SES and weight status in primary school-aged children. METHOD: This cross-sectional study was conducted in the Hunter region of New South Wales. Primary schools were randomly selected from a list of government schools and 5,206 students in years 1-6 from the 16 participating schools were invited to participate in the study. RESULTS: Findings show the majority of children in the study bring their recess snack and lunch from home. However, the majority of children do use the school canteen and less healthy foods and high-sugar drinks are commonly purchased. CONCLUSIONS: This study confirms the relevance of the school canteen as a means of affecting children's eating habits. IMPLICATIONS: Improvement in the foods sold through schools provides an important contribution to model supportive environments for healthy food choices. Strategies should also be directed towards affecting the content of lunchboxes and the home environment.

Body Weight↗

PubMed2004

Low vision service delivery: an audit of newly developed outreach clinics in Northern Ireland.

Recent publications recommend that low vision services are multi-professional; easily accessible; freely available to all those with visual impairment; monitored by professional and patient groups, and responsive to user feedback. These standards were applied when developing low vision outreach services in Northern Ireland in 1999/2000. Results are reported of the complete clinical audit cycle, coupled with a patient satisfaction telephone questionnaire, which was used to evaluate the service. Of the 48 patients randomly selected from the list of clinic attendees, 28 (58%) were female, 27 (56%) over 80 years of age and 38 (78%) had a primary ocular diagnosis of age related macular degeneration (AMD). Of the 46 low vision aids issued at patients' first appointments, 30 (67%) were illuminated stand magnifiers and 29 (63%) had magnification levels of x5 or less. A total of 46 (96%) patients reported that they had benefited from low vision services.

Aged↗

PubMed2003

Do depressed older adults who attribute depression to "old age" believe it is important to seek care?

OBJECTIVE: To determine whether depressed older adults who attribute becoming depressed to "old age" rather than illness are more likely to believe it is not important to seek treatment for depression. DESIGN: Cross-sectional mailed survey. SETTING: Academically affiliated primary care physicians' network. PARTICIPANTS: Surveys were mailed to 588 patients age > or =65 years who were randomly identified from patient lists of 20 physicians. Surveys were returned by 429 patients (73%). Patients were eligible for this study if they scored > or =2 points on the 5-item Geriatric Depression Scale (n = 94) and were not missing key variables (final n = 90). MEASUREMENTS AND MAIN RESULTS: Of the 90 depressed patients, 48 (53%) believed that feeling depressed was very important to discuss with a doctor. In unadjusted analysis, older adults who did not believe it is very important to discuss feeling depressed with a doctor were more likely to attribute becoming depressed to aging (41% vs 17%; P =.012). In a logistic regression model adjusting for sociodemographic characteristics, number of impairments in basic and instrumental activities of daily living, medical comorbidity, and physical (PCS-12) and mental (MCS-12) component summary scores from the Medical Outcomes Study Short-Form-12, depressed older adults who attributed depression to aging had a 4.3 times greater odds than those who attributed depression to illness to not believe it is very important to discuss depression with a doctor (odds ratio [OR], 4.3; 95% confidence interval [CI], 1.3 to 14.5). CONCLUSIONS: Among older persons with depression, attributing feeling depressed to old age may be an important barrier to care seeking.

Aged↗

PubMed1995

Dental, visual, auditory and olfactory complications in Paget's disease of bone.

OBJECTIVE: To determine the prevalence of dental problems in Paget's patients and in a control population without Paget's disease. The relationship of localization of bony involvement of Paget's disease with the prevalence of dental, auditory, visual, and smell changes is examined. DESIGN: Cross-sectional national survey. PARTICIPANTS: Four hundred ninety-eight subjects with Paget's disease were generated randomly from the mailing list of the Paget Foundation. INTERVENTION: Each subject was sent a cover letter, two questionnaires, and a stamped, addressed return envelope. One questionnaire contained questions specific for the individual with Paget's disease. Subjects were asked to give the other questionnaire, which contained the same questions except for those asking about the specifics of Paget's disease, to an unaffected spouse or a similar aged friend. MEASUREMENTS: All subjects were asked about their age, gender, race, educational level, income, living situation, chronic medical conditions, self-rating of their general physical and dental health, the number of teeth present, and the presence of dental, auditory, visual, and olfactory problems. Paget's subjects were also asked to indicate which bones were affected. RESULTS: Paget's disease subjects assessed their oral health to be poorer than the controls. Paget's subjects were more likely to report pain when opening the mouth and were more likely to have had dental extractions. A significantly higher percentage of Paget's individuals with facial or maxillomandibular involvement reported having heart trouble. Paget's individuals with skull, facial or maxillo-mandibular involvement were more likely to report a change in their hearing, sight, and smell than Paget's subjects without involvement of the craniofacial complex. Dental problems were reported by 93% of those Paget's subjects with maxillomandibular involvement, compared with only 10% for those with skull involvement only or involvement at sites distant to the craniofacial complex. CONCLUSIONS: Patients with Paget's disease of bone involving facial or maxillo-mandibular parts of the skeleton have a higher prevalence of change in hearing, sight, smell, and dental problems. We also have found an association of heart disease in patients who have involvement of facial or maxillo-mandibular bones.

Adult↗

PubMed2006

The relationship between sexual activity and urinary incontinence in older women.

OBJECTIVES: To determine whether continence status is associated with sexual activity in older women. DESIGN: Cross-sectional postal survey. SETTING: Random selection from a list of respondents to a Canada Post survey. PARTICIPANTS: Community-dwelling women aged 55 to 95. MEASUREMENTS: The International Consultation on Incontinence Questionnaire Short Form measured the presence, severity, and type of incontinence. Sexual activity and marital status were assessed using single close-ended questions. The Medical Outcomes Study 12-item Short-Form Health Survey was used to query physical and mental health status. RESULTS: Data from 2,361 women (mean age 71) were available for analysis. Thirty-nine percent reported urinary incontinence (UI), and 27% were sexually active. UI was associated with sexual activity in crude logistic analyses (odds ratio (OR)=0.82, 95% confidence interval (CI)=0.68-0.98) but not in multivariate models adjusted for physical and mental health. Marital status and age were the strongest predictors of sexual activity (OR 8.94, 95% CI=6.89-11.60 for married women; OR=3.09, 95% CI=2.57-3.73 for age <or=70), with significant relationships also observed with physical and mental health (OR=1.04, 95% CI=1.03-1.04 and OR=1.02, 95% CI=1.01-1.04, respectively). Frequency of UI was not related to being sexually active, although greater amounts of urine loss, stress incontinence, and nocturnal incontinence were independently associated with sexual activity (OR=0.53, 95% CI=0.33-0.85; OR=1.40 95% CI=1.01-1.94; and OR=0.24, 95% CI=0.10-0.61, respectively). CONCLUSION: Many older women remain sexually active as they age regardless of continence status. Caution should be exercised in interpreting intervention studies aimed at improving sexual function in incontinent older women if marital status and physical and mental health are not considered.

Aged↗

PubMedDate not supplied

Experienced obstetric nurses' decision-making in fetal risk situations.

OBJECTIVE: To determine which clinical factors experienced obstetric nurses consider most important in determining fetal risk during the intrapartum period. DESIGN: Ten dichotomized variables relevant to participants' clinical decision-making were manipulated in fractional factorial vignettes. Participants were asked to rate the severity of fetal risk on a Likert scale after reading the vignettes. SETTING: About 87% of the participants worked in institutions with 4,000 or fewer deliveries per year. More than 25% worked in tertiary level facilities, and the remainder were employed in primary or secondary level facilities. PARTICIPANTS: Participants (N = 573), randomly selected from a list of nurses certified in "inpatient obstetric nursing" by the National Certification Corporation, were mailed the vignettes. The average number of years of intrapartum nursing experience was 13. MAIN OUTCOME MEASURE: Multiple regression analysis was used to determine the weights given to the 10 clinical factors by participants. RESULTS: Fetal scalp pH, maternal parity, amniotic fluid color, and long-term variability of the fetal heart rate were the most important predictors of nurses' fetal risk assessments. CONCLUSIONS: Long-term variability was the most important cardiotocographic factor in nurses' fetal risk assessments and the only cardiotocographic factor of the best 4 predictors of fetal risk. This indicated that participants were realistic about the limitations of electronic fetal monitoring (EFM).

Adult↗

PubMed2000

The proportion of upper gastrointestinal symptoms in the community associated with Helicobacter pylori, lifestyle factors, and nonsteroidal anti-inflammatory drugs. Leeds HELP Study Group.

OBJECTIVE: Upper gastrointestinal disorders are common in the community, yet the determinants of these symptoms are poorly characterized. The association between upper gastrointestinal symptoms and Helicobacter pylori (H. pylori), socioeconomic status, nonsteroidal antiinflammatory drug (NSAID) use, smoking, alcohol, and coffee intake was assessed in a cross-sectional survey. METHODS: Subjects between the ages of 40-49 yr were randomly selected from the lists of 36 primary care centers. Participants attended their local primary care center and were interviewed by a researcher using a validated dyspepsia questionnaire. H. pylori status was determined by a nonfasting 13C-urea breath test. RESULTS: A total of 32,929 subjects were invited, and 8,407 (25%) attended and were eligible. Of these, 2,329 (28%) were H. pylori positive and 3,177 (38%) had dyspepsia. Also, 44% of H. pylori-infected participants reported dyspepsia compared with 36% of uninfected subjects [odds ratio = 1.39; 95% confidence interval (CI) 1.26-1.53]. H. pylori infection remained a significant risk factor for dyspepsia in a multiple logistic regression model (odds ratio = 1.21; 95% CI 1.09-1.34), suggesting that 5% of dyspepsia in the population is attributable to H. pylori. NSAIDs, low educational attainment, renting accommodation, absence of central heating, sharing a bed with siblings, and being married were also significantly associated with dyspepsia in this model. Smoking, but not drinking alcohol or coffee, was marginally associated with dyspepsia, but this finding was not robust. These factors were not associated with any dyspepsia subtype. CONCLUSIONS: H. pylori is significantly associated with dyspepsia and may be responsible for 5% of upper gastrointestinal symptoms in the community.

Adult↗

PubMed1996

Mammogram utilization among farm women.

Utilization of preventive health care services is lower in rural populations than in urban populations, possibly as a result of barriers to preventive health care that are characteristic of rural settings. This study was conducted to identify factors associated with mammogram utilization among farm women. Mammogram utilization among farm women from six southern Minnesota counties was examined as part of a larger community-based cancer intervention study. Farm women aged 40 and older were randomly selected from a list of farm households and interviewed by telephone to determine mammogram utilization and factors related to utilization. Of the 606 respondents, 78 percent reported ever having a mammogram and 49 percent reported a mammogram within the past year. Physician recommendation for a screening mammogram and family history of breast cancer were found to be associated with ever having a mammogram. Correct knowledge of mammogram screening guidelines was associated with a mammogram within the past 12 months. Overall, physician recommendation was the most influential determinant of utilization. As more emphasis is placed on prevention, patient education by physicians can have the greatest impact on mammogram utilization.

Agriculture↗