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Contraceptives and cervical carcinoma.

https://arctichealth.org/en/permalink/ahliterature109872
Source
Br Med J. 1969 Nov 1;4(5678):302-3
Publication Type
Article
Date
Nov-1-1969

Cross-cultural differences in the reporting of global functional capacity: an example in cataract patients.

https://arctichealth.org/en/permalink/ahliterature50985
Source
Med Care. 1998 Jun;36(6):868-78
Publication Type
Article
Date
Jun-1998
Author
J. Alonso
C. Black
J C Norregaard
E. Dunn
T F Andersen
M. Espallargues
P. Bernth-Petersen
G F Anderson
Author Affiliation
Health Services Research Unit, Institut Municipal d'Investigació Mèdica, Barcelona, Spain.
Source
Med Care. 1998 Jun;36(6):868-78
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Bias (epidemiology)
Cataract - ethnology - physiopathology
Comparative Study
Cross-Cultural Comparison
Cultural Characteristics
Denmark
Female
Health Status Indicators
Humans
Logistic Models
Male
Manitoba
Multivariate Analysis
Outcome Assessment (Health Care) - methods - standards
Questionnaires - standards
Reproducibility of Results
Research Support, Non-U.S. Gov't
Sensitivity and specificity
Spain
United States
Visual acuity
Abstract
OBJECTIVES: Patient-based health status measures have an important role to play in the assessment of health care outcomes. Among these measures, global assessments increasingly have been used, although the understanding of the performance of these indicators and the determinants of patients responses is underdeveloped. In this study, the performance of a single-item global indicator of visual function in cataract patients of four international settings was compared. METHODS: Visual acuity and ocular comorbidity was assessed by patients' ophthalmologist using Snellen-type charts in patients referred for a first cataract surgery in the United States, Manitoba (Canada), Denmark, and Barcelona (Spain). Patients also were interviewed by telephone and asked to report overall trouble with vision on a single-item indicator ("great deal," "moderate," "a little," "none") and to complete the Visual Functioning Index (VF-14), a scale of visual function ranging from 0 (worst function) to 100 (best level of function), along with other questions including the degree the patient was bothered by symptoms as measured by the Cataract Symptom Score (CSS). A total of 1,407 patients completed the clinical examination and the preoperative interview. RESULTS: Distribution of overall trouble with vision varied across the sites, with the proportion of patients reporting a great deal of trouble ranging from 21.7% to 37.9%. In all sites, patients reporting more trouble with vision tended to show a poorer age-adjusted and sex-adjusted visual acuity. The proportion of patients reporting great deal of trouble with vision was higher in the groups with worse visual acuity (P
PubMed ID
9630128 View in PubMed
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Diagnosis and management of hypertension: the stated practices of family physicians.

https://arctichealth.org/en/permalink/ahliterature240599
Source
Can Med Assoc J. 1984 Apr 15;130(8):985-8
Publication Type
Article
Date
Apr-15-1984
Author
E. Dunn
J. Hilditch
M. Chipman
G. Hardacre
M. Morrison
Source
Can Med Assoc J. 1984 Apr 15;130(8):985-8
Date
Apr-15-1984
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - methods
Family Practice
Follow-Up Studies
Humans
Hypertension - diagnosis - drug therapy
Male
Middle Aged
Ontario
Probability
Questionnaires
Abstract
Hypertension is an important and common problem in family practice, but there is no general agreement on the systolic and diastolic pressures at which it should be diagnosed and treated. Responses from 273 family physicians surveyed by mail in Metropolitan Toronto showed a wide variation in the pressures used as cut-off points. The probability that in a given patient hypertension would be diagnosed or treated at different systolic and diastolic pressures varied considerably among the physicians, the variation increasing with the age of the patient. There was also wide variation in opinion among the surveyed physicians about how often patients should be screened for hypertension; depending on the patient's age, up to 35% of the physicians stated that the blood pressure should be measured at every visit. Only one third reported using any one or more methods to ensure that patients with hypertension were not lost to follow-up. The family physicians with an academic appointment used higher cut-off points for diagnosis and treatment, and they screened and scheduled follow-up visits less frequently than those without an academic appointment.
Notes
Cites: Am J Med. 1972 May;52(5):653-635027555
Cites: Br Med J. 1979 Mar 31;1(6167):843-6435839
Cites: Am J Public Health. 1981 Apr;71(4):413-67468884
Cites: N Z Med J. 1983 Oct 12;96(741):751-46604888
Cites: N Engl J Med. 1983 Nov 17;309(20):1246-76633575
PubMed ID
6704861 View in PubMed
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International applicability of the VF-14. An index of visual function in patients with cataracts.

https://arctichealth.org/en/permalink/ahliterature51030
Source
Ophthalmology. 1997 May;104(5):799-807
Publication Type
Article
Date
May-1997
Author
J. Alonso
M. Espallargues
T F Andersen
S D Cassard
E. Dunn
P. Bernth-Petersen
J C Norregaard
C. Black
E P Steinberg
G F Anderson
Author Affiliation
Health Services Research Unit. Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain.
Source
Ophthalmology. 1997 May;104(5):799-807
Date
May-1997
Language
English
Publication Type
Article
Keywords
Aged
Cataract - physiopathology
Cataract Extraction
Comparative Study
Female
Humans
Longitudinal Studies
Male
Middle Aged
Patient satisfaction
Reproducibility of Results
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Sickness Impact Profile
Treatment Outcome
Vision Tests - instrumentation
Visual Acuity - physiology
Abstract
PURPOSE: There is increased recognition that a rigorous approach to functional assessment should complement the assessment of clinical status. The authors compare the reliability, validity, and responsiveness to clinical change of a visual function index (VF-14) in non-U.S. and in U.S. patients with cataracts. DESIGN: An observational longitudinal study was performed. PARTICIPANTS: One thousand four hundred seven first eye cataract surgery patients were recruited in four international sites: Manitoba (Canada), Denmark, Barcelona (Spain), and the United States. INTERVENTION: Patients were evaluated before cataract surgery and at a 4-month postoperative follow-up visit. Patients completed the preoperative interview and the clinical examination (766 in the United States, 152 in Manitoba, 291 in Denmark, and 198 in Barcelona), and 91.3% of those (1284) also completed the 4-month postoperative follow-up interview and were evaluated postoperatively by an ophthalmologist. MAIN OUTCOME MEASURES: The authors used the following measures: the visual function index (VF-14), the Sickness Impact Profile (SIP), global measures of patients' trouble and satisfaction with vision, and best-corrected visual acuity (VA) in each eye. RESULTS: The VF-14 showed a high internal consistency reliability level in all sites (Cronbach's alpha coefficients > or = 0.84). Correlation of preoperative visual function index scores with the Vision-Related SIP was strong (r = -0.68 in non-U.S. and r = -0.57 in U.S. patients) and with VA in the eye with better vision was moderate (r = 0.40 and r = 0.27, respectively), the pattern of relationships being very similar among U.S. and non-U.S. patients. In patients with only first-eye surgery who reported that their initial trouble with vision had improved, the amount of change in visual function as assessed by the VF-14 (effect size) was large (1.01 for the non-U.S. patients and 1.17 for the U.S. patients). CONCLUSIONS: The non-U.S. versions of the visual function index (VF-14) analyzed are as reliable, valid, and responsive to clinical change as the original U.S. version. These versions are appropriate for international studies of cataract patients outcomes and possibly in routine clinical practice.
PubMed ID
9160026 View in PubMed
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International variation in anesthesia care during cataract surgery: results from the International Cataract Surgery Outcomes Study.

https://arctichealth.org/en/permalink/ahliterature207513
Source
Arch Ophthalmol. 1997 Oct;115(10):1304-8
Publication Type
Article
Date
Oct-1997
Author
J C Nørregaard
O D Schein
L. Bellan
C. Black
J. Alonso
P. Bernth-Petersen
E. Dunn
T F Andersen
M. Espallargues
G F Anderson
Author Affiliation
Institute of Public Health, Faculty of Health Sciences, University of Copenhagen, Denmark.
Source
Arch Ophthalmol. 1997 Oct;115(10):1304-8
Date
Oct-1997
Language
English
Publication Type
Article
Keywords
Anesthesia - economics - methods - standards
Canada
Cataract Extraction
Cost-Benefit Analysis
Denmark
Humans
Interprofessional Relations
Monitoring, Intraoperative - methods - standards
Physician's Practice Patterns
Questionnaires
Random Allocation
Retrospective Studies
Spain
Treatment Outcome
United States
Abstract
To describe international variation in anesthesia care and monitoring during cataract surgery and to discuss its implications for cost and safety.
A standardized questionnaire was sent to random samples of ophthalmologists in the United States, Canada, and Barcelona, Spain, and to all ophthalmologists in Denmark. The survey was conducted in 1993 and 1994. Certified ophthalmologists who had performed 1 or more cataract extractions in the previous year were eligible for enrollment.
The response rates were 62% in the United States (n=148), 67% in Canada (n=276), 70% in Barcelona (n=89), and 80% in Denmark (n=82). The anesthetic technique for cataract surgery varied significantly between sites (P
PubMed ID
9338678 View in PubMed
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International variation in ophthalmologic management of patients with cataracts. Results from the International Cataract Surgery Outcomes Study.

https://arctichealth.org/en/permalink/ahliterature72764
Source
Arch Ophthalmol. 1997 Mar;115(3):399-403
Publication Type
Article
Date
Mar-1997
Author
J C Norregaard
O D Schein
G F Anderson
J. Alonso
E. Dunn
C. Black
T F Andersen
P. Bernth-Petersen
L. Bellan
M. Espallargues
Author Affiliation
Department of Social Medicine, Faculty of Health Sciences, University of Copenhagen, Denmark.
Source
Arch Ophthalmol. 1997 Mar;115(3):399-403
Date
Mar-1997
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cataract - complications - therapy
Cataract Extraction - methods - statistics & numerical data
Comparative Study
Denmark
Female
Humans
Male
Middle Aged
Ophthalmology - statistics & numerical data - trends
Physician's Practice Patterns - statistics & numerical data - trends
Questionnaires
Random Allocation
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Spain
Treatment Outcome
United States
World Health
Abstract
OBJECTIVES: To describe international variation in the management of patients with cataacts in 4 health care systems and to discuss the potential implications for cost and utilization of services. DESIGN: To characterize current clinical practice on patients with no coexisting medical or ocular conditions, a standardized questionnaire was sent to random samples of ophthalmologists in the United States (response rate, 82.5%), Canada (66.9%), and Barcelona, Spain (70.4%), and to all ophthalmologists in Denmark (80.1%). From the United States, 526 ophthalmologists who performed cataract surgery participated in the study; there were 276 from Canada, 89 from Barcelona, and 82 from Denmark. RESULTS: Although in all 4 sites most surgeons reported that they performed A-scanning, fundus examination, and refraction routinely before surgery, significant crossnational variation was observed in preoperative ophthalmic and medical testing. While preoperative medical tests were virtually unused in Denmark, they were widely used in the other sites. A significantly higher proportion of the surgeons in the United States and Barcelona reported that they performed less than 100 extractions per year compared with surgeons in Canada and Denmark (P
PubMed ID
9076214 View in PubMed
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Mother-child separation: a study in a remote health care setting.

https://arctichealth.org/en/permalink/ahliterature244013
Source
Can Med Assoc J. 1981 Nov 15;125(10):1114-7
Publication Type
Article
Date
Nov-15-1981
Author
C. Higgins
E. Dunn
D. Conrath
Source
Can Med Assoc J. 1981 Nov 15;125(10):1114-7
Date
Nov-15-1981
Language
English
Publication Type
Article
Keywords
Age Factors
Child
Epidemiologic Methods
Female
Hospitalization
Humans
Infant, Newborn
Labor, Obstetric
Male
Maternal Deprivation
Ontario
Pediatrics
Pregnancy
Sibling Relations
Abstract
The literature indicates that the birth of a sibling and the consequent temporary separation from the mother is usually a stressful experience for a child. It was hypothesized that this stress would result in an increased number of visits by the child to health care facilities because of new health problems. In a controlled study of 89 matched pairs of Indian families in a remote region of northwestern Ontario this hypothesis was not supported. During the intervals studied - the anticipatory period before delivery, the separation itself and the period immediately following the mother's return home - the number of diagnoses of new medical problems was significantly less for the children who were separated from their mothers for the birth of a sibling. As well, the number of diagnoses of new medical problems in the children separated form their mothers decreased over the three intervals. The fathers' reluctance to seek health care probably played a major role in this decrease.
Notes
Cites: Psychoanal Study Child. 1971;26:264-3155163230
Cites: Child Psychiatry Hum Dev. 1974 Fall;5(1):3-394477058
Cites: J Pediatr. 1979 Jul;95(1):147-54480000
Cites: Am J Psychiatry. 1961 Mar;117:798-80313776425
PubMed ID
7326642 View in PubMed
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Patients' acceptance of waiting for cataract surgery: what makes a wait too long?

https://arctichealth.org/en/permalink/ahliterature51028
Source
Soc Sci Med. 1997 Jun;44(11):1603-10
Publication Type
Article
Date
Jun-1997
Author
E. Dunn
C. Black
J. Alonso
J C Norregaard
G F Anderson
Author Affiliation
Health Sciences Clinical Research Centre, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
Source
Soc Sci Med. 1997 Jun;44(11):1603-10
Date
Jun-1997
Language
English
Publication Type
Article
Keywords
Aged
Cataract Extraction - psychology
Comparative Study
Denmark
Female
Humans
Logistic Models
Male
Manitoba
National Health Programs
Patient Acceptance of Health Care
Predictive value of tests
Prospective Studies
Questionnaires
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Spain
Time Factors
Visual acuity
Waiting Lists
Abstract
The patient's perspective about waiting for elective surgery is an important consideration in the management of waiting lists, yet it has received little attention to date. This study was undertaken to assess the acceptability of personal waiting times from the perspective of patients, and to examine waiting time and patient characteristics associated with the perception that a wait for cataract surgery is too long. The international prospective study was conducted in three sites with explicit waiting systems: Manitoba, Canada; Denmark; and Barcelona, Spain. Patients over the age of 50 years were recruited consecutively from ophthalmologists' practices at the time of their enlistment for first-eye cataract surgery. Anticipated waiting time, opinions about personal waiting time, and patients' visual and health characteristics were identified by means of telephone interviews. The 550 patients interviewed at the time of enlistment for surgery anticipated waits varying from
PubMed ID
9178406 View in PubMed
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Practices associated with cataract surgery in Canada: results of a national survey.

https://arctichealth.org/en/permalink/ahliterature207818
Source
Can J Ophthalmol. 1997 Aug;32(5):315-23
Publication Type
Article
Date
Aug-1997
Author
L. Bellan
E. Dunn
C. Black
Author Affiliation
Department of Ophthalmology, Faculty of Medicine, University of Manitoba, Winnipeg.
Source
Can J Ophthalmol. 1997 Aug;32(5):315-23
Date
Aug-1997
Language
English
Publication Type
Article
Keywords
Anesthesia, Local - statistics & numerical data
Canada
Cataract Extraction - methods - statistics & numerical data
Female
Health Surveys
Humans
Laser Therapy - statistics & numerical data
Male
Middle Aged
Ophthalmology - methods - standards
Physician's Practice Patterns - statistics & numerical data
Retrospective Studies
Societies, Medical
Treatment Outcome
Abstract
To examine Canadian ophthalmologists' reported practices related to cataract surgery.
Mailed questionnaire survey.
Canada.
Random sample of 698 ophthalmologists from the mailing list of the Canadian Ophthalmological Society. Of the 528 eligible ophthalmologists 353 completed the questionnaire (response rate 67%). A total of 276 respondents were classified as cataract surgeons (performed at least one cataract operation in the preceding year [1992]) and were included in the study.
Reported use of preoperative ophthalmic tests, surgical technique, cataract anesthesia (including type of block and who administers it) and postoperative care.
Most of the preoperative tests examined either were so routine as to be done in almost all cases or were rarely done at all. A total of 52% of the respondents were identified as predominantly extracapsular cataract extraction surgeons (ECCE), 46% as predominantly phacoemulsification surgeons and 2% as predominantly intracapsular cataract extraction surgeons. Overall, 57% of the respondents reported high use of retrobulbar anesthesia, 18% reported high use of peribulbar anesthesia, and 0.7% reported high use of general anesthesia. The mean number of postoperative visits in the first 4 months after surgery was 4.25. The mean rate of Nd:YAG laser capsulotomy in the first year after cataract surgery was 17.9%; 91% of the respondents reported a rate less than 40%.
There seems to be limited use of nonessential preoperative ocular testing by Canadian cataract surgeons. Although ECCE remains the most common type of surgery performed, there appears to be a substantial number of surgeons trying phacoemulsification, and this will likely become the predominant technique in the near future. The self-reported practices of Canadian surgeons with relation to preoperative testing and postoperative follow-up appear to be consistent with the Clinical Practice Guideline for cataract surgery set by the US Agency for Health Care Policy and Research. However, variations in the number of postoperative visits and Nd:YAG capsulotomy rates merit further investigation.
PubMed ID
9276119 View in PubMed
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Prevalence of dysthymic disorder in primary care.

https://arctichealth.org/en/permalink/ahliterature201008
Source
J Affect Disord. 1999 Aug;54(3):303-8
Publication Type
Article
Date
Aug-1999
Author
M. Steiner
B. Bell
G. Browne
J. Roberts
A. Gafni
C. Byrne
E. Dunn
L. Chalkin
J. Kraemer
M. Mills
D. Wallik
Author Affiliation
System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Ontario, Canada.
Source
J Affect Disord. 1999 Aug;54(3):303-8
Date
Aug-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Diagnosis, Differential
Dysthymic Disorder - diagnosis - epidemiology
Female
Humans
Male
Middle Aged
Ontario - epidemiology
Prevalence
Primary Health Care - statistics & numerical data
Abstract
Dysthymic disorder is characterised as a chronic state of depressed mood which is not otherwise attributable to physical, psychological or social events. While it can occur alone, there is increasing evidence that the majority of individuals who meet criteria for dysthymic disorder also experience more severe episodic mood disorders throughout their lifetime, and there is also an aggregation of mood disorders within their family members. Patients with dysthymic disorder are most often seen in primary care. Some researchers suggest that the majority of these individuals are never diagnosed or are not diagnosed until a more severe episodic mood disorder develops. The objective of this study was to determine the 12-month prevalence of Axis I psychiatric disorders, and in particular dysthymic disorder, in a primary care Health Service Organization in Ontario, Canada.
Eligible and consenting adults registered with a primary care Health Service Organization were screened using the modified form of the University of Michigan Composite International Diagnostic Interview.
Of the 6280 eligible subjects, 4327 (69%) consented to screening. Two hundred and twenty-two (5.1%) subjects screened positive for dysthymic disorder. In addition, 90% of those who screened positive for dysthymic disorder also screened positive for other Axis I disorders including major depressive disorder, panic, simple phobia, and generalized anxiety disorder.
There is much potential for the primary care physician to play a pivotal role in the recognition and treatment of dysthymic disorder and associated Axis I disorders. A focus on the family as a unit for care may be especially important given the reported aggregation of dysthymic disorder within families.
Notes
Erratum In: J Affect Disord 1999 Oct;55(2-3):245
PubMed ID
10467975 View in PubMed
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15 records – page 1 of 2.