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PubMed1998

"Healthometer"--an instrument for self-distributed health screening and prevention in the population.

In the ongoing expansion of medical systems toward prevention and health promotion, primary care is increasingly recognized as a key vehicle and agent. In order to establish a comprehensive health dialogue in the population, there is a need for innovative instruments corresponding to the information and linked media revolution that this shift is a part of. Based upon the experiences of the Department of Preventive Medicine in Malmö, Sweden, a self-mediated, interactive health testing and promotion instrument called "healthometer" has been developed and tested for feasibility. The instrument uses a special variety of a quintile-distributed visual analog scale with the thermometer as reference and allows: (a) easy summation and averaging of single or different aggregates of the test items as a "wellness" profile and score with emphasis upon the positive aspects of health, and (b) recognition against this on the whole favorable background of the weak points motivating further action. The instrument, which can be distributed on paper or electronic medium, supports participation and insight in the initial stages of a directed individual health program for the continuation of which the utilization of professional counsel is stimulated.

Adult↗

PubMed1983

Effects of instruction in basic communication skills on physical therapists and physical therapy students.

The purpose of this study was to test the hypothesis that laboratory instruction within a one-semester course could significantly change the communication skills of physical therapists and physical therapy students in the desired direction. Effective use of communication skills, the dependent variable, is defined in the counseling psychology literature. The independent variables were parts of two academic courses for physical therapists: one for graduate students (physical therapists) and one for undergraduate students. Data from the two groups were treated separately in a one-group, pretest-posttest, quasi-experimental design. The test for overall effect of changes in communication skills of undergraduate students was significant at the .0001 level. Post hoc tests for changes in use of seven specific skills varied in significance level from .8 to .0001. Education techniques, not subject variability, accounted for most of the change. Graduate student data did not reach traditional significance levels, but encouraging trends were noted. Results can be interpreted in terms of education, clinical experience, and measurement tools.

Adult↗

PubMed2003

Post-mortem collection of human joint tissues for research.

OBJECTIVE: A feasibility study aiming to obtain post-mortem knee joint tissues from 10 donors for research. METHODS: Next of kin were approached by bereavement officers then informed about the project by the study nurse. Written consent was sought to collect bone, cartilage and soft tissue from both knees, and to extract data from medical notes. RESULTS: During the 4-month study period 259 families attended the King's Mill Hospital Bereavement Centre, 36 of whom met with the study nurse, 10 of whom consented to joint tissue collecting. The process of seeking consent required approximately 1 h of direct contact. Participants often looked to this as an extension of the bereavement counselling process and many expressed gratitude that some good might be derived from the death. Reasons for non-recruitment included operational restraints and relatives' distress. Donors were more likely to be male (90%) than were non-donors (49%, Z = -2.6, P < 0.01). Coroner's post-mortem examinations took place on similar proportions of donors (20%) and non-donors (19%, Z = -0.06, P = 0.96). CONCLUSIONS: Post-mortem joint tissue collection for research remains feasible in the presence of a skilled, well co-ordinated, multidisciplinary team, even when post-mortem examination would not otherwise be required.

Aged↗

PubMed2001

Opportunities to improve prevention and services for HIV-infected women in nonurban Alabama and Mississippi.

OBJECTIVE: The intent of this study was to identify opportunities for improving the effectiveness of HIV prevention before nonurban (rural and small-city resident) Southern women are infected and the medical and social services offered to them after they are infected. METHODS: At several HIV clinics in nonurban Alabama and Mississippi, women with HIV infection (who reside in small cities and towns outside of Birmingham) were identified and interviewed about the period during which they probably acquired HIV and about their needs and the services provided after they were found to be infected with HIV. RESULTS: Before they were infected, these 211 young (mean age, 33 years), mainly African-American (67%) women often reported being seen at HIV testing sites (37%) and, among drug users, at drug treatment facilities (30%), where they presumably received counseling to prevent becoming infected. Once infected, many (21%) said they were not directed to HIV treatment sites, half (50%) were sexually active in the month before they were interviewed, many (13%) sought treatment of sexually transmitted diseases in the 12 months before the interview, and many (36%) reported unmet needs for HIV treatment related to having no insurance or Medicaid. CONCLUSIONS: Prevention and treatment of HIV for nonurban Southern women are not fully effective. Given the continued sexual activity of these women, more focus on preventing transmission from persons who are already infected is warranted.

Adult↗

PubMed1982

Geriatric sexual dysfunction: a case survey.

This study examines questionnaire data obtained from a group of older persons with sexual dysfunction mistakenly referred through a newspaper column. These 35 respondents (28 men, seven women) were characterized by age (43-82 years), symptomatic sexual problems, and a willingness to write about them. They were chiefly men had varying degrees of erectile failure and were negatively affected by the development of their problems. Two thirds had consulted a physician. The older subjects were more likely to be abstinent, to have total erectile failure (if men), to have known their physicians only a short time, and to describe their physicians as uninterested or pessimistic. Couples involving a medically ill wife couples married for a long time, and couples who defined sexuality in a nonaffective way were less affected by the development of sexual difficulties. A small group of older men had become impotent because of prolonged abstinence related to lengthy illness of their wives. These findings indicate that some physicians show an age-related bias in treating such patients; some contributory factors are outlined. The data may help clinicians in their counseling of such patients and in the identification of certain subgroups at risk. Directions are suggested for further systematic research.

Adult↗

PubMed1994

The spectrum of beta thalassaemia mutations in the UAE national population.

The beta thalassaemia alleles in 50 beta thalassaemia heterozygotes originating from many parts of the United Arab Emirates (UAE) have been characterised using the allele specific priming technique of the polymerase chain reaction (PCR). The IVSI-5 (G-->C) mutation was found to be present in 66%, while six other alleles occurred at the much lower frequencies of 2% to 8%. These were codon 8/9 (+G), IVSI-1, 3' end (-25 bp), codon 5 (-CT), IVSII-1 (G-->A), codon 30 (G-->C), and codon 15 (G-->A). The mutation types and percentages are compared with other Mediterranean Arab countries and neighbouring areas. It is proposed that IVSI-5 and other Asian Indian mutations were introduced into the UAE by population migration from the region previously known as Baluchistan. These findings should be useful for genetic counselling and the development of a first trimester prenatal diagnosis programme based on direct detection of mutations in the UAE.

Base Sequence↗

PubMed2004

Development of a cervical cancer educational program for Chinese women using intervention mapping.

This article describes the development of a program to increase Pap screening behavior among women in Taiwan. Intervention mapping, an innovative process of intervention design, guided the development of this program. The development process included a needs assessment identifying factors influencing Pap screening behavior relevant to Chinese women. The program used methods such as information transmission, modeling, persuasion, and facilitation. Strategies included direct mail communication, role-model stories and testimonials, and a telephone-counseling component. The delineation of specific plans for implementation and evaluation are also described.

China↗

PubMed2004

Molecular analysis using DHPLC of cystic fibrosis: increase of the mutation detection rate among the affected population in Central Italy.

BACKGROUND: Cystic fibrosis (CF) is a multisystem disorder characterised by mutations of the CFTR gene, which encodes for an important component in the coordination of electrolyte movement across of epithelial cell membranes. Symptoms are pulmonary disease, pancreatic exocrine insufficiency, male infertility and elevated sweat concentrations. The CFTR gene has numerous mutations (>1000) and functionally important polymorphisms (>200). Early identification is important to provide appropriate therapeutic interventions, prognostic and genetic counselling and to ensure access to specialised medical services. However, molecular diagnosis by direct mutation screening has proved difficult in certain ethnic groups due to allelic heterogeneity and variable frequency of causative mutations. METHODS: We applied a gene scanning approach using DHPLC system for analysing specifically all CFTR exons and characterise sequence variations in a subgroup of CF Italian patients from the Lazio region (Central Italy) characterised by an extensive allelic heterogeneity. RESULTS: We have identified a total of 36 different mutations representing 88% of the CF chromosomes. Among these are two novel CFTR mutations, including one missense (H199R) and one microdeletion (4167delCTAAGCC). CONCLUSION: Using this approach, we were able to increase our standard power rate of mutation detection of about 11% (77% vs. 88%).

5' Untranslated Regions↗

PubMed1999

Standards for batterer intervention programs in Canada: a history and review.

This article reports on the growing trend of setting standards for intervention with batterers. All existing Canadian standards for batterer intervention programs (BIPs) are examined, including a discussion on how they came into effect and any controversy associated with their development. A brief background of the battering intervention field and the growth of BIP standards in North America is provided, followed by a description of the types and content of Canadian standards. Compliance with standards were mandatory in two regions and voluntary in three others. Two more regions had standards in a draft stage of development. Elements of standards typically included directives on: general program goals; the protocol and procedures programs should follow, including counselling format; and program staff ethics and qualifications. The article concludes with a discussion of the findings and suggestions for improving standards.

Canada↗

PubMed1999

The behavioural phenotype in velo-cardio-facial syndrome (VCFS): from infancy to adolescence.

In this contribution the current status and recent findings of the behavioural phenotype in VCFS (22q11 deletion) are discussed with regard to motor development, cognition and neurodevelopment, and behaviour and temperament. Motor: hypotonia in infancy, gross-motor milestones are delayed, problems with coordination and balance from preschool age on, problems with tempo/speed during adolescence. Cognition and neurodevelopment: learning disabilities (82-100%), intellectual disability (45%), better verbal abilities than performal abilities, poor attention and concentration, visuo-perceptual-spatia problems, good (auditory) memory. An important subgroup of children (55%) has a non-verbal learning disability (NLD). Behaviour and social-emotional development AD(H)D, withdrawn and shy, person-dependent social problems in relationships with peers, anxious, risk for child psychiatric problems as well as for the development of psychiatric problems during adolescence and early adulthood. Information on the behavioural phenotype in VCFS (22q11 deletion) is of great importance to clinicians as an aid to syndrome diagnosis, but even more to parents because it offers immense direct practical value to the management of the behaviour of their child. Appropriate counseling and information on the long-term expectations, and better insight in the behaviour will lead to the development of realistic ways of coping with their child.

Adolescent↗

PubMedDate not supplied

[Neurofibromatosis type 2 (NF2)--classical example of a rare familial cancer syndrome].

Type 2 neurofibromatosis (NF2) is a dominantly inherited disorder characterized by a predisposition to multiple tumours of the nervous system. The incidence in the Caucasian population is estimated between one in 35,000 and one in 40,000 of live births. The NF2 gene was isolated and shown to have mutations in NF2 patients. It is considered to belong to tumour suppressor gene family. Direct NF2 gene analysis enables verification of tentative clinical diagnosis and makes genetic counselling possible.

Adult↗

PubMed1958

Prepartum depression; a study of seventy unwed mothers treated with d-amphetamine sulfate and amobarbital.

Seventy unwed pregnant patients in states of mild to moderate depression evidenced by one or more symptoms (tenseness, "nervousness," crying spells, listlessness, fatigue, nausea and vomiting, insomnia and overeating), received informal psychotherapy and a sustained-release capsule combining d-amphetamine sulfate and amobarbital.Forty-eight patients had complete or substantial relief of symptoms, 15 had partial relief, seven had slight or no relief. Use of the preparation seemed to make tense, "nervous" patients more communicative and amenable to counseling, but was less effective in listless, easily fatigued patients. Because of its direct mood-alleviating action and its ability to facilitate psychotherapy, the d-amphetamine sulfate-amobarbital combination proved a very effective treatment for mild and moderate depression accompanying pregnancy.

Amobarbital↗

PubMedDate not supplied

Providing information at the point of care: educational diagnostic reports from a genetic testing service provider.

Strategies to facilitate the provisioning of genetic health-care services by primary care physicians will improve access to these services for the average patient while making the most efficient use of limited human and financial resources within the health-care system. Genetic laboratories have become a major source of information and consultation for clinicians ordering genetic tests. This article describes the development and evaluation of a program to provide physician-directed information from a molecular testing facility to assist physicians in selecting and counseling patients and interpreting genetic test results. Semi-structured telephone interviews were used to gather physicians' opinions about the utility of the program and the way in which the information was used in their practice. Forty-three percent of those interviewed were unfamiliar with some of the information provided, with test methodology and sensitivity/specificity most often identified as novel information. Fifty-two percent of pediatric specialists were unfamiliar with some aspect of the information Sheet, despite being the highest consumers of testing services in this sample. Pediatricians and pediatric specialists also rated the initiative highest in terms of its usefulness in their practice, followed by genetic specialists. Overall, physicians confirmed the utility of the program as an educational tool for themselves, and for other non-patient educational activities in which they are involved.

Attitude of Health Personnel↗

PubMed2005

An innovative tobacco use cessation program for military dental clinics.

Tobacco use is the chief avoidable cause of death and illness in our society. Military leaders are concerned with rising medical costs and the related negative effects on combat readiness associated with tobacco use. Tobacco use cessation (TUC) programs available in the military services have not reached their full potential. Dental officers have an opportunity to assume a more active role as first-line providers in TUC programs. This paper presents a model TUC program for use in military dental clinics. It emphasizes the dentist's role in directly prescribing pharmacologic agents in nicotine replacement therapy (NRT) combined with appropriate patient counseling. Other key elements of this TUC program include the non-threatening manner in which patients are offered access to TUC, its convenience when compared with other programs, and the minimal cost to implement this program.

Bupropion↗

PubMed1990

Professional satisfaction among California general dentists.

Dentists' assessments of their jobs provide insights about issues in the dental profession needing attention. This study assessed professional satisfaction among 558 California general dentists using the 54-item, multi-faceted Dentist Satisfaction Survey (DSS). Although dentists tended to be satisfied with various facets of their jobs and careers, substantial variation in the levels of satisfaction was noted. The most satisfied dentists were older, reported higher incomes, attended more continuing education, and employed more dental auxiliaries than dentists who were the most dissatisfied. Fifty-eight percent of the variation in overall job satisfaction was explained by quality of nonwork life and satisfaction with five facets of the profession: respect received from being a dentist, the actual process of delivering care, income derived from dentistry, relationships with patients, and reduced levels of job-related stress. Dentists were most dissatisfied with the threat of malpractice, level of income, demands of managing the practice, and amount of personal time. Professional organizations should direct programs to address these issues. Dental educators should use these findings to counsel predoctoral students about the realities of dental practice and as an outcome measure of their programs. Moreover, these findings document the perceptions of the practicing profession and support several components of the SELECT recruitment strategy.

Adult↗

PubMed1992

Counselor of quality.

Coping with cancer from the patient's or counselor's viewpoint means that strengths and resources depend on assessing predominant problems and acting appropriately to alleviate them. It does not always mean resolution of problems, but it does require understanding where the pressure points are that lead to more distress. Thus, counselors anticipate as well as understand actual distress; visualize various outcomes of different interventions, medical or otherwise; and narrow the gap between what is hoped for and what might be possible. Pastoral counseling needs a viewpoint that maintains morale in the utmost phase of terminal illness. Facing mortality is difficult for the counselor as well as significant others. Therefore, they must deal directly with bereavement and potential loss, if possible, indicating their willingness to confront ultimate questions, even without answers. Overall, the purpose of quality counseling is in the counselor: limitation is not futility. The job of counseling is not to figure out the universe or explain the unexplainable. Rather, the purpose of counseling is to help a suffering individual to come back within the range of normalized behavior and to become acceptable and credible. In this way, out of the web of vulnerability can come further strengths and resources.

Adaptation, Psychological↗

PubMed2001

Clinical staff as mentors in pre-registration undergraduate nursing education: students' perceptions of the mentors' roles and responsibilities.

This paper reports part of a multiple-phase action research initiated by a university nursing department in Hong Kong. Local hospitals were invited to collaborate in a joint mentoring programme which recruited clinical staff to mentor pre-registration nursing students during clinical placement. Interviews based on the five roles -assisting, befriending, guiding, advising and counselling, as outlined by the English National Board, were conducted to explore students' views of the mentor's roles. Findings showed that students in general agreed that the five roles depicted were necessary roles of the mentors. They saw the roles of assisting and guiding as most crucial, while the befriending role was useful to facilitate their settling into the ward. The advising and counselling roles were seen as less important. It was concluded that students tended to be more instrumental in viewing their mentor's behaviours; activities that have a direct effect on their learning are considered as more important, while other factors which have a less immediate or less direct effect on their learning, are seen as of lower priority.

Counseling↗

PubMed1994

[Smoking habit questionnaire for outpatients].

UNLABELLED: During September 1992, outpatients of a general hospital received questionnaire on medical smoking cessation advice and smoking habit assessment by a physician. The staff of the Internal Medicine Service were asked about the frequency of outpatient smoking habit assessment. Of 185 patients interviewed, 37% were smokers, 38.5% were ex-smokers and 24.5% had never smoked; 46% of smokers reported that they had been told to quit smoking by a physician. Those who smoked more cigarettes per day were more likely to have been advised to stop. Of ex-smokers, 16% said that they had received medical aid for quitting. The frequency of smoking habit assessment was; in every physician-patient contact 20%, sometimes 36%, hardly ever 12% and 32% said that they were never questioned about smoking habits (Table 2). Those who reported to have been counseled to quit, were more likely to report smoking habit assessment (Table 3). Of physicians, 81% reported assessing routinely all ambulatory patients' smoking habit. Smoking prevalence among physicians was 43.3%, and 23.3% of them smoked in the office. These findings on the frequency of physicians' smoking advice are similar to those of Anda et al and Frank et al (Table 4). CONCLUSIONS: 1) physician's smoking cessation advice and smoking habits assessment reported by patients were low, 2) physicians report higher frequency of smoking habit assessment than patients, 3) physicians' smoking prevalence was higher than patients' prevalence. As a first approach to increase medical interventions against smoking, quitting programs directed to health personnel must be implemented.

Adult↗