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PubMed2002

A comparison of the index of complexity outcome and need (ICON) with the peer assessment rating (PAR) and the index of orthodontic treatment need (IOTN).

AIM: To evaluate any relationship between ICON, IOTN and PAR. To establish whether or not ICON could replace these indices as a measure of orthodontic treatment complexity, outcome and need. METHOD: The study models of 55 consecutively treated cases were examined and PAR, IOTN and ICON recorded. RESULTS: The study showed significant correlations between IOTN and ICON with respect to need and PAR and ICON with respect to outcome. CONCLUSION: It appears that ICON does reflect UK opinion and the current study provides some evidence that ICON may effectively replace PAR and IOTN as a means of determining need and outcome.

Analysis of Variance↗

PubMed1999

Using a dual method needs assessment to evaluate the training needs of public health professionals.

A dual method research approach was used to identify the training needs of the public health professionals in Washington. A mail questionnaire was implemented, followed by focus groups with Washington State Department of Health (DOH) and local health department (LHD) professionals. Focus groups were used successfully to enhance and clarify the survey findings by identifying the specific content of the highest rated training needs (interpersonal communication, cross-culture and cross-age communication, participatory teaching/training skills, and electronic communication) and by pinpointing preference for different modes of training delivery for different training needs.

Communication↗

PubMed2006

Need and non-need factors associated with addiction treatment utilization in a cohort of homeless and housed urban poor.

BACKGROUND: Research on addiction treatment utilization in indigent samples mainly has been retrospective, without measures of addictive consequences, social network influences, and motivation. Prospective assessment of factors influencing utilization could inform policy and clinical care. OBJECTIVE: We sought to identify factors associated with utilization of addiction treatment and mutual help groups among substance-dependent persons with high rates of homelessness. RESEARCH AND METHODS: This was a prospective cohort of patients detoxified from alcohol or drugs at baseline who were followed for 2 years in a randomized clinical trial of linkage to primary care (n = 274). Outcomes included utilization of Inpatient/Residential, Outpatient, Any Treatment, and Mutual Help Groups. Predictor variables in longitudinal regression analyses came from the literature and clinical experience, organized according to theoretical categories of Need, and non-Need (eg, Predisposing and Enabling). RESULTS: Many subjects used Inpatient/Residential (72%), Outpatient (62%), Any Treatment (88%) or Mutual Help Groups (93%) at least once. In multivariable analyses, addictive consequences (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.12-1.71), motivation (OR 1.32, 95% CI 1.09-1.60), and female gender (OR 1.80, 95% CI 1.13-2.86) were associated with most treatment types (ORs are for Any Treatment). Homelessness was associated with Residential/Inpatient (for Chronically Homeless vs. Housed, OR 1.75, 95% CI 1.04-2.94). Living with one's children (OR 0.51, 95% CI 0.31-0.84) and substance-abusing social environment (OR 0.65, 95% CI 0.43-0.98) were negatively associated with Any Treatment. CONCLUSIONS: In this cohort of substance-dependent persons, addictive consequences, social network variables, and motivation were associated with treatment utilization. Non-need factors, including living with one's children and gender, also were significant.

Adult↗

PubMed1987

Variability in assessment of need for orthodontic treatment when using certain treatment-need indices.

The need for orthodontic treatment was assessed in a sample of 29 children by using four treatment-need indices (ISMHB by the Swedish Medical Health Board, HMAR by Salzmann, INOT by Ingervall & Rönnerman, and TPI by Grainger). Furthermore, the need for treatment was evaluated clinically according to the criteria of Järvinen. When scoring the cases, and when selecting the cases with the highest scores, the study showed a marked variation between the indices, and indicated that the different methods selected different groups of children for treatment. Indirectly, the conclusion could be drawn that there were differences in the validity of the indices, even though it was not possible to evaluate the degree of validity on the basis of the knowledge we have today about the disadvantages and consequences of malocclusions.

Adolescent↗

PubMed2004

Comparing a quality of life measure and the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN) in assessing orthodontic treatment need and concern.

OBJECTIVE: To compare the use of the Aesthetic Component (AC) of IOTN and the Child Perceptions Questionnaire (CPQ) in assessing orthodontic treatment need and concern. DESIGN: Cross-sectional observational study. SUBJECTS AND METHODS: The subjects were 204 children aged 10-12 years studying in 10 schools in Bristol, UK. They completed a questionnaire comprising the CPQ and questions regarding orthodontic concern. AC scores as rated by the child and by the calibrated examiner were recorded. MAIN OUTCOME MEASURES: CPQ scores were calculated from the responses in the questionnaire. AC scores and responses to questions regarding orthodontic concern were recorded. RESULTS: The children gave themselves lower AC scores compared to the examiner (p<0.001). The only section of the CPQ that correlated significantly with Examiner AC was the emotional impacts section (rho=0.151). CPQ scores had a slightly higher correlation with self-perceived AC than Examiner AC. However, the correlations were still very low. The emotional impacts section of CPQ (rho=0.332) and overall CPQ score (rho=0.282) were better than the examiner AC (rho=0.209) at reflecting how bothered the children were by the alignment of their teeth, and how upset they would be if they couldn't receive orthodontic treatment (rho=0.464, 0.428 and 0.214, respectively). Children with a normative need for orthodontic treatment, based on examiner AC did not have a worse oral health-related quality of life. CONCLUSION(S): The CPQ and IOTN AC measure different attributes. There should be a shift towards using quality of life measures to supplement the IOTN in assessing the perceived need for orthodontic treatment.

Adolescent↗

PubMed1999

The Northwick Park Care Needs Assessment (NPCNA): a measure of community care needs: sensitivity to change during rehabilitation.

OBJECTIVES: To determine whether the Northwick Park Care Needs Assessment (NPCNA) is sensitive to change occurring during rehabilitation and provides a reliable estimate of care needs in the community, and to compare the NPCNA with the Functional Independence Measure (FIM). DESIGN: Prospective cohort study. SETTING: Postacute neurorehabilitation unit for young patients with complex disabilities. SUBJECTS: Thirty-nine consecutive patients with brain injury admitted over six months. MEASUREMENTS AND METHODS: The NPCNA was assessed on admission and at discharge. Two subsets of patients were also assessed (a) at three-month follow-up in the community (n = 15), and (b) both in hospital and in the home environments at the discharge time point (n = 28). Data were compared with FIM scores on admission and discharge. RESULTS: The median total weekly care hours fell from 52 hours (interquartile range (IQR) 25-66) on admission, to 17 hours (IQR 6-46) on discharge (p<0.001). There was a median reduction of approximate weekly cost of care from 600 pound sterling (IQR 224-824 pound sterling) to 168 pound sterling (IQR 56-280 pound sterling) (p<0.001). These benefits were sustained at follow-up, and the NPCNA measured in hospital at discharge gave a good estimation of the care hours and weekly cost of care in the community at three months after discharge. There was no significant correlation with FIM gain. CONCLUSIONS: In this study the NPCNA, measured while the patient was still in hospital, gave a good estimation of care needs in the community and was sensitive to change occurring during rehabilitation in patients with severe complex disabilities.

Activities of Daily Living↗

PubMedDate not supplied

Delayed or forgone care among children with special health care needs: an analysis of the 2001 National Survey of Children with Special Health Care Needs.

OBJECTIVE: To examine the associations of sociodemographic characteristics with both the prevalence and the causes of delayed or forgone care in a nationally representative sample of children with special health care needs. METHODS: Data were abstracted from the 2001 National Survey of Children with Special Health Care Needs. The families of children with special health care needs (CSHCN) who reported delayed or forgone care were asked about the reasons. The 12 reasons in the questionnaire were grouped into 5 categories. Bivariate and multivariate logistic regression analyses were conducted in SUDAAN to examine the relationship between sociodemographic characteristics of CSHCN and the incidence of delayed or forgone care by its reasons. RESULTS: Nearly 10% of CSHCN had experienced delayed or forgone health care in the past 12 months in 2001. Logistic regression showed that delayed or forgone care was more likely to be reported by the families of CSHCN who were adolescents, who had more severe limitations, lived in the South or West, lacked medical insurance, and who lived in families under or near the federal poverty line. Hispanics were more likely to report "lack of medical specialty" and "had language, communication, or cultural problems with provider." Both Hispanics and non-Hispanic others were twice as likely to report "provider not accessible" as reasons for the delayed or forgone care compared with non-Hispanic whites or blacks. conclusion: CSHCN with certain socioeconomic status and sociodemographic characteristics, as well as those with severe limitations in activity, were more likely to be affected by circumstances that result in delayed or forgone care.

Adolescent↗

PubMedDate not supplied

A Need-based model for determining staffing needs for the public sector outpatient mental health service system.

This article proposes a need-based model for determining staffing needs for regional or national public sector outpatient mental health services. It constitutes a spreadsheet method involving a sequence of calculations relating demographic variables, workers' productivity, anticipated demand, and standards pertaining to annual visits per client distributed among the core mental health professions. The authors demonstrate the application of the model to national planning of adult outpatient mental health services using standards based on both expert consensus and existing staffing patterns while they note the need for more rigorously derived and empirically based standards. It is suggested that by using clearly stated assumptions and quantifiable variables, the model can facilitate constructive negotiations among various agencies and community organizations involved in policymaking and in budget allocations.

Adult↗

PubMed2004

Behavioral needs of the transition cow and considerations for special needs facility design.

Improved building designs come from a better understanding of the behavioral needs of the dairy cow. The costs to provide for these needs in the facility must be offset by improved milk production, health, and longevity. Research is still required to more fully understand the health implications of many building design considerations and their impact on disease. Perhaps the most important end result of an improved environment for the transition cow, however, is an improvement in animal well-being. Better buildings that accommodate the behavioral needs of cows present "win-win" situations where dairy cattle thrive and work is more enjoyable. This results in an improved image for the industry, greater consumer confidence in the quality and safety of the final food product, and a prosperous dairy industry.

Animal Husbandry↗

PubMedDate not supplied

Microbiological aspects and technological need: technological needs for nitrates and nitrites.

Nitrate and nitrite are used in meat and fish curing, and in the manufacture of certain cheeses. Nitrate itself has little antimicrobial effect and in most applications could be replaced by lower concentrations of nitrite. Further, improved hygiene diminishes the need for nitrite. The antimicrobial activity and technological needs for nitrate and nitrite are reviewed. It is concluded that the technological needs for nitrite in meat products stored at < 10 degrees C could be met by added nitrite concentrations of 50 mg/kg. The overall effect of nitrate in salted fish appears to be marginal. In such products, Vibrio parahaemolyticus does not grow at salt concentrations of 10% and food poisoning by this organism is not related to the absence of nitrate or nitrite; growth of Clostridium botulinum Type E (the predominant cause of botulism from fish products) is arrested by salt concentrations of 3-4%. Listeria monocytogenes in seafood cannot be controlled by nitrite. The use of nitrate in cheese production could be avoided, or at least reduced to a low level by avoiding silage with a high count of gas-producing Clostridia and hygienic milk collection.

Bacteria↗

PubMed1967

The world outlook for conventional agriculture. More emphasis is needed on farm price policy and plant research if future world food needs are to be met.

1) The worldwide demand for food will continue to be strong in the coming decades. Two forces-rapidly growing population and, in much of the world, rapidly rising incomes-are expected to result in increases in the demand for food even more rapid than those that have occurred during the past. 2) Conventional agriculture has assured an adequate food supply for the economically advanced one-third of the world. The challenge now is to assure an adequate food supply for the remaining two-thirds, where population is now increasing at the rate of 1 million people per week and where malnutrition is already widespread. 3) Economically feasible prospects for significantly expanding the world's area of cultivated land in the 1960's and 1970's are limited and largely confined to sub-Saharan Africa and the Amazon Basin. Even here, agronomic problems will limit the rate of expansion. When the cost of desalting seawater is substantially reduced-probably not before the late 1970's or early 1980's at best-it may become feasible to irrigate large areas of desert. 4) Given the limited possibilities for expanding the area of land under cultivation, most of the increases in world food needs must be met, for the foreseeable future, by raising the productivity of land already under cultivation. Food output per acre, rather static throughout most of history, has begun to increase rapidly in some of the more advanced countries in recent decades. All of the increases in food production over the past quarter century in North America, western Europe, and Japan have come from increasing the productivity of land already under cultivation. The area under cultivation has actually declined. 5) Achieving dramatic gains in land productivity requires a massive investment of capital and the widespread adoption of new technology. A similar effort must now be made in the less-developed nations if these nations are to feed their people. The most important single factor influencing this rate of investment is food prices, more particularly the relationship between the price farmers receive for their food products and the cost of modern inputs such as fertilizer. 6) In some of the more-developed countries where per-acre yields have been rising for a long time, there is now evidence that the rate of yield increase may be slowing. Nonrecurring inputs may have made their maximum contribution to output in the case of some crops, pushing yield levels past the middle of the S-shaped logistic curve. Although this cannot be determined with any certainty, the possibility that the middle of the curve has been passed in some instances should be taken into account in viewing the long-term future. 7) If the rate of increase in yield per acre does in fact begin to slow in some of the agriculturally advanced countries, additional pressure will be put on the less-developed countries-which have much of the world's unrealized food-production potential-to meet the continuing future increases in world food needs. 8) Man has not yet been able to bypass the process of photosynthesis in the production of food. This dependence on photosynthesis plays a significant role in determining the upper levels of the S-shaped yield curve. Additional research is urgently needed to increase the photosynthetic efficiency of crops and to raise the upper levels of economically feasible yields.

Agriculture↗

PubMed1994

The need to know: biological learning needs identified by practicing psychiatric nurses.

1. Psychiatric nursing in the 1990s requires integrating an expanding biological focus into nursing practice to accommodate both the growing biological knowledge base and changing patients' needs. 2. The following areas of learning needs for practicing psychiatric nurses were identified: knowledge of medications; recognition of interactions of patient physical conditions and medications with other substances; obtainment of skills to manage acute and chronic medical problems in the psychiatric milieu, and to differentiate medical and psychiatric concerns; maintenance of safety and management of the impact of environmental factors; and achievement of self-care for the caregiver. 3. There was widespread interest from the nurses participating in this study in knowing what nurses in other settings were experiencing in their practice and the learning needs they perceived.

Adult↗

PubMed1991

Support in a time of need. The team approach at Mercy Medical Hospice addresses medical, emotional, and spiritual needs.

Mercy Medical Hospice, Daphne, AL, uses an interdisciplinary team approach, which includes medical, nursing, social work, pastoral care, pharmacy, therapies, volunteer, and bereavement services. Mercy Medical has two home care offices and offers inpatient respite care for short periods, which is helpful for those who have an inadequate care giver system or need time to work out a better alternative to care in the home. An assessment of medical and nursing care needs, mental and emotional state, and psychological and spiritual needs is the first step after patients enter hospice. The entire team develops a care plan for the patient and family. Among the issues they address are education about the disease process, medication for pain control and symptom management, and how the patient and family cope with the patient's imminent death. Working with the dying and their families can be stressful for staff members, and they offer each other a lot of support. Working in hospice requires good stress management techniques, but staff feel that it is a calling that enriches their lives.

Alabama↗

PubMed1997

Need and Demand for Oral Medicine Services in 1996. A report prepared by the Subcommittee on Need and Demand for Oral Medicine Services, a subcommittee of the Specialty Recognition Committee, American Academy of Oral Medicine.

The need and demand for oral medicine services in the United States and Canada was determined by a prospective survey of American Academy of Oral Medicine practitioners who attended the Academy's 1996 annual meeting. Of the 50 surveys returned from 149 eligible registrants, it was determined that, on the average, oral medicine practitioner respondents practiced 2.3 days per week and treated 8.7 patients per day; this amounts to more than 40,000 patient-care visits per year. Almost 90% of patients were treated because of medically compromising conditions, oral mucocutaneous disease, or chronic orofacial pain. Most of the care (52%) was provided in non-university settings. Most treatment involved the comprehensive evaluation of complex oral problems (36.7%), the prescription of medications (24.2%), or comprehensive dental treatment (21.8%) for patients with severe and life-threatening medical conditions. These results suggest that oral medicine services are needed and that demand for these services is high.

Adolescent↗

PubMed2001

Changing oral care needs in the United States: the continuing need for oral medicine.

OBJECTIVE: The purpose of this article is to provide oral care providers evidence of oral conditions and medical compromise that is impacting the oral health and oral health needs of the public. DESIGN: Data were analyzed based on current epidemiologic data, derived in large part from the Health and Nutrition Examination Surveys, the National Center for Health Statistics, National Health Interview Survey Series 1994-1997; American Cancer Society, National Cancer Institute Surveillance Examination and End Results data base, Morbidity and Mortality Weekly Reports, peer-reviewed publications, and surveys of oral medicine-related disorders. RESULTS: Millions of Americans have medical conditions that complicate their oral health care. Oral health problems associated with age, medical health and treatment, and institutional setting are increasing. Chronic orofacial pain, persistent oral soft tissue lesions, and salivary gland and chemosensory disorders are common problems of modern society. CONCLUSIONS: Evidence suggests that the next decade will bring a significantly increased demand for diagnosis and management of patients with oral conditions and patients with oral manifestations of systemic conditions, and an increase in general oral care needs of patients who are medically compromised. These increasing demands should be reflected in dental education and continuing education.

Aged↗

PubMed1998

Self-reported need of information, counselling and education: needs and interests of re-applicants.

An interview study was performed to establish and evaluate the need for education and counselling of hearing aid users (HA users) in order to review present procedures of information and potential referral to the educational sector. The study comprises 102 consecutively selected hearing-impaired adults (>18 years), the only inclusion criterion being experienced HA user. The interview took place immediately after the patient's latest HA fitting appointment and consisted of 24 structured and closed questions. The findings indicate that a significant proportion of HA users, especially the elderly, do not experience a need for or show an interest in further education and counselling concerning their hearing handicap. It is concluded that the present organization of services meets the demands of a majority of re-applicants.

Adult↗

PubMedDate not supplied

Bioterrorism risk perceptions and educational needs of public health professionals before and after September 11, 2001: a national needs assessment survey.

The study objectives were to compare local public health professionals' bioterrorism risk perceptions, the extent of bioterrorism preparedness training, and to describe preferred methods for delivery of preparedness education in the United States. National needs assessments were conducted via a mailed survey to 3,074 local public health departments in October 2000 and November 2001. Compared to a survey conducted in October 2000, the perceived risk of a bioterrorism attack in the United States increased dramatically after September 11 (p < 0.0001); however, 57% of respondents believed one was unlikely to occur within their own community. Public health professionals perceive their own communities to be at low risk for a bioterrorism event. Ongoing, updated, standardized bioterrorism preparedness education is needed.

Bioterrorism↗

PubMed1993

[Functional level, care needs and family-based care for home-care recipients with extended care needs].

A study of home care and home health services was undertaken in three Swedish municipalities. Persons who received extended home care and home health care were interviewed. The interviews covered different themes such as impairments, care needs, functions and activities in the horizontal social network (the informal network), and opinions concerning how care is and should be provided. A modified ADL-index was used to assess the functional level of daily living. Care needs were measured by the judgement of the care recipient, and by the interviewer's judgement. The correspondence between these measures was high, with some exceptions. Lower correspondence between the measures was obtained for three categories of care recipients: individuals with communicative dysfunctions, younger individuals with reduced ability to move and, thirdly, individuals with psychosocial problems. Problems concerning measurement of care given by family members were also identified and discussed.

Activities of Daily Living↗