Accuracy of patient recall of opportunistic smoking cessation advice in general practice

OBJECTIVE: To determine the accuracy of patient recall of a question about smoking in a specified consultation in general practice; the accuracy of smokers' recall of advice to stop smoking; and predictors of accurate recall. DESIGN: Analysis of 1075 audiotapes was compared blind with matching patient questionnaires administered after the consultation to calculate sensitivity and specificity for patient recall as a dichotomous variable. Predictors of recall were determined by logistic regression. SETTING: General practitioner training practices, New South Wales, Australia. SUBJECTS: Thirty-four trainees and consecutive samples of their patients 16-65 years of age. RESULTS: Patient recall of a question about smoking had a high false positive rate of 21% but a sensitivity of 93%. Smokers over-reported advice to stop smoking (specificity 82%; sensitivity 92%). Predictors of accuracy of a question about smoking included patient sex (women 1.58 times more likely than men to be accurate); smoking status (smokers 1.7 times as likely as non-smokers to be accurate); and interval since consultation (those who completed their questionnaires within a week were 1.84 times more likely to be accurate). CONCLUSIONS: Patient recall is systematically biased towards over-reporting of a question about smoking status and, among smokers, of advice to quit. Although we recommend its continued application in health services evaluation, findings should be interpreted with caution, particularly if subjects are male or the interval between recall of smoking cessation advice and the occasion of service in which it might have occurred is considerably delayed.


     

Detecting delaminations in a composite beam using anti-optimization

The present study proposes a detection technique for delaminations in a laminated beam. The proposed technique optimizes the spatial distribution of harmonic excitation so as to magnify the difference in response between the delaminated and intact beam. The technique is evaluated by numerical simulation of two-layered aluminum beams. Effects of measurement and geometric noise are included in the analysis. A finite element model for a delaminated composite, based on a layer-wise laminated plate theory is used in conjunction with a step function to simulate delaminations     

An anthropocentric approach to knowledge-based preventive maintenance

It is common knowledge today that application of sound manufacturing concepts and techniques will only provide cost-effective, long-term return when manufacturing functions are totally integrated with the operators, maintenance engineers and other associated personnel. This paper presents a human-centred methodology and its associated knowledge-based tool, to utilize equipment failure information for the purpose of machine down-time minimization. Based upon a structured and rigorous assessment of each breakdown, and combined with total employee participation, continuous improvement of maintenance function and operational effectiveness of equipment can be made a reality.     

Fertilization in vitro. A review over the medical indications and suggestion to unified guidelines for public fertility clinics in Denmark

Medical indications for in vitro fertilization and embryo transfer (IVF-ET) internationally and in Denmark are reviewed. Reports from large international centres document that tubal infertility, unexplained infertility, endometriosis and male infertility are equally good indications for IVF. Traditionally, tubal infertility has been the only medical indication qualifying for IVF treatment within the National Health Service in Denmark. Thus, in this country, couples with unexplained and male infertility and with endometriosis have to pay up to 25,000 D.Kr. per IVF-ET treatment in private fertility clinics. Since there is no scientific basis for this discrimination, it is urged that the present rules are changed, so that couples with unexplained and male infertility and endometriosis are also allowed IVF treatment free of charge in the public fertility clinics.     

Expression of a human homeobox-containing gene is regulated by 1,25(OH)2D3 in bone cells

The seasonal variation in the nutrient composition of Enhydra fluctuans and Marsilea quadrifolia, two edible semi-aquatic plants, was studied in order to promote their consumption as green leafy vegetables. Both plants had a high crude protein content throughout all harvesting seasons. Enhydra fluctuans had a low ash content and was a good source of beta-carotene (3.7 to 4.2 mg/100 g on a fresh weight basis). Marsilea quadrifolia exhibited wide fluctuations between seasons and was not very promising in nutrient composition when compared to other commonly used green leafy vegetables.     

Transformer modelling for distribution system studies. II. Additionof models to YBUS and ZBUS

For pt.I see ibid., vol.7, no.2, p.567-74 (1992). A distribution transformer modeling procedure is discussed which represents the distribution transformer with a minimum of input data for network, load, and fault studies thereby allowing the transformer to be routinely included as part of the distribution network. How these transformer methods are used in the formation of Y_BUS and Z _BUS system models is described     

Planning prompts and indexed terms in textbook search tasks.

Text search is a type of strategic reading that involves locating specific goal-relevant information. Previous research has indicated that college and high school students often exhibit inefficient or unsuccessful text-search performance. Consequently, the effects of 2 manipulations on text-search performance were investigated: (1) the presence of indexed terms in a text-search task and (2) the use of a planning prompt before beginning a task. 34 college students engaged in 6 text-search tasks. Half of these tasks contained terms that could be used in an index; half required that a search term be generated. Half of the subjects were randomly assigned to a prompt condition in which they were prompted to plan their search before beginning each task. The results indicated that a planning prompt raised the success level of search performance, as did the presence of terms that were searchable in the textbook's index. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

VRCTC-310--a novel compound of purified animal toxins separates antitumor efficacy from neurotoxicity

Two purified animal venom toxins, crotoxin and cardiotoxin, have been combined to produce a unique natural product (VRCTC-310) currently under investigation as an antitumor agent by the National Cancer Institute. In vitro, it has demonstrated cytotoxic disease specificity and a unique mechanism of action when submitted to COMPARE analysis. In vivo, tolerance was developed to the neurotoxic properties of crotoxin which allowed comparison of several schedules of fixed and escalating daily i.m. doses to mice bearing s.c. Lewis Lung carcinoma. An 83% inhibition of tumor growth was achieved using an escalating dose schedule starting at 1.8 mg/kg and reaching 6.3 mg/kg/day on day 20. Although some irritation around the sites of i.m. injection was noted, animal weight loss was negligible and there were no other signs of adverse toxicity. This natural product represents a new, membrane interactive anticancer agent which produces a unique spectrum of cytotoxicity in vitro and which has demonstrated interesting in vivo antitumor efficacy.