46 research outputs found
Sleep quality, the neglected outcome variable in clinical studies focusing on locomotor system; a construct validation study
Background: In addition to general health and pain, sleep is highly relevant to judging the well-being of an individual. Of these three important outcome variables, however, sleep is neglected in most outcome studies. Sleep is a very important resource for recovery from daily stresses and strains, and any alteration of sleep will likely affect mental and physical health, especially during disease. Sleep assessment therefore should be standard in all population-based or clinical studies focusing on the locomotor system. Yet current sleep assessment tools are either too long or too specific for general use.
Methods: Based on a literature review and subsequent patient-based rating of items, an expert panel designed a four-item questionnaire about sleep. Construct validation of the questionnaire in a random sample of the German-speaking Swiss population was performed in 2003. Reliability, correlation, and tests for internal consistency and validity were analyzed.
Results: Overall, 16,634 (70%) out of 23,763 eligible individuals participated in the study. Test-retest reliability coefficients ranged from 0.72 to 0.87, and a Cronbachâs alpha of 0.83 indicates good internal consistency. Results show a moderate to good correlation between sleep disturbances and health perception, and between sleep disturbances and overall pain.
Conclusions: The Sleep Standard Evaluation Questionnaire (SEQ-Sleep) is a reliable and short tool with confirmed
construct validity for sleep assessment in population-based observational studies. It is easy to administer and therefore suitable for postal surveys of the general population. Criterion validity remains to be determined
Physician privacy concerns when disclosing patient data for public health purposes during a pandemic influenza outbreak
Background: Privacy concerns by providers have been a barrier to disclosing patient information for public health\ud
purposes. This is the case even for mandated notifiable disease reporting. In the context of a pandemic it has been\ud
argued that the public good should supersede an individualâs right to privacy. The precise nature of these provider\ud
privacy concerns, and whether they are diluted in the context of a pandemic are not known. Our objective was to\ud
understand the privacy barriers which could potentially influence family physiciansâ reporting of patient-level\ud
surveillance data to public health agencies during the Fall 2009 pandemic H1N1 influenza outbreak.\ud
Methods: Thirty seven family doctors participated in a series of five focus groups between October 29-31 2009.\ud
They also completed a survey about the data they were willing to disclose to public health units. Descriptive\ud
statistics were used to summarize the amount of patient detail the participants were willing to disclose, factors that\ud
would facilitate data disclosure, and the consensus on those factors. The analysis of the qualitative data was based\ud
on grounded theory.\ud
Results: The family doctors were reluctant to disclose patient data to public health units. This was due to concerns\ud
about the extent to which public health agencies are dependable to protect health information (trusting beliefs),\ud
and the possibility of loss due to disclosing health information (risk beliefs). We identified six specific actions that\ud
public health units can take which would affect these beliefs, and potentially increase the willingness to disclose\ud
patient information for public health purposes.\ud
Conclusions: The uncertainty surrounding a pandemic of a new strain of influenza has not changed the privacy\ud
concerns of physicians about disclosing patient data. It is important to address these concerns to ensure reliable\ud
reporting during future outbreaks.University of Ottawa Open Access Author Fun
Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received
Background
The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy.
Objective
To report outcomes according to treatment received in men in randomised and treatment choice cohorts.
Design, setting, and participants
This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy.
Intervention
Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment.
Outcome measurements and statistical analysis
Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores.
Results and limitations
According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa.
Conclusions
Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group.
Patient summary
More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common
Multi-messenger Observations of a Binary Neutron Star Merger
On 2017 August 17 a binary neutron star coalescence candidate (later
designated GW170817) with merger time 12:41:04 UTC was observed through
gravitational waves by the Advanced LIGO and Advanced Virgo detectors.
The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray
burst (GRB 170817A) with a time delay of ⌠1.7 {{s}} with respect to
the merger time. From the gravitational-wave signal, the source was
initially localized to a sky region of 31 deg2 at a
luminosity distance of {40}-8+8 Mpc and with
component masses consistent with neutron stars. The component masses
were later measured to be in the range 0.86 to 2.26 {M}ÈŻ
. An extensive observing campaign was launched across the
electromagnetic spectrum leading to the discovery of a bright optical
transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC
4993 (at ⌠40 {{Mpc}}) less than 11 hours after the merger by the
One-Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The
optical transient was independently detected by multiple teams within an
hour. Subsequent observations targeted the object and its environment.
Early ultraviolet observations revealed a blue transient that faded
within 48 hours. Optical and infrared observations showed a redward
evolution over âŒ10 days. Following early non-detections, X-ray and
radio emission were discovered at the transientâs position ⌠9
and ⌠16 days, respectively, after the merger. Both the X-ray and
radio emission likely arise from a physical process that is distinct
from the one that generates the UV/optical/near-infrared emission. No
ultra-high-energy gamma-rays and no neutrino candidates consistent with
the source were found in follow-up searches. These observations support
the hypothesis that GW170817 was produced by the merger of two neutron
stars in NGC 4993 followed by a short gamma-ray burst (GRB 170817A) and
a kilonova/macronova powered by the radioactive decay of r-process
nuclei synthesized in the ejecta.</p
Problem gambling survey, 1996 : final report
The present research presents a smaller scale replication of the 1993 survey program ("Social Gmaing and Problem Gambling in British Columbia", Angus Reid / Gemini Research, 1994) to assess whether any significant changes have occurred in the prevalence of problem gambling in the Province of British Columbia. Specific objectives include: Monitoring any changes in the extent of problem gambling in British Columbia, using the same South Oaks Gambling Screen (SOGS) employed in the benchmark survey; Tracking gaming behaviour among the population at large and problem gamblers, and; Monitoring public perceptions of gambling problems and related gaming issues in the province, impact of new developments such as Club Keno, and new cross border casino developments.British Columbia Lottery Corporatio