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PubMed1998

A countrywide programme of continuing professional development in Argentina. Argentine Society of Paediatrics, Subcommittee of Continuing Paediatric Education.

The Argentinean Society of Paediatrics introduced in 1993 a continuing professional development (CPD) programme to raise standards of clinical practice. The aims of the project were to introduce a structured, distance learning programme accessible to all paediatricians in the country, but especially for those working far from centres of paediatric excellence. The programme is planned on an annual basis. It includes four activities: a written manual designed by a team of medical experts and educationalists comprising 12 topics; field work for participants; annual meetings in several locations in the country for discussion of the subjects; and an evaluation based on centrally designed multiple choice questions distributed by mail. In spite of a registration free of 90 Pounds a year, participation in the programme increased from 3357 in 1993 to 4126 in 1996, from a membership of 10 216 paediatricians in Argentina. The popularity of the programme may result from an appropriate interpretation of professional needs of paediatricians in Argentina, adequate organisational arrangements that reach all colleagues, including those working in remote areas, and a genuine motivation of paediatricians for participating in a learning process.

Argentina↗

PubMed2005

Survey of health needs and concerns of rural Pennsylvanians.

INTRODUCTION: This survey was undertaken to determine the most important health and safety needs of farmers and rural citizens of Pennsylvania. METHODS: In June of 2004, a one-page questionnaire was distributed by mail to 32,700 members of the Pennsylvania Farm Bureau as an attachment to their monthly newsletter. RESULTS: The lack of affordable health care insurance was overwhelmingly cited as the most important unmet health care need (73%). No other issue was chosen by more than 10 percent of respondents. This lack of affordable health insurance was also cited as the most important health or safety problem to be addressed in the respondent's communities (71%). When asked the most important health or safety problem affecting them as individuals or their community, the respondents chose "no major problem or need" as the most frequent response (46%). The issue of affordable health insurance was not an option for this question. The predominant concern regarding the lack of affordable health insurance was consistent across all regions of the Commonwealth and for farmers as well as residents of all community sizes sampled. DISCUSSION: This study would indicate that the lack of affordable health insurance is the preeminent health and safety issue for many Pennsylvania farmers and rural citizens.

Health Services Accessibility↗

PubMed2004

Characteristics of a Japanese adult twin database of high school graduates.

This paper profiles a unique cohort of adult Japanese twins. The database contains more than 700 twin pairs, aged 18 to 66 years, who are all graduates of the secondary school attached to the faculty of education of the University of Tokyo. This school was established in 1948, when the study of twins was burgeoning in Japan, and about 10 to 20 pairs of twins have been admitted there every year to participate in studies on twins in education and in related projects. The zygosity of all twins was determined carefully on the basis of various sources. Data from the perinatal period to adulthood were linkable using ID numbers. Follow-up surveys in the field of medical genetics were performed in 1985, 1989 and 1999. For the third survey, which was sent and received exclusively by mail, the distribution and collection process was also assessed in detail. The response rate was around 40%, which statistically was influenced mainly by previous participation and sex. The limitation of this cohort is its selection bias concerning socioeconomic status and its imbalance in favor of monozygotic pairs.

Adolescent↗

PubMed2005

Measuring hearing aid outcomes using the Satisfaction with Amplification in Daily Life (SADL) questionnaire: Australian data.

The aims of this study were to investigate hearing aid satisfaction for a group of older Australians fitted with government-funded hearing aids using the Satisfaction with Amplification in Daily Life (SADL) questionnaire; to compare the Australian data gathered with the provisional normative data reported by Cox and Alexander (1999); and to investigate the relationship between SADL satisfaction and several participant variables, hearing aid variables, and other outcome measures. The SADL questionnaire and a Client Satisfaction Survey (CSS) were distributed by mail to 1284 adults fitted with government-funded hearing aids three to six months previously. 1014 surveys were returned. The mean age of participants was 75.32 years; 54.4% of participants were male, and 54.8% were fitted binaurally. Participants were fitted primarily with digitally programmable hearing aids of various styles (22.5% BTEs, 34.8% ITEs, 41.8% ITCs, 0.9% nonstandard [NS] devices). Overall, participants reported a considerable level of satisfaction with their devices. SADL Global and subscale scores were significantly higher for the Australian sample than the U.S. norms described by Cox and Alexander (1999).

Adult↗

PubMed2001

Pork producers' attitudes, knowledge, and production practices that relate to on-farm food safety.

A survey was distributed by mail to a random selection of Illinois pig farmers marketing 1,000 or more pigs in 1998 to assess their knowledge, attitude and behavior regarding on-farm food safety. Valid responses were received from 353 of the 946 surveys mailed (37.3%). Pork production accounted for more than 50% of gross agricultural revenues among 65.0% of respondents, and 91.2% were classified as "owner-operators." Knowledge of food-borne pathogens was mixed, with correct responses to questions as follows: Trichina, 80.4%; Salmonella, 58.5%; Toxoplasma, 19.9%; and Campylobacter, 12.8%. Producers strongly agreed that food safety was a shared responsibility at every level of the food chain, including the farm level, with an average score for all steps in the pork chain of 4.5 on a scale from 1 (not important) to 5 (very important). When asked whether third party verification of on-farm practices was important, 51.2% agreed and 48.8% either disagreed or neither agreed nor disagreed. Associations between demographic categories and knowledge of and attitudes toward food safety were detected for herd size, proportion of agricultural receipts from pig production, grower versus birth-to-market production, age categories, and whether the respondent owned the pigs or facilities. Many (53.4%) were willing to apply a suggested food safety practice, even if there was no net profit for the practice. Findings suggest that Illinois pork producers accept an important role in pork food safety and express a willingness to participate but have knowledge gaps that should be filled.

Animals↗

PubMedDate not supplied

Assessment of learning needs of registered nurses for osteoporosis education.

PURPOSE: To answer the questions: How important is osteoporosis education? What are the topics that must be included in osteoporosis education? DESIGN: Nonexperimental descriptive. SAMPLE: 225 questionnaires were distributed to Registered Nurses in acute, ambulatory, and long-term care; 139 (62%) responded. METHODS: Nurse experts in osteoporosis developed and refined a needs assessment questionnaire that was distributed by mail. The 5-page questionnaire included demographic items. Other items inquired about the respondent's perceived need for osteoporosis education for patients and nurses, and the respondent's knowledge of and need for education in 27 specific topics. FINDINGS: Respondents expressed strong interest in and need for an educational program on osteoporosis. They rated their (mean) knowledge of 22 of 27 specific topics as between "limited" and "adequate." Subjects delineated important core content to be included in the educational program. These subjects included risk factors, prevention, assessment, calcium intake, nutrition, menopause, pharmacotherapeutics, and fall prevention. CONCLUSIONS: Subjects found their own knowledge of certain topics in osteoporosis as less than adequate. Subjects documented the need for osteoporosis education for patients and nurses. IMPLICATIONS FOR NURSING EDUCATION: There is a need for continuing education offerings to inform nurses and patients about osteoporosis prevention, detection, and management.

Adult↗

PubMed2001

Physicians' prevention practices and incidence of neonatal group B streptococcal disease in 2 Canadian regions.

BACKGROUND: The impact of expert guidelines on the prevention of neonatal group B streptococcal (GBS) disease has not been studied in Canada. Our aim was to determine physician practices with regard to this condition before and after publication of Canadian guidelines and to monitor concurrent trends in the incidence of neonatal GBS disease. METHODS: We used repeat cross-sectional surveys, distributed by mail to all family practitioners and obstetricians attending deliveries in Alberta and in the Metropolitan Toronto and Peel region, Ontario, in 1994, 1995 and 1997, to document prevention practices. Audits were conducted for a subset of respondents to confirm reported practices. Population-based surveillance involving all microbiology laboratories in both regions for 1995-1998 was used to document rates of neonatal disease. RESULTS: The overall survey response rates were as follows: for 1994, 1128/1458 (77%); for 1995, 1054/1450 (73%); and for 1997, 1030/1421 (72%). During 1995 and 1997, significantly more obstetric care providers were screening at least 75% of pregnant women in their practices than had been the case in 1994 (747/916 [82%] and 693/812 [85%] v. 754/981 [77%]; p < 0.001). The percentage of obstetric care providers who reported practice that conformed completely with any of 3 consensus prevention strategies increased from 10% in 1994 to 29% in 1997 (p < 0.001). There was a concurrent overall significant decrease in incidence of neonatal GBS disease during the same period. INTERPRETATION: The adoption by Canadian obstetric care providers of neonatal GBS prevention practices recommended by expert groups was slow but improved significantly over time. These findings highlight the difficulties associated with achieving compliance with diverse and frequently changing recommendations. However, the associated incidence of neonatal GBS disease, which was low or declining, suggests that efforts to disseminate current GBS prevention guidelines have been moderately successful.

Alberta↗

PubMed1975

Practice objectives and goals; a survey of family practice residents.

This study shows that the majority of family practice residents initially become aware of individual community needs for family physicians in either medical school or early in residency training, but the final decision in regard to the selection of a specific community for private practice is not generally made until late in the third year of residency training. When the final decision as to practice location is established, the family practice resident and his family have regarded at least six different factors as significant. Most family practice residents will enter private practice as members of a group practice, rather than as solo practitioners. There is a direct relationship between the population of the family practice resident's home community and the size of the communities being considered for private practice. The most influential recruiting technique is personal contact by the physicians and citizens of the community, whereas the least effective method of recruiting is through printed material distributed through mail service.

Evaluation Studies as Topic↗

PubMedDate not supplied

How can local health agencies improve health knowledge and skills of child care centre operators?

As the number of child care centres increases across Canada, local health agencies are increasingly involved in health issues within these facilities. 90% of operators of the 98 child care centres in an Ontario community responded to a mail survey distributed by the local health unit to determine health needs in these facilities. Infectious disease was reported to be the major health problem of the children. 76% of operators requested information about infectious diseases, in particular through use of written materials made available to their centre. The level of education of operators was high with 79% having completed community college courses. Over 70% of operators had attended continuing education sessions or workshops on child abuse, growth and development and nutrition; fewer operators reported attending sessions on infectious diseases, child safety, parent-child relationships and dental health. As a result of the needs assessment, a health unit multidisciplinary team has met and initiated a number of activities including meeting with child care centre operators, publication of newsletter for operators, and development of educational materials.

Child↗

PubMed2005

Information preferences and practices among people living with HIV/AIDS: results from a nationwide survey.

OBJECTIVES: This study was designed to reach many segments of the diverse HIV/AIDS community and broaden understanding of how information can better assist people living with HIV/AIDS. METHODS: Data were collected through a self-administered mail survey distributed nationwide at clinics, drug treatment centers, and other AIDS service organizations. RESULTS: The 662 respondents preferred getting information from people--including health professionals, family, and friends--and considered people the most trustworthy, useful, understandable, and available information sources. Forty-three percent selected doctors as their most preferred source. The Internet was not rated highly overall but was preferred by those with more education or living in metropolitan areas. Seventy-two percent said they actively search for HIV/AIDS-related information, and 80% said they give advice or tell others where to get such information. However, 71% agreed that it is easy to feel overwhelmed by information, and 31% agreed that not seeking information can be beneficial. CONCLUSIONS: Overall, information seeking is an important activity for this sample of people living with HIV/AIDS. Many sources are widely available to them but, together, can be overwhelming. They rely on health professionals far more than print or media sources and receive encouragement and support from family and friends.

Access to Information↗

PubMed2006

Patients' opinions on privacy, consent and the disclosure of health information for medical research.

A structured survey of patients in three illness groups (acquired immune deficiency syndrome, multiple sclerosis and mental disorders) was undertaken to describe patients' perspectives on privacy, consent and the use of their health information for medical research. The survey was distributed by mail to subjects in the AIDS and MS groups and was completed in a clinic waiting room by people in the mental disorders group. Of the 478 patients approached for participation, 235 returned completed surveys (response rate 49.2 percent). Most subjects were concerned about privacy and they valued opportunities to provide consent for the use of their personal health information for research. Contextual factors, such as identification, type of illness and who was conducting the research, were important to individuals' preferences in granting consent. When health information was used specifically for research, the majority of subjects wanted to be asked for their consent unless anonymity was assured. Privacy and control over personal health information were important to patients in these groups. Patients prefer to be asked for research access to their health information.

Acquired Immunodeficiency Syndrome↗

PubMed1990

[The prevalence of Parkinson disease in West Germany--are general practice data a suitable survey instrument?].

Investigations on prevalence rates in idiopathic Parkinson's disease (IPD) have raised fairly different results due to variations in methodology. Door-to-door studies in circumscribed geographical areas revealed lower prevalence rates in China and Japan compared to countries of the Western hemisphere. Due to the health system organization and present legislation on personal data referral such systematic door-to-door epidemiological surveys seem nearly impossible in the Federal Republic of Germany. The present pilot study therefore used doctor's practices as a means to obtain evidence rates on patients diagnosed on and treated for IPD. Standardized questionnaires with appropriate items regarding symptoms, diagnosis and treatment for the disease were distributed by mail or personally in 387 practices of general practitioners, internal specialists, neurologists, and psychiatrists and 3 hospital ambulances in the handestadt Lübeck, the Kreis Stormarn and the Kreis Herzogtum Lauenburg. Investigation time was March, 1 to June, 30, 1987. Each patient cared for IPD was to fill up a personal questionnaire with similar items as well. A second estimation of prevalence was made according to published sales of L-Dopa drugs for treatment of IPD. The third estimation used statistics about disease pattern of the Bundesverband der Allgemeinen Ortskrankenkassen (AOK). Participation of doctors was to be maintained high by varying methods of repeated requirements during the investigation period. 41 of 210 (20%) of the doctors requested by mail and 126 of the 180 visited physicians (70%) participated in the study with 1018 patients altogether. The estimate of prevalence for the Hansestadt Lübeck was 188, for the Kreis Stormarn 206 and for the Kreis Herzogtum Lauenburg 147 patients per 100,000 (183 in toto). According to latest data on L-Dopa drug sale the prevalence rate in the above areas was 144/100,000. According to the statistics of disease pattern of the AOK the prevalence estimate was 185/100,00 assured persons. These results are discussed with special emphasis on the methodological aspects.

Cross-Sectional Studies↗

PubMed1994

An SDI program for distributing funding opportunities using electronic mail.

As the competition for funding increases, the need to make researchers aware of all available funding is becoming more acute. The solution presented here is a Selective Dissemination of Information (SDI) service which electronically mails funding information that matches a researcher's keywords. The keywords are part of extensive faculty profiles that make up a Faculty Expertise database. The funding information comes from the Sponsored Programs Information Network (SPIN) database. The software enables researchers to learn about appropriate funding opportunities without spending time actively searching for them.

Databases, Factual↗

PubMed1997

QE-Mail--improving communication between the hospital and general practitioners.

OBJECTIVE: To describe the process of developing a therapeutic bulletin with a view to improving communications between providers of primary and secondary care and to survey general practitioners to assess their responses to the bulletin and to ascertain their further information needs. METHODS: A clinical panel was convened to select relevant topics for inclusion in the bulletins. The topic for each bulletin was researched and written using standard information sources and relevant experts. A survey was mailed with the first edition of the bulletin, to GPs in the Western Division of General Practice and in country areas, and to Directors of Nursing from country hospitals. RESULTS: The overall response rate to the survey was 41%. The majority of respondents had read the bulletin and found it useful. Most thought that the presentation, in terms of length, detail and layout, was suitable. Topics suggested for future editions included antibiotics, antihypertensives and antidepressants. CONCLUSION: The bulletin, QE-Mail, was well received and helped to inform GPs about current practices at the hospital. Future directions include the use of e-mail to distribute the bulletins and a follow up survey to determine if the bulletin is still meeting practitioners' needs.

Communication↗

PubMed1998

The British Columbia Positive Women's Survey: a detailed profile of 110 HIV-infected women.

OBJECTIVE: To describe the health, social environment, medical care received and satisfaction with medical care of HIV-infected women in British Columbia. DESIGN: Self-administered 75-item questionnaire distributed by mail or in person between March 1994 and February 1996 through community AIDS organizations and physicians' offices. SETTING: British Columbia. PARTICIPANTS: A total of 110 HIV-positive women. OUTCOME MEASURES: Sociodemographic data, risk factors for HIV infection, details about HIV testing, health status and medical treatment, use of health care services, degree of satisfaction with medical care and psychosocial stressors. RESULTS: Most of the women surveyed were aged 25 to 39 years (70.0%), were Canadian born (76.4%) and were white (80.9%). Over one-third did not complete high school, and half had an annual household income of less than $20,000. Of the 110 women 51.8% had children, who were HIV-positive in 12.3% of cases. The most frequently reported risk factor for HIV infection was sex with a man (49.1%); 19.1% reported both sex with a man and injection drug use, and 12.7% reported injection drug use only. Seventy-five women indicated that they had become infected through sex with a man, with or without injection drug use. Of these, 65 indicated whether or not this was the result of sexual assault or rape; 8 (12.3%) answered affirmatively. Of the 81 women who responded to the question regarding prior sexual assault or abuse, 43 (53.1%) reported being sexually assaulted as an adult, 35 (43.2%) reported being sexually abused as a child, and 22 (27.2%) reported being sexually abused or assaulted both as a child and as an adult. Women who were sexually abused as a child were more likely than those who were not abused as a child to have injection drug use as a risk factor (54.3% v. 7.5%). Menstrual cycle changes were reported by 70.1% of the respondents. Most women stated that they had not received adequate pre- or post-test counselling, and 47.0% were not satisfied with their doctor's care. Psychosocial concerns identified to be of greatest importance were financial problems, lack of intimacy or satisfying sexual relationship, and fear of rejection or discrimination. CONCLUSION: Several important concerns for HIV-positive women were identified, including dissatisfaction with medical care, fear of discrimination, violence and abuse, and poverty.

Adult↗

PubMed1998

Pilot study of six Colorado dental hygiene independent practices.

PURPOSE: The purpose of this pilot study was to gather demographic data about six Colorado dental hygienists who were practicing independently and their practices as well as assess productivity and service mix, evaluate structure and process, and compare the findings in these practices to those of a study of California Health Manpower Pilot Project #139. METHODS: A convenience sample of six dental hygiene independent practices was studied. A 21-item survey was distributed by mail to obtain demographic and practice information. Weekly surveys tracking patient visits and services provided were completed for three months. A general office audit to evaluate structure and a record audit of 22 patient records to evaluate process were conducted during visits at each practice site. The overall responses for each phase of this study were tabulated and frequencies were calculated using the SPSS/PC+ statistical package. RESULTS: The dental hygienists had practiced for an average of 13 years prior to establishing their practices. Four of the six practices were office-based, one was institution-based, and one was office- and institution-based. Health history, extraoral/intraoral examination, periodontal probing, adult prophylaxis, and oral hygiene instruction were provided during a majority of patient visits. The general office audit revealed compliance with infection control, office protocols for emergency situations, and practice management protocols. The patient record audit indicated a high standard for process of care for the practice sites. CONCLUSION: The six practices revealed a variety of backgrounds among the dental hygienists and diverse practice characteristics regarding both the populations served and practice settings. The services provided were consistent with allowable services for unsupervised practice. Compliance with specific guidelines was verified during the general office and patient record audits. Consistent with the findings of California Health Manpower Pilot Project #139, the care provided by the Colorado dental hygiene independent practitioners in this study and the environment in which the care was provided do not exhibit any undue risk to the health and safety of the public.

Adult↗

PubMed2002

Development and evaluation of an electronic drug and therapeutics bulletin.

OBJECTIVE: To describe the development, implementation, and initial evaluation of a paperless drug and therapeutics bulletin that is distributed by electronic mail from the pharmacy department of an Australian teaching hospital. OUTCOMES: A standardized format for the bulletin was designed and approved in February 2001. The aim of the bulletin is to facilitate the timely dissemination of concise, factual information about issues of current interest in therapeutics, drug safety, and the cost-effective use of medicines. A simple and attractive graphic design was chosen, and the hospital's clinical pharmacists and drug information staff developed an initial bank of content during the period immediately preceding the launch. The bulletin is presented as a 1-page, read-only file in Word for Windows format and was initially distributed by electronic mail to all users of the hospital's computerized communication network. As the popularity of the bulletin increased, healthcare practitioners from outside of the hospital began to request permission for inclusion on the circulation list, and the content was frequently forwarded by E-mail to workers in other hospitals and community-based settings. The bulletin is now distributed to pharmacists around Australia via 2 separate moderated discussion lists, one of which provides an archive site for previous editions. Healthcare workers in Singapore, the US, Canada, and New Zealand also receive the bulletin, which is now also abstracted by a major Australian pharmacy journal. A readership survey (also electronically distributed) was used to seek feedback after the publication of the first 12 editions. Readers indicated a high level of satisfaction with the content, format, and frequency of distribution of the materials. CONCLUSIONS: Although the concept and execution of this project was relatively simple, an extensive literature review did not reveal any previously published reports describing this type of approach to the distribution of a pharmacy bulletin. The development and implementation of the electronic drug and therapeutics bulletin has provided an opportunity to use modern communication technology to promote safe and effective medication use and appears to have been well received.

Australia↗

PubMed2006

International survey of knowledge of indications for EUS.

BACKGROUND: The knowledge level for EUS indications among gastroenterologists across different locations and practices is not known. The aim of this study was to assess knowledge of EUS indications among a diverse group of gastroenterologists, both nationally and internationally. METHODS: A web-based survey was designed to assess knowledge of EUS with respect to 4 organ systems: esophagus, gastroduodenum, hepatopancreatobiliary, and colorectum. The survey was distributed by electronic mail (e-mail) to members of the American Society for Gastrointestinal Endoscopy. RESULTS: The survey was distributed to 3848 physicians, of whom 2848 had an active e-mail address. There were 323 respondents (11.3%), of whom 210 were U.S. members and 113 international. Overall, the mean score for the different organ systems for all respondents was highest for gastroduodenum (93% correct) and lowest for colorectum (71%) compared with esophagus (79%) and hepatopancreatobiliary (83%) systems. The mean total score was higher for U.S. respondents (84% correct) compared with international respondents (79%, p < 0.0001). Endosonographers fared better than those who were not endosonographers (85% vs. 81%, p = 0.0002). CONCLUSIONS: Knowledge levels of colorectal applications of EUS are poorest among the 4 organ systems studied. Future educational initiatives should focus on applications of EUS in this category. Studies are required to assess the impact of this education on the appropriateness of EUS referral patterns.

Bile Ducts↗