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At least 1,387 records · Page 77Linked to original sources

PubMed2005

Measurement of electrical skin impedance of dermal-visceral zones as a diagnostic tool for inner organ pathologies: a blinded preliminary evaluation of a new technique.

BACKGROUND: As complementary and alternative medicine is gaining popularity among health consumers, diagnostic screening tools based on neuroreflexology are also being developed. These techniques, which are based on the rationale that measurement of electrical impedance of specific dermatomes reflects corresponding internal organ pathologies, have not yet been the subject of conventional scientific research. OBJECTIVES: To determine the effectiveness of a neuroreflexology-based screening test, specifically the Medex device (Medex Screen Ltd.), for diagnosing patients undergoing conventional internal organ assessment, in a hospital setting. METHODS: Patients admitted to an internal medicine department, who met the inclusion criteria and agreed to participate, underwent conventional medical evaluation that included past medical history and physical examination. Another examination was conducted by a second physician using the Medex device to determine internal organ pathologies. A third researcher compared the actual "conventional" diagnosis with the Medex device output using standard statistical analysis. RESULTS: Overall, 150 patients participated in the study. Correlation was significant for all categories (P < 0.01) except for blood and lymphatic disease. A high sensitivity (>70%) was measured for cardiovascular, respiratory, gastrointestinal and genitourinary diseases. The highest measure of agreement, as represented by the Cohen-Kappa factor, was found for respiratory disease (0.57). CONCLUSIONS: Although the exact mechanism is not entirely clear, measurement of electroskin impedance of dermal-visceral zones has the potential to serve as a screening tool for inner organ pathologies. Further research should be conducted to create more evidence to support or dispute the use of this technique as a reliable diagnostic tool.

Complementary Therapies↗

PubMed2005

Researchers study use of the 'MATI' for improving AIDS drug adherence. Early data confirm tool's usefulness.

Investigators have found that an adherence tool that addresses multiple factors contributing to adherence difficulties can assist with better adherence. The Medication Adherence Training Intervention (MATI) is a newly-invented tool that prepares patients for adherence by incorporating medication adherence education, the patient's history and medication experiences, with motivation and empowerment interventions, says Shvawn McPherson Baker, PharmD, MPH, a research associate in the division of hepatology at the University of Miami School of Medicine in Miami, FL. "We developed the MATI along the context of clinical pharmacy, clinical medication, and clinical psychology, interfacing the three of them to come up with an approach to patient care," Baker says. "We looked at how to best incorporate the patient's abilities with our abilities." One aspect to the MATI that's important is how it is designed to be a nonjudgmental tool that doesn't admonish patients for their poor adherence habits, Baker notes. "The approach is 'Let's take off the white coat and work on this together,'" Baker says. "Let's see if there's a readiness for medication adherence and provide education on that."

HIV Infections↗

PubMed2005

Does the use of an automated tool for self-reporting mood by patients with bipolar disorder bias the collected data?

CONTEXT: Automating data collection from patients can improve data quality, enhance compliance, and decrease costs in longitudinal studies. About half of all households in industrialized countries now have a home computer. OBJECTIVE: While we previously validated the ChronoRecord software for self-reporting mood on a home computer with patients who have bipolar disorder, this study further investigates whether this technology created a bias in the collected data. METHODS: During the validation study, 80 of 96 (83%) patients returned 8662 days of data (mean, 114.7 +/- 32.3 SD days). The patients' demographics were compared with those of similar longitudinal studies in which patients used paper-based data collection tools. In addition, because demographic characteristics may influence attitudes toward technology, observer-rated scores on the Hamilton Depression Rating Scale and Young Mania Rating Scale were used to group patients by severity of illness, and the self-reported mood ratings were analyzed for evidence of bias from the patients' gender, ethnicity, diagnosis, age, disability status, or years of education. Analysis was performed using the 2-way analysis of variance and general linear model. RESULTS: The patients' demographic characteristics were very similar to those of patients with bipolar disorder who participated in comparable longitudinal studies using paper-based tools. After grouping the patients by severity of illness, none of the demographic variables had a significant effect on the patients' self-reported mood using the automated tool. CONCLUSION: The use of a computer does not seem to bias sample data. As with studies using paper-based self-reporting, results from studies of patients using ChronoRecord software on a home computer to report mood can be generalized.

Adolescent↗

PubMed2005

Risk factors for participation restriction in leprosy and development of a screening tool to identify individuals at risk.

The World Health Organisation International Classification of Functioning, Disability and Health defines participation as involvement in a life situation. Participation restrictions are problems experienced in any life situation, for example, in relationships or in employment. Our research explored risk factors for participation restrictions experienced by people affected by leprosy. Our objective was to develop a screening tool to identify individuals at risk. An initial round of qualitative fieldwork in eight centres in Nepal, India and Brazil identified 35 potential risk factors for participation restriction. These were then further assessed through quantitative fieldwork in six centres in India and Brazil. In all, 264 individuals receiving leprosy treatment or rehabilitation services made a retrospective assessment of their status at time of diagnosis. Their level of participation restriction was assessed using the Participation Scale. Regression analysis identified risk factors for participation restriction including fear of abandonment by family members (odds ratio 2.63, 95% CI 1.35-5.13) and hospitalization at diagnosis (3.98, 1.0-7.32). We recommend four consolidated items as the basis for a simple screening tool to identify individuals at risk. These are the physical impact of leprosy, an emotional response to the diagnosis, female gender and having little or no education. Such a tool may form the basis for a screening and referral procedure to identify newly diagnosed individuals at risk of participation restrictions and in need of actions that may prevent such restrictions.

Adolescent↗

PubMed2006

High-Level Mobility Assessment Tool (HiMAT): interrater reliability, retest reliability, and internal consistency.

BACKGROUND AND PURPOSE: The High-Level Mobility Assessment Tool (HiMAT) assesses high-level mobility in people who have sustained a traumatic brain injury (TBI). The purpose of this study was to investigate the interrater reliability, retest reliability, and internal consistency of data obtained with the HiMAT. SUBJECTS: Three physical therapists and 103 people with TBI were recruited from a rehabilitation hospital. METHODS: Three physical therapists concurrently assessed a subset of 17 subjects with TBI to investigate interrater reliability. One physical therapist assessed a different subset of 20 subjects with TBI on 2 occasions, 2 days apart, to investigate retest reliability. Data from the entire sample of 103 subjects were used to investigate the internal consistency of this new scale. RESULTS: Both the interrater reliability (intraclass correlation coefficient [ICC]=.99) and the retest reliability (ICC=.99) of the HiMAT data were very high. For retest reliability, a small systematic change was detected (t=3.82, df=19), indicating a marginal improvement of 1 point at retest. Internal consistency also was very high (Cronbach alpha=.97). DISCUSSION AND CONCLUSION: The HiMAT is a new tool specifically designed to measure high-level mobility, which currently is not a component of existing scales used in TBI. This study demonstrated that the HiMAT is a reliable tool for measuring high-level mobility.

Adult↗

PubMed2006

[Determination of ventricular volumes in coronary artery disease: comparison of two gated SPECT analysis tools with MRI].

AIM: Comparison of two gated SPECT analysis tools -- gated SPECT quantification (GSQ) and emory cardiac toolbox (ECT) -- in patients with coronary artery disease (CAD) and severely impaired left ventricular function (preoperative: EF <35% by cardiac catheter). PATIENTS, METHODS: A total of 56 gated SPECT examinations (one-day hybrid-protocol with (201)Tl-chloride for rest and (99m)Tc-sestamibi for stress applied during low-dose dobutamine stress MR-examination; temporal resolution; 8 phases per cardiac cycle) were performed in 36 patients (31 preoperatively, 25 postoperatively) and compared with MRI in 48 cases. Left ventricular end-diastolic (LV-EDV) and end-systolic (LV-ESV) volumes as well as the left ventricular ejection fraction (LV-EF) were calculated. RESULTS: The total volumetric assessment by both analysis algorithms (n = 56) showed good intraclass correlation coefficients preoperatively (n = 31), but even better postoperatively (n = 25). The mean reconstruction time was approximately 3 minutes ( +/- 2 SD) for GSQ and 15 minutes ( +/- 5 SD) for ECT. In comparison to MRI the results of both analysis tools also correlated well, but the agreement decreased in the presence of scared tissue. The mean LV-EF (MRI) preoperatively was 30.4%, in 6/36 patients above the values calculated from cardiac catheter, postoperatively 34.6%. CONCLUSION: Both gated SPECT analysis tools showed reliable volumetric assessments in high-risk patients with CAD and severely reduced LV-EF in comparison to MRI, with advantages for GSQ in terms of postprocessing time. However, for the calculation of LV-EF a markedly lower concordance with MR-results was observed for both methods depending on the presence of myocardial scars.

Aged↗

PubMed1997

The efficiency of tools used to retract a football helmet face mask.

OBJECTIVE: The purpose of this study was to evaluate time, head movement, and ratings of satisfaction with several popular tools used for retracting a football helmet face mask. DESIGN AND SETTING: Subjects retracted the face mask using a Phillips screwdriver, a Trainer's Angel, and an anvil pruner. A utility knife had to be eliminated from the study after the first two subjects were injured. SUBJECTS: Five certified athletic trainers, five emergency medical technicians, and five student athletic trainers retracted a face mask with each tool. MEASUREMENTS: Time was measured by stopwatch and movement by a force platform. Efficiency was calculated from total time and radial area. Ratings of satisfaction were reported by the subjects. RESULTS: There was no difference in the total time to retract the face mask using the three tools. Movement was significantly (p < .05) greater with the Trainer's Angel than with the anvil pruner or screwdriver. Subjects were more satisfied with the anvil pruner than the Trainer's Angel or screwdriver. When grouped by the subjects' credentials, there were no differences in time or rating of satisfaction among the certified athletic trainers, emergency medical technicians, or student athletic trainers, but there was a difference for movement. The student athletic trainers produced the least movement and the certified athletic trainers produced the most. CONCLUSIONS: It is suggested that the skill of face mask retraction be learned and practiced.

Journal Article↗

PubMed2004

The Global Mental Health Assessment Tool--Primary Care Version (GMHAT/PC). Development, reliability and validity.

The Global Mental Health Assessment Tool--Primary Care Version (GMHAT/PC) is a computerised clinical assessment tool developed to assess and identify a wide range of mental health problems in primary care. It generates a computer diagnosis, a symptom rating, a self-harm risk assessment, and a referral letter. Patients from primary care and community psychiatric outpatient clinics and a small sample of inpatients were interviewed for a period of two months using the GMHAT/PC. A proportion of patients were simultaneously rated by a psychiatrist and a general practitioner for inter-rater reliability. All patients also completed the Hospital Anxiety and Depression Scale (HAD). To conduct the interview was easy in all settings and took 10-15 minutes for patients who had psychiatric symptoms. Inter-rater agreement on mental state symptom groups ranged from 0.49 to 1 (kappa). The computer diagnosis correlated highly with the clinical diagnosis and there was a good level of agreement between HAD ratings and GMHAT/PC ratings. These data suggest that the GMHAT/PC is an easy to administer computerised tool which can be used in primary care for the standardised assessment of mental health problems.

Journal Article↗

PubMed2006

[Development of new surgical tools, Q-PAL and HP-Jet for endoscopy only used unilateral transnasal approach for pituitary adenomas].

UNLABELLED: The aim of this study is to present surgical techniques and results of endoscope-assisted transnasal approach (TNA) for pituitary adenomas. It is a new alternative for Hardy's surgery (TSS). We performed TNA assisted by only endoscope through single nostril. METHOD: We enter the sphenoid sinus directly through the natural ostium and ablate neither the nasal septum nor the vomer bone. We found the hardest problem of this method resides in its deep and narrow working space which obstructs usage of two tools at same time. To overcome this problem we developed two surgical tools, Q-PAL and HP-Jet. Q-PAL is combination of PAL and suction. We place flexible PAL wire electrode through suction tube so as PAL tip protrudes from suction tip. This eliminates coagulation smoke which otherwise disturbs surgeons view. HP-Jet is a combination of a suction tool and an irrigator. The irrigator is connected to syringe containing saline. Saline is injected manually from tip bursting up tumor tissue with its jet pressure. It is safe and effective instrument suitable for extirpation of rather fragile tissue like adenomas existing in deep and blind spaces. CASES: Since 2004 we have operated on 16 patients using endoscopic TNA. Eight were non-functioning adenomas, and 8 functioning. RESULTS: Results of surgery were compared with those of 10 cases operated by TSS. More than 70% removal of adenoma was achieved in 75% of cases with TNA, but in only 71% with TSS. Postoperative CSF rhinorrhea was seen in one case. Four cases showed postsurgical transient diabetes insipidus. We had no case with postsurgical infection. With the help of instruments having multiple functions in single probe such as Q-PAL and HP-Jet, we can execute endoscopic TNA more smoothly and more safely.

Adenoma↗

PubMed2006

Individualising weight loss prescription--a management tool for clinicians.

BACKGROUND: Obesity is a global epidemic and a growing cause of comorbidities seen by clinicians. Yet apart from recent guidelines developed by the National Health and Medical Research Council there are few clinical tools available to tackle this problem. OBJECTIVE: This article describes a tool for detecting aspects of both diet and lifestyle likely to adversely affect the body weight of an individual. DISCUSSION: The Diet, Activity and Behaviour Questionnaire (DAB-Q) is designed to identify the nutrition, physical activity and eating behaviours likely to lead to energy imbalance and increased body weight in an individual. This tool can be used in clinical practice to help individualise appropriate behavioural prescriptions for successful weight management.

Australia↗

PubMed2006

Automated tool for the detection of cell nuclei in digital microscopic images: application to retinal images.

PURPOSE: To develop an automated tool that provides reliable, consistent, and accurate results for counting cell nuclei in tissue sections. METHODS: We propose a novel method based on an image processing algorithm to analyze large sets of digital micrographs. The nucleus detector design is based on a Laplacian of Gaussian filter. We use the leave-one-out cross validation method for estimating the generalization error, which is then used to choose the model and parameters of the proposed nucleus detector with both fluorescent and dye stained images. We also evaluate the performance of a nucleus detector by comparing the results with manual counts. RESULTS: When our nucleus detector is applied to previously unanalyzed images of feline retina, it correctly counts nuclei within the outer nuclear layer (ONL) with an average error of 3.67% ranging from 0 to 6.07%, and nuclei within the inner nuclear layer (INL) with an average error of 8.55% ranging from 0 to 13.76%. Our approach accurately identifies the location of cell bodies. Even though we have a relatively large error in the INL due to the large intra-observer variation, both manual counting and nucleus detector result in the same conclusion. This is the first time that cell death in the INL in response to retinal detachment is analyzed quantitatively. We also test the proposed tool with various images and show that it is applicable to a wide range of image types with nuclei varying in size and staining intensity. CONCLUSIONS: The proposed method is simple and reliable. It also has widespread applicability to a variety of sample preparation and imaging methods. Our approach will be immediately useful in quantifying cell number in large sets of digital micrographs and from high-throughput imaging. The tool is available as a plug-in for Image J.

Algorithms↗

PubMed2006

[The "Depression Monitoring list" (DeMoL) with integrated PHQ-D-Rationale and design of a tool for the case management for depression in primary care].

BACKGROUND: Structured and regular monitoring and/or case management support treatment continuity of patients with depression in primary care. Central tools are questionnaires with stratified operating instructions. Questions should be geared towards treatment relevance in primary care and identify clinical parameters in a reliable and valid manner and in due time. Stratified information transfer to the general practitioner should be objective to ensure patient-related communication in the practice team. METHOD: Development of a draft tool based on evidence-based guidelines, peer-reviewed pre-test, practice test among users. RESULT: The Depression Monitoring List (DeMoL) with integrated PHQ-D for interviews with depressive patients to be conducted by practice assistants assesses 1.)'clinical diagnosis' and 2.) 'patient adherence' and 3.) governs the information flow in the practice via a 'robot scheme'. Users (doctors and practice assistants) evaluated the tool as practicable and relevant for patient care in family practices. Experiences gained can also be used for the treatment of other chronic diseases.

Case Management↗

PubMed2006

[The Objective Structured Clinical Examination and its potential applications as an assessment and feedback tool for IDF primary care physicians--a pilot study].

BACKGROUND: In recent years, the Israel Defense Forces IDF developed special training programs for junior military physicians at the beginning of their service and CME courses for senior military physicians. The Objective Structured Clinical Examination (OSCE) is a well established assessment tool in medical education that can be of vast use in military training programs for primary care physicians. AIM: To evaluate the OSCE as an assessment tool of military primary care physicians. METHODS: Forty-one military primary care physicians completed a 10-station OSCE. The clinical scenario choices were based on the most prevalent problems in the annual statistics of the Israeli Medical Corps between the years 1988-1998. Each station consisted of two parts: a doctor-SP (standardized patient) encounter and a written exercise. Both parts were evaluated by checklists designed and validated by a committee of OSCE experts and senior military physicians. RESULTS: The overall reliability of the exam was alpha = .88. The examinees highly valued the relevance of the scenarios to their every day practice (4.38 out of 5.0) and the reliability of the standardized patients (4.0 out of 5.0). A total of 92% request feedback on their performance. CONCLUSIONS: This pilot study found the OSCE to be a feasible, valid and reliable tool that can serve to assess the capability of physicians to deal with major issues in military primary health care. The OSCE can also play a major role in structured feedback provided to these physicians.

Education, Medical, Continuing↗

PubMed2006

Authoring tools for web based surveys: A descriptive study.

Researchers utilizing web-based survey in their data collection have increased in the past decade. In parallel, the number of web-based survey tools offered by commercial vendors also have increased. This study was conducted to establish and define the critical success criteria for evaluation of a survey authoring tool and to review the top five most commonly used commercial tools.

Data Collection↗

PubMedDate not supplied

Nutritional screening tools--How does the MNA compare? Proceedings of the session held in Chicago May 2-3, 2006 (15 Years of Mini Nutritional Assessment).

Malnutrition occurs frequently in the elderly and is correlated with decreased functionality and thereby quality of life, as well as increased morbidity and mortality. This holds true for elderly people living in the community, patients in acute-care hospitals, as well as residents in long-term care facilities. To diagnose malnutrition, it is crucial to have sensitive, easy-to-use and specific tools at hand. The focus of this article is to compare strengths and weaknesses of the most commonly used assessment tools for malnutrition in the elderly, Malnutrition Universal Screening Tool (MUST), Mini Nutrition Assessment (MNA), Subjective Global Assessment (SGA), and Nutrition Risk Screening (NRS 2002). In conclusion, 15 years after its introduction, the Mini Nutritional Assessment (MNA), which was especially developed for elderly people, remains the gold-standard for ambulatory living elderly and those living in long-term care facilities, whereas the NRS 2002 has especially good potential in the acute-care setting, as it was developed specifically for hospitalized patients who need nutritional support.

Aged↗

PubMed2006

The diagnostic utility of Self-Reporting Questionnaire (SRQ) as a screening tool for major depression in hemodialysis patients.

There is overwhelming evidence that individuals with Major Depressive Disorder (MDD) are being seriously under diagnosed and under treated. The Self-Reporting Questionnaire (SRQ) is a good screening instrument for the detection of psychiatric disorders. However, the clinical significance of SRQ as a screening test for MDD in patients on hemodialysis (HD) has yet to be elucidated. The purpose of this study was to evaluate the diagnostic utility of the SRQ in detecting MDD in a cohort of patients with end-stage renal disease (ESRD) on maintenance HD. Twenty-six patients on maintenance HD were randomly recruited and were asked to complete the SRQ. The participants were, in addition, interviewed by a psychiatrist, who had been blinded to the SRQ score. We examined the ability of SRQ to detect patients who were diagnosed to have MDD based on psychiatric assessment. Among the 26 patients assessed, four patients were diagnosed to have MDD based on current diagnostic criteria. Logistic regression analysis showed that SRQ could predict patients with MDD with adjusted odds ratio of 1.9 (CI, 1.06- 3.42). Being a female was the most important variable for having a high SRQ (F=16.9, P=0.0004). The limitations of this study include a relatively small sample size and a high rate of somatic symptoms reported in the non-depressed population that limited the positive predictive value of the SRQ. Thus, although the SRQ has a high sensitivity, the positive predictive value of the SRQ is poor at low cut offs. In conclusion, our study suggests that an ideal screening tool in patients on HD should have minimal emphasis on the somatic symptoms of MDD. Until such a tool is available, clinical assessment remains the best screening tool for MDD.

Adult↗

PubMed1991

Assessment and prevention of osteoporosis through use of a client self-reporting tool.

Osteoporosis is an age-related process that affects one out of every four women above 65 years of age. This article focuses on the assessment of osteoporosis through use of an osteoporosis assessment tool that is filled out by the client. The tool requests information about the woman's demographic profile, chief complaint, related symptoms, pain profile, risk profile, past medical history, nutritional history, fitness profile, menopausal history and self-care practices. The tool also includes information for the health care provider to complete about the client's lab analysis. Assessment needs to be extensive in order to uncover the specific factors that place an individual at risk for the silent changes of osteoporosis. The health care provider can elicit the aid of the client in securing such a comprehensive assessment.

Adult↗

PubMed1991

Development and testing of a carbohydrate monitoring tool for athletes.

Improving carbohydrate intake in athletes will increase muscle glycogen storage. This in turn can improve exercise time and performance by delaying fatigue. However, planning and consuming a diet that contains 60% to 70% carbohydrate is difficult for most athletes. To develop a simple carbohydrate monitoring tool for athletes, we analyzed three sets of 3-day diet records from 17 male endurance runners over a 10-week competitive period and 9 female endurance runners over a 9-week training period. We then developed a simple carbohydrate monitoring tool. To validate the instrument, we compared each athlete's carbohydrate intake as estimated using the instrument with the athlete's actual carbohydrate intake from the 3-day diet records. Mean estimated percents of energy from carbohydrate using the carbohydrate monitoring tool were not significantly different from the actual mean carbohydrate intakes. Examination of individual diets showed that the estimated carbohydrate was always within 2% of the actual carbohydrate. Therefore, the instrument did a good job of estimating the percent of energy from carbohydrate in the diets of endurance runners. This instrument will provide a quick method by which the athlete can assess and improve carbohydrate intake on a daily basis without the use of daily diet records.

Diet↗