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PubMed1991

Response bias in a case-control study: analysis utilizing comparative data concerning legal abortions from two independent Swedish studies.

Independent reports of legal abortions in two Swedish epidemiologic studies of breast cancer in young women, covering the same women and overlapping the same time period, have been compared in order to estimate a putative response bias. One study used case-control methods and obtained data by retrospective interviews from 317 cases and 512 controls. The other study was based on objectively documented information froma nationwide registry covering legally induced abortions. Analysis demonstrated a ratio between the odds ratios from the two studies of 1.5 (95 percent confidence interval 1.1-2.1) and an observed ratio of 22.4 (p less than 0.007) between underreporting of previous induced abortions among controls relative to overreporting among cases. This response bias may explain the tendency toward increased risk of breast cancer which, according to several case-control studies, appears to be associated with induced abortion.

Abortion, Legal↗
PubMed1994

Do women forget their births? A study of maternity histories in a rural area of Senegal (Niakhar).

5068 maternity histories were recorded among women aged 15-89 years in a rural area of Senegal. The quality of the estimates of fertility, child mortality, and perinatal mortality was analyzed for consistency. There was no evidence of any major underreporting of births, deaths, or still births according to age, even among the oldest women. Estimates were compared with comparable values derived from a longitudinal demographic surveillance system (DSS) in the same area. The age patterns of cumulated fertility and mortality derived from the maternity histories were consistent with those of the DSS. Differences in the levels of fertility and mortality with respect to the longitudinal records could be explained by small differences within the selected villages, by selection biases, and by recent trends in demographic parameters. Values of perinatal mortality were also equivalent to those recorded by the DSS. Women did not seem to forget their births to an extent large enough to produce strong biases, even at older ages. However, an analysis of differences by field workers revealed that some 2% of the births and 4% of the deaths may have been omitted, which gives an idea of the potential accuracy of maternity histories for the estimation of fertility and mortality levels.

Africa↗
PubMed1992

Occupational stress in neurosurgery: an exploratory study.

Occupational stress in nursing has been a popular topic for investigation. In particular, comparisons between practice areas such as the intensive care unit (ICU) and medical-surgical unit have attempted to identify what factors are stressful, and whether some nursing environments are more stressful than others. Such studies have led to inconclusive findings. While many practice areas have been studied, the neurosurgical ICU and neuromedical/neurosurgical units have largely been overlooked. Using interviews, this exploratory study examined aspects of nursing perceived as stressful by staff members working in ICU and medical-surgical units in a neuroscience center. Findings suggested that patient care, communication, workload, management and supervision, organizational and personal circumstances are major sources of stress. These findings are in keeping with studies of stress conducted in national and international non-neurosurgical nursing practice areas.

Burnout, Professional↗
PubMed2000

Adolescents' perceptions of maternal disapproval of sex: relationship to sexual outcomes.

PURPOSE: To examine the relationship between adolescents' perceptions of maternal abstinence attitudes, adolescent-maternal relationship satisfaction, and the occurrence in the ensuing 12 months of: (a) sexual intercourse, (b) the use of birth control at intercourse, and (c) the occurrence of pregnancy. We also examined the accuracy of adolescents in perceiving the attitudes of their mothers as well as factors that predicted underestimations of these attitudes. Finally, the study evaluated the relative predictive power of adolescent perceptions of maternal abstinence attitudes and the actual maternal abstinence attitudes. METHODS: This was a prospective study using a subsample of the Longitudinal Study of Adolescent Health database, which is a nationally representative school-based sample. The sample for the present study was approximately 10,000 adolescents in grades 7 to 11 who completed 2 interviews in their homes at a 1-year interval. Mothers of the adolescents were interviewed only during Wave 1. Interviews covered a variety of topics, including adolescent risk behaviors and family relationships. Measures at Wave 1 were used to predict outcomes at Wave 2, employing logistic and multiple regression techniques. RESULTS: Adolescents' perceptions of maternal attitudes toward the adolescents' engaging in sexual intercourse, and adolescent satisfaction with the maternal relationship were predictive of the occurrence of sexual intercourse between Wave 1 and Wave 2, as well as the occurrence of pregnancy. The more disapproving adolescents perceived their mothers to be toward their engaging in sexual intercourse and the more satisfied adolescents were with their relationship with their mothers, the less likely adolescents were to initiate sexual activity or to become pregnant. Only relationship satisfaction was predictive of the use of birth control, such that more satisfied adolescents were more likely to use birth control at their most recent intercourse. The correlation between adolescent perceptions of maternal abstinence attitudes and actual maternal attitudes was .26. Adolescent perceptions of maternal attitudes tended to be a more consistent predictor of outcomes than actual maternal attitudes. CONCLUSIONS: The results are consistent with a growing body of literature that suggests the importance of adolescents' perceptions of maternal attitudes in determining sexual risk behaviors. Adolescents may misperceive the attitudes of parents, suggesting the need for communication between parent and teen.

Adolescent↗
PubMed1996

Michael S. Brown, MD and Joseph L. Goldstein, MD. 1985 Nobel laureates in medicine.

When Michael S. Brown, MD and Joseph L. Goldstein, MD first met as interns at the Massachusetts General Hospital in 1966, they could hardly have imagined that their careers would continue to be intertwined some 30 years later. It was shortly following their arrival as clinical associates at the National Institutes of Health in 1968 that the pair developed an interest in abnormalities of cholesterol metabolism. Bolstered by epidemiologic data that showed elevated cholesterol levels in many patients with myocardial infarction, Brown and Goldstein, who relocated to the University of Texas Southwestern Medical Center in 1972, began a search for receptors important in cholesterol homeostasis. These studies, performed in their early stages while juggling clinical duties at Parkland Hospital, culminated in a series of scientific achievements which merited among other honors the Hazen Award in 1982, the Lasker Award in 1985, and the Nobel Prize in Medicine in 1985. Today, as Regental Professors of the University of Texas, Brown and Goldstein head a laboratory group which continues to test the cutting edge of medical research. Although impressed with the pace of technological advances in biology, the declining role of clinically oriented physicians in biomedical research troubles the pair. Interviewed in their library in Dallas, Brown and Goldstein spoke about the complicated balance of science, medicine, and education necessary to produce another generation of successful investigators.

Cholesterol↗
PubMed2003

[Are academic radiologists evaluating the professional ethics of their residents?].

PURPOSE: Ethics is a challenging topic to teach and calls for competencies complex to pin point. Nevertheless, evaluation of ethics is a milestone on the way to autonomous medical practice. Our objectives were 1; To describe the "hidden knowledge" of academic radiologists evaluating the ethics of their residents; 2; To look for common denominators by comparing the evaluative practice of academic radiologists from France and Quebec. METHOD: 8 academic radiologists were interviewed on a critical episode of ethics evaluation of residents. The 8 transcripts were coded then co-coded using a USA reference from the radiology literature. RESULTS: 8/8 radiologists referred to 8 common issues of ethics, 7/8 shared an extra one, related to the teaching setting and 3/8 added the specific issue of consent to radiological procedure. CONCLUSION: The same ethical issues are shared by radiologists working in USA, France and Quebec. There are great similarities in evaluating ethics of residents among academic radiologists from France and Quebec, the diffusion of which being potentially useful to medical ethics training.

Ethics, Medical↗
PubMed1983

Tailoring sex-education programs to adolescents--a strategy for the primary prevention of unwanted adolescent pregnancies.

The data for this paper were derived from 88 unstructured interviews conducted with a purposive sample of adolescents from September 1978 through July 1979. We content analyzed all interview abstracts with particular emphasis on the comments and suggestions made by adolescents in regard to sex education in order to ascertain their needs. Three areas in need of immediate revision were identified--curriculum, format, and lecturer. Respondents also provided a variety of suggestions which can be used by educators and planners in developing and implementing sex-education programs; thereby making programs sensitive to the expressed needs and wants of adolescents. This qualitative study supports the findings of many quantitative studies which found that many adolescents do not have, yet want, sensitive sex-education programs.

Adolescent↗
PubMed2006

Complementing random-digit-dial telephone surveys with other approaches to collecting sensitive data.

Surveys of sensitive topics, such as the Injury Control and Risk Surveys (ICARIS) or the Behavioral Risk Factors Surveillance System (BRFSS), are often conducted by telephone using random-digit-dial (RDD) sampling methods. Although this method of data collection is relatively quick and inexpensive, it suffers from growing coverage problems and falling response rates. In this paper, several alternative methods of data collection are reviewed, including audio computer-assisted interviews as part of personal visit surveys, mail surveys, web surveys, and interactive voice response surveys. Their strengths and weaknesses are presented regarding coverage, nonresponse, and measurement issues, and compared with RDD telephone surveys. The feasibility of several mixed mode designs is discussed; none of them stands out as clearly the right choice for surveys on sensitive issues, which implies increased need for methodologic research.

Behavioral Risk Factor Surveillance System↗