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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↗

PubMed2004

Management of whiplash-associated disorder addressing thoracic and cervical spine impairments: a case report.

STUDY DESIGN: Clinical case report. OBJECTIVES: To describe a physical therapy program addressing impairments of the upper thoracic and cervical spine region for an individual with a whiplash-associated disorder. BACKGROUND: A 32-year-old female with complaint of diffuse posterior cervical and upper thoracic region pain was evaluated 2 weeks following a motor vehicle accident. The patient reported that she was unable to sit for longer than 10 minutes or perform household duties for longer than 1 hour. In addition, she was unable to perform her tasks as a postal worker or participate in her customary running and aerobic exercise activities because of pain in the cervical and upper thoracic region. METHODS AND MEASURES: An examination for physical impairments was performed, including the measurement of cervical range of motion using the CROM device, and the assessment of soft tissue and segmental mobility of the upper thoracic and cervical spine regions. The Northwick Park Neck Pain Questionnaire was used to assess functional limitations and disability. Manual therapy and therapeutic exercises were applied to address the identified impairments. Manual therapy techniques included soft tissue mobilization, joint mobilization, and joint manipulation. RESULTS: The patient's cervical range of motion was improved and the disability score improved from 25% to 19.5% 3 days after the initial session addressing the thoracic spine. Following a second session also addressing thoracic spine impairments and the use of therapeutic exercises for 7 days, the disability score improved to 11.1%. At the final visit 17 days following the third visit, which focused on addressing the cervical spine impairments, there was complete resolution of signs and symptoms and disability. CONCLUSIONS: Interventions addressing the impairments of the upper thoracic and cervical spine region were associated with reducing pain, increasing cervical range of motion, and facilitating return to work and physical activities in a patient with a whiplash-associated disorder. There is a need for continued research investigating the efficacy of providing interventions to the thoracic spine for patients with whiplash-related injuries.

Accidents, Traffic↗

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↗

PubMed2004

Addressing multiple behavioral risk factors in primary care. A synthesis of current knowledge and stakeholder dialogue sessions.

BACKGROUND: Addressing behavioral risk factors in primary care has become a pressing concern due to the increasing burden of behavioral risk factors on disease, healthcare costs, and public health. Risk factors considered include smoking, risky drinking, sedentary lifestyle, and unhealthy diet-singly or in combination. The already burdened primary care system needs a practical approach to efficiently and effectively address any combination of multiple risk factors. Multiple perspectives and broad insight are urgently needed to gain a deeper understanding of the interacting scientific, systems, and policy issues associated with multiple risk factor interventions (MRFIs). PURPOSE: This paper synthesizes findings from literature reviews, epidemiologic analyses, and structured interactive dialogue sessions, and includes a set of recommendations designed to stimulate further action. METHODS: Several papers were produced to document current knowledge, research evidence, and salient issues related to multiple risk factor assessment and intervention. Structured interactive dialogue sessions were then conducted with clinician, health system, and health policy leaders regarding what advantage or energy would be liberated by a multiple risk factor approach (rather than separate single risk factor approaches), and how to build a policy framework or constituency for MRFIs. This information is synthesized in this paper. RESULTS: There is a clear need to address MRFIs among multiple stakeholders, including patients, purchasers, payers, clinicians, health system leaders, and policy-level stakeholders. MRFIs need to bring with them a compelling value proposition for all stakeholders, and a vision of practical and systematic ways to make it a reality in already-pressed primary care practices. Involving stakeholders in dialogue aimed at helping them see the world through each other's eyes helps overcome discouragement and generates energy for jointly designing new approaches. Recommendations for further action include the creation of multistakeholder dialogue, creation of a policy agenda, development of a translation or integration agenda that connects researchers and practitioners in a two-way exchange, initiation of a series of demonstration projects around MRFIs, and support for research on multiple (rather than only single) risk factor interventions. CONCLUSIONS: The need to address multiple behavioral risk factors in primary care is increasingly urgent. Whereas stakeholders by themselves may be willing to address multiple risk factors, they agree that it can only be done successfully with a collaborative approach. Findings based on evidence reviews, hypotheses generation, and stakeholder dialogue provide guidance for appropriate further action that, based on what is known already, can be initiated right away.

Adult↗

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↗

PubMedDate not supplied

Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care.

OBJECTIVES: Racial/ethnic disparities in health in the U.S. have been well described. The field of "cultural competence" has emerged as one strategy to address these disparities. Based on a review of the relevant literature, the authors develop a definition of cultural competence, identify key components for intervention, and describe a practical framework for implementation of measures to address racial/ethnic disparities in health and health care. METHODS: The authors conducted a literature review of academic, foundation, and government publications focusing on sociocultural barriers to care, the level of the health care system at which a given barrier occurs, and cultural competence efforts that address these barriers. RESULTS: Sociocultural barriers to care were identified at the organizational (leadership/workforce), structural (processes of care), and clinical (provider-patient encounter) levels. A framework of cultural competence interventions--including minority recruitment into the health professions, development of interpreter services and language-appropriate health educational materials, and provider education on cross-cultural issues--emerged to categorize strategies to address racial/ethnic disparities in health and health care. CONCLUSIONS: Demographic changes anticipated over the next decade magnify the importance of addressing racial/ethnic disparities in health and health care. A framework of organizational, structural, and clinical cultural competence interventions can facilitate the elimination of these disparities and improve care for all Americans.

Attitude of Health Personnel↗

PubMed2003

Addressing current challenges to cardiac rehabilitation care.

Cardiac rehabilitation, the structured programming of exercise and risk reduction teaching and counseling to promote healthy living with heart disease, is grounded in a strong nurse-patient relationship. This relationship provides a foundation for meeting current healthcare challenges. Three challenges are presented and addressed through specific examples. The challenge of the changing cardiac rehabilitation population is addressed through the example of the heart failure patient. The challenge to create innovative programming is addressed through the example of the Therapeutic Rehabilitative Intensive Program, developed to meet the needs of people who live in communities without cardiac rehabilitation services. The challenge to measure outcomes is addressed through the example of choosing a blood pressure measurement method. In addressing each challenge, the role of the advanced practice nurse is described.

Blood Pressure↗

PubMed2003

Post office box addresses: a challenge for geographic information system-based studies.

BACKGROUND: Geographic information system (GIS)-based health studies require information on the physical location of data points, such as subject addresses. In a study of California women diagnosed with breast cancer between 1988 and 1997, we needed to locate the residential addresses of 4,537 women with post office boxes (POBs). METHODS: We investigated the feasibility of tracing street addresses for the POBs and examined potential selection biases and case attribute misclassifications introduced by different methods of handling POBs in GIS-based health studies. RESULTS: Our tracing method yielded street addresses for only 34% of POBs in our study. Examination of subjects' case characteristics revealed that boxholders were not representative of the full population. Geocoding using a POB's delivery-weighted five-digit zip code centroid, as a proxy for street address, resulted in case attribute misclassification for 81% of boxholders. CONCLUSIONS: Disease registries should modernize their infrastructure to complement GIS technologies. Epidemiologists should understand GIS data limitations and consider potential biases introduced by incomplete or inaccurate geocoding.

Adult↗

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↗

PubMed2002

Evaluation of a variable-addressability monocular.

A variable-addressability monocular that provides a variation in resolution across the field of view is presented. The variation in resolution is based on the eye's visual-acuity curve. A prototype has been built that does a nonlinear mapping of the pixels, designed to work most efficiently with the human visual system. In addition a conventional, uniform-addressability prototype has been built. A human-factors experiment is presented that directly compares the variable-addressability prototype with the conventional system. The human-factors results show that the variable-addressability prototype provides better resolution 13% of the time but is 15% slower in use than the uniform-addressability prototype.

Journal Article↗

PubMed2004

Address entry while driving: speech recognition versus a touch-screen keyboard.

A driving simulator experiment was conducted to determine the effects of entering addresses into a navigation system during driving. Participants drove on roads of varying visual demand while entering addresses. Three address entry methods were explored: word-based speech recognition, character-based speech recognition, and typing on a touch-screen keyboard. For each method, vehicle control and task measures, glance timing, and subjective ratings were examined. During driving, word-based speech recognition yielded the shortest total task time (15.3 s), followed by character-based speech recognition (41.0 s) and touch-screen keyboard (86.0 s). The standard deviation of lateral position when performing keyboard entry (0.21 m) was 60% higher than that for all other address entry methods (0.13 m). Degradation of vehicle control associated with address entry using a touch screen suggests that the use of speech recognition is favorable. Speech recognition systems with visual feedback, however, even with excellent accuracy, are not without performance consequences. Applications of this research include the design of in-vehicle navigation systems as well as other systems requiring significant driver input, such as E-mail, the Internet, and text messaging.

Accidents, Traffic↗

PubMed1986

Address register research for the 1991 census of Canada.

"The current Canadian census is based on the local enumerator who lists and visits each dwelling in his/her enumeration area to drop off the questionnaires just before census day. Other approaches to compiling an address list exist, however. This paper describes current research into the use of an address register for the next Canadian census, to take place in 1991. Possible applications of an address register are described, earlier research is summarized and potential sources for an address register in the Canadian context are mentioned. The paper concludes with a number of concerns which must be addressed in addition to the more technical issues."

Americas↗

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↗