bluuebunny/crossref_metadata_2025_split huggingface dataset:
Restraint, Seclusion and PRN Medication in English Services for People with Learning Disabilities Administered by the National Health Service: An Analysis of the 2007 National Audit Survey
Authors: Sturmey Peter 
Published: February 2009

Background  There is much interest in the use and prevention of unnecessary restrictive behavioural procedures; however, accurate estimates of their use are lacking. The Healthcare Commission and Commission for Social Care Inspection (2007) recently reported such data from a large sample of units administered by the National Health Service (NHS).Materials  This study analysed data from The Healthcare Commission on the use of personal and mechanical restraint, PRN (as needed) medication and other restrictive procedures were analysed from 509 service units and 3902 service users.Results  Approximately 80% of service units reported using PRN medication and approximately half of service units used personal or mechanical restraints. A small number of services units used restrictive procedures much more than most service units. A small number of service users experience a very large number of applications of restrictive procedures.Conclusion  Contemporary English services administered by the NHS and independent health care use restrictive behaviour management procedures commonly, including non‐evidence‐based practices, such as PRN medication. These services should focus resources on the small proportion of services units and service users and adopt evidence‐based practices to safely reduce these restrictive procedures, enhance service user quality of life and ensure value for money from commissioned services.
Physics-Based Modeling and Control of Residual-Affected HCCI Engines
Authors: Shaver Gregory M. , Gerdes J. Christian , Roelle Matthew J. 
Published: February 2009

Abstract
Homogeneous charge compression ignition (HCCI) is a novel combustion strategy for IC engines that exhibits dramatic decreases in fuel consumption and exhaust emissions. Originally conceived in 1979, the HCCI methodology has been revisited several times by industry but has yet to be implemented because the process is difficult to control. To help address these control challenges, the authors here outline the first generalizable, validated, and experimentally implemented physics-based control methodology for residual-affected HCCI engines. Specifically, the paper describes the formulation and validation of a two-input, two-state control-oriented system model of the residual-affected HCCI process occurring in a single engine cylinder. The combustion timing and peak pressure are the model states, while the inducted gas composition and effective compression ratio are the model inputs. The resulting model accurately captures the system dynamics and allows the simultaneous, coordinated control of both in-cylinder pressure and combustion timing. To demonstrate this, an H2 optimal controller is synthesized from a linearized version of the model and used to dictate step changes in both combustion timing and peak pressure within about four to five engine cycles on an experimental test bed. The application of control also results in reductions in the standard deviation for both combustion timing and peak pressure. The approach therefore provides accurate mean tracking, as well as a reduction in cyclic dispersion. Another benefit of the simultaneous coordination of both control inputs is a reduction in the control effort required to elicit the desired response. Instead of using a peak pressure controller that must compensate for the effects of a combustion timing controller, and vice versa, the coordinated approach optimizes the use of both control inputs to regulate both outputs.
The Risk of Accidents Among Older Drivers
Authors: Brorsson Bengt 
Published: February 2009

The number of older persons holding a driver's licence is rapidly increasing, as is the number of older persons driving a car. This paper examines driver accident-risk by age group, focusing on the older driver. Two different measures of accident risk are used; involvement in personal injury traffic accidents per million kilometers driven, and involvement in traffic accidents where one or more pedestrians were injured per million kilometers driven. The latter measure is used to refute the assumption that the elderly's risk of being involved in personal injury accidents might, to some extent, be explained by the fact that older drivers generally tend to run a higher risk than younger drivers of being injured in the event of a traffic accident. Another motive is that it provides a measure of the extent to which drivers of different ages present a risk to their fellow road users. This study shows that drivers in the 75-84 age group are at four to six times greater risk than are middle-aged drivers of being involved in personal injury traffic accidents.
Changing Smoking, Drinking, and Eating Behaviour among Pregnant Women in Denmark
Authors: Olsen Jørn , Frische Grethe , Poulsen Anni O. , Kirchheiner Helle 
Published: February 2009

Health behaviour during pregnancy was examined before and after a comprehensive health campaign targeted at pregnant women in Odense, Denmark. Furthermore, lifestyle habits were compared before and during the campaign with similar habits in Aalborg, Denmark. All 13,815 pregnant women (equal numbers from each city) were enrolled in the study, and 11,980 gave information on eating, drinking, and smoking habits during pregnancy. Data collection in both cities took place from April 1984 to April 1987. The campaign, which was entitled “Healthy Habits for Two”, ran from April 1985 to April 1987 in the city of Odense only. No significant change in health behaviour in the Odense area was noted after the start of the campaign.
Attitudes towards HIV infection and sexual risk behaviour
Authors: Schmidt K. , Krasnik A. , Brendstrup E. , Zoffmann H. , Larsen S.O. 
Published: February 2009

To describe attitudes towards HIV infection in relation to sexual risk behaviour and sociodemographic factors in a representative sample of Danish men 16-55 years of age, a self-administered anonymous questionnaire was distributed in connection with a personal health interview and returned by prepaid mail. The response rate was 55%, corresponding to 1,155 participants. In contrast to the official AIDS prevention strategy, 28% of the participants stated that HIV infected persons should be forbidden to have sexual relationships, and 44% that they should be registered by the authorities. 33% of the participants had had sexual behaviour which may be associated with increased risk of HIV infection: more than one female partner during the previous 12 months, sexual contact with prostitutes or sex with other men. Despite good basic knowledge of AIDS, only 41-59% of these men perceived themselves at risk, and only 47-54% of men perceiving themselves at risk had adopted risk-reducing sexual behaviour. The results indicate a need for innovative health education of the general public about AIDS prevention at community and individual level. In the absence of effective treatment and without prospect of a vaccine in the near future the prevention of AIDS must focus on modifying behaviour associated with increased risk of HIV infection, in particular sexual behaviour.
Health care utilization after referral from a hospital emergency department
Authors: Hansagi Helen , Allebeck Peter , Edhag Olof 
Published: February 2009

In a trial, patients who came to a hospital Emergency Department (ED) with non-urgent complaints were advised and referred to primary health care outside the hospital. The effect of this was assessed by measuring health care utilization one year before and one year after the referral, using the Stockholm County computerized medical information system and ED medical records. The proportion of the 189 referred patients who visited the ED decreased from 48% to 42%, whereas in a control group of 107 patients the proportion increased from 41% to 51%. A small proportion, 7%, of the referred patients with four or more ED visits accounted for 45% of the total number of ED visits the year before the trial. These frequent ED users did not reduce their ED utilization more than frequent ED users in the control group. The use of health care centres increased in the referred group and was practically unchanged in the control group. However, those referred patients who continued to use the ED still quite often did so for non-urgent complaints.
Health Workers and AIDS
Authors: Krasnik Allan , Fouchard Jan R. , Bayer Thomas , Keiding Niels 
Published: February 2009

The objective of the study was to measure the level of HIV/AIDS related anxiety among health care workers and identify its determinants. Data were obtained by means of a mailed, anonymous, self-administered questionnaire distributed to 2561 Danish medical doctors, nurses and nursing aides drawn randomly from the lists of members of the respective national associations. The data were analysed on the basis of a pre-study model including 12 variables hypothesizing a hierarchy of causal dependencies with anxiety at the top. 44% of the participants expressed HIV/AIDS related anxiety — hospital workers more than primary care workers, the older less than the younger. Anxiety was significantly associated with negative/restrictive attitudes towards HIV positives and gay men and with low levels of knowledge about HIV transmission and less education about HIV/AIDS. Negative/restrictive attitudes towards HIV positives were associated both with less knowledge regarding HIV transmission and fewer contacts with HIV positives. Similar associations were found regarding gay men. It is suggested that new kinds of training programmes be established which focus much more on attitudes and norms concerning HIV/AIDS — especially among health care workers with only occasional contact with HIV patients.
Salmonella and Shigella Carriers Among Refugees from the Middle East and Sri Lanka in Denmark
Authors: Kjersem Helge , Jepsen Søren , Larsen Leith , Black Finn 
Published: February 2009

One per cent of ten thousand refugees were asymptomatic carriers of Salmonella and Shigella species found by a differentiated health check programme at a Danish Red Cross arrival centre in Denmark 1985 and 1986. Six patients with typhoid fever and one with S. parathyphi-A septicaemia all fell ill within the first few weeks after arrival. A child of a chronic S. typhi carrier developed typhoid fever four months after arrival. Cases of sporadic and mild diarrhoea occurred due to Salmonella and Shigella species. The carriers were instructed in prophylactic, hygienic measures and no outbreaks developed. The health check system in this period seemed to be sufficient in relation to preventing outbreaks of infections caused by non-typhoid Salmonella and Shigella species. The relative cost-effectiveness of a more intensive S. typhi screening on arrival is questionable. The organization of health check systems should be reviewed regularly, as each refugee situation is different and will change in different periods.
Work and “lifestyle” in occupational mortality in Denmark
Authors: Tüchsen Finn , Zebitz Ursula 
Published: February 2009

Using social class standardization Fox and Adelstein found that 18% of all mortality was attributed to work, while 82% was attributable to lifestyle. Fox and Adelstein had access to 25 occupational orders. We have made similar calculations on Danish mortality statistics including 146 occupational groups. Our results are very different: more than 50% of all mortality among Danish men seems to be related to work. Of 51,317 work-related deaths in 10 years, one third were due to cancer, and half due to cardiovascular diseases (CVD). The marked differences in results have lead to considerations on the applicability of the model and the underlying assumptions. One conclusion is that social differences and differences in mortality between social groups are so small in Denmark that a few subgroups with “deviant” mortality and/or lifestyle will be determinants of the results. Inclusion of more occupational groups increases the percentage of deaths associated with work.
Referral of non-urgent cases from an emergency department
Authors: Hansagi Helen 
Published: February 2009

A phenomenon of great concern in several Western countries is the number of patients with non-urgent ailments attending the often overloaded hospital emergency departments (EDs). With a view to providing these patients with more appropriate care, they were, in a trial at Huddinge Hospital, Sweden, advised and directed to other care facilities by a specially trained nurse. A survey indicated that 84% of the patients who agreed to a referral followed the advice given. Referred patients were satisfied with the specific service at the ED to the same extent as were control patients receiving care according to the usual routines of the ED. Moreover, the former were more likely to have a positive general attitude towards the ED. There was a positive relationship between improvement of presenting symptom and satisfaction with care at the ED, and between satisfaction and favourable attitude towards the ED. However, although patients were willing to engage in a primary health care oriented behaviour, they did not report improvement to the same extent as did ED treated patients and their general attitude towards primary health care facilities was not more favourable, at least not within a few weeks after referral.
Heritability of defects of far vision in young adults — a twin study
Authors: Jaakko M. Teikari , Jaakko Kaprio , Markku Koskenvuo , James O'Donnell 
Published: February 2009

Heritability of defects of far vision in young adults — a twin study. J. Teikari, J. Kaprio, M. Koskenvuo and J. O'Donnel (University of Helsinki, Department of Public Health, Hartmaninkatu 3, SF-00290 Helsinki, Finland). A questionnaire to study defects in far vision in the Finnish Twin Cohort Study was sent to 600 twin pairs of 30 and 31 years of age divided equally by gender and zygosity. An excess in female prevalence of defects in far vision was observed (p < 0.001). Validation of the questionnaire method to assess negative spherical equivalent of refraction was performed by asking the twins to send their last prescription for glasses. Accuracy of the questionnaire method to detect a defect in far vision was tested using a subsample of cases where actual refraction obtained from the prescription for glasses was available. This actual refraction value was compared with the individuals answers to the questions of far vision. Of the subjects 5.5% were false negatives and 1.8% of the individuals were false positives. In 152 pairs one or both twins had a defect in far vision. Under a threshold liability model, the proportion of total (phenotypic) variance in liability attributable to additive genetic effects was 0.91 in this twin data, while no evidence for effects due to dominance was found.
Diseases and symptoms as predictors of hospital care in an aged population
Authors: Anttila Sari K. 
Published: February 2009

Diseases and symptoms as predictors of hospital care in an aged population. A prospective register-based study. The association between diseases and symptoms and general hospital care was studied in a geographically defined population of 1040 persons aged 65 years or over (90% of the eligible non-institutionalized elderly). In eight years, 25% of the subjects used over 60 hospital bed-days. In age-controlled analyses high use of hospital care was predicted by chronic urinary infections and in women also by chronic bronchitis, diabetes mellitus and heart failure. Among men, the risk of high use of hospital care was greatest in those reporting chronic urinary infection (risk ratio 1.9), and among women in those reporting chronic bronchitis (2.1) and diabetes (2.0). As far as symptoms were concerned, the highest risks of hospital care were found in men reporting tremor (risk ratio 1.6) and depressive symptoms (1.5); and in women reporting memory disturbances and dizziness (risk ratios 1.9 and 1.7, respectively). High use of care was predicted by six symptoms in men and seven in women. Reported symptoms proved to be better predictors of high use of hospital care than reported diagnoses.
Alcohol consumption in a Danish cohort during 11 years
Authors: Sælan Henrik , Møller Lars , Køster Anne 
Published: February 2009

Alcohol consumption in a Danish cohort during 11 years. Sælan, H., Møller, L. and Køster, A. Social Welfare Department City of Copenhagen, Bernstoffsgade 17, DK-1592 Copenhagen V, Denmark. A cohort living in Copenhagen County, originally consisting of 1198 persons, 577 men and 621 women, 40-years of age in 1976, was reexamined in 1981, and again in 1987. Of the original cohort 1052 (88%) participated in 1976, 992 (84%) in 1981, and 965 (85%) in 1987. The purpose of this study was to describe changes in alcohol consumption in the cohort, with the view of identifying subgroups, who have changed their alcohol consumption behaviour to a certain extent. Alcohol consumption was measured by the same questionnaire all three times as to the level of consumption and frequency. Alcohol consumption peaked in 1981 (45-year olds) with 10.4 drinks on average a week. Men increased their consumption by 8% and women by 37%. There was an overall downward tendency in the consumption frequency among men, whereas the opposite was the case among women. The two groups are converging toward a weekly consumption frequency. It seems now that women are leading the change toward a greater wine consumption in relative and absolute terms. It is therefore concluded that female consumption should be considered as a target in future preventive programmes.
Condom use due to the risk of AIDS
Authors: Herlitz Claes 
Published: February 2009

Condom use due to the risk of AIDS: Trends in the general population of Sweden. Claes Herlitz. Department of Social Medicine, University of Uppsala, Uppsala, Sweden. This study examines the use of condoms due to the risk of AIDS in the general population of Sweden during 1986–1989. The study is based on annual mail surveys (1986–1989) of random population samples aged 16–44 years -4000 individuals in each sample. The response rate was 71%. The study indicates that the use of condoms increased significantly during the first years of the study period, particularly among 18–24-year-olds. Roughly the same tendency was observed regarding the perception of personal risk related to HIV infection. In 1988 a positive connection was established between condom use and personal risk perception. Between 1988 and 1989 (as the public interest in the AIDS issue declined) no further increase in condom use was observed but rather a tendency of reversal towards previous levels. Having several sexual partners was not significantly associated with a more frequent use of condoms, nor was the occurrence of casual sexual contacts. In most of the casual sexual contacts reported condoms were not used.
Waiting time to pregnancy and pregnancy outcome among Danish workers in the textile, clothing, and footwear industries
Authors: Schaumburg Inger , Boldsen Jesper L. 
Published: February 2009

Delay in conception and pregnancy outcome among Danish workers in the textile, clothing and footwear industries. Schaumburg, I. and Boldsen, J. L. (Institute of Community Health, University of Odense, J. B. Winsløws Vej 17, DK 5000 Odense C, Denmark). The relationship between time from planned to achieved pregnancy and pregnancy outcome has been studied in a group of 18,658 workers in the textile, clothing and footwear industries. Information on pregnancy outcome and delay in conception in the period 1979–84 was collected by self administered questionnaires in 1985. The response rate was 70.3%. During the study period there had been 5,171 live births and 70S spontaneous abortions. Information on delay in conception was collected in broad categories. The data were analysed by means of a newly developed statistical parametric model in order to collect all possible information from the highly grouped data. Median waiting time before a pregnancy which ended in spontaneous abortion was 1.68 times longer than median waiting time before a pregnancy leading to a live birth. There seems to be a correlation between the length of the waiting time and abortion.
Nurses' Attitudes Towards Shiftwork and Quality of Life
Authors: Escribà-Agüir Vicenta 
Published: February 2009

Nurses' Altitudes Towards Shiftwork and quality of Life. Vicenta Escriba-Agüir. (Institut Valencià d'Estudis en Salut Público, Spain). The repercussions on the social and family life of shiftworkers are important. The objectives of this work are to compare the attitudes to permanent and rotating shiftwork, and the impact of shiftwork on social and family life. A cross-sectional epidemiological study was carried out in 606 female and 367 male nurses chosen at random from public hospitals in the Valencian region. Information was gathered by means of a questionnaire, and descriptive analysis was carried out. It can be concluded that workers on rotating shifts who are dissatisfied with their working hours give incompatibility with social and family life as the main reason. Furthermore, working nights (permanently or rotating) disturbs harmony between working hours and days off of the spouse.
Feasibility of a 2-km walking test for fitness assessment in a population study
Authors: Laukkanen Raija M. T. , Oja Pekka , Ojala Katriina H. , Pasanen Matti E. , Vuori Ilkka M. 
Published: February 2009

Feasibility of a 2-km walking test for fitness assessment in a population study. Laukkanen, R. M. T., Oja, P., Ojala, K. H., Pasanen, M. E. and Vuori, I. M. President Urhu Kaleva Kekkonen Institute for Health Promotion Research, Kaupinpuistonkatu 1, SF-33500, Tampere A simple 2-km Walking Test has been developed for determining the cardiorespiratory fitness of healthy adults. In the present study the following aspects of the feasibility of this test for population assessment were investigated: participation willingness, the percentage of test qualified subjects, the percentage of acceptable test performances and the resources needed for field test administration. A representative sample was drawn from the 27 to 65-year-old population in a rural municipality in northeastern Finland. Subjects were recruited on the basis of the results of health questionnaires and interviews. One fourth of the volunteers were excluded from the test because of health problems. The 2-km walking tests were administered outdoors in the municipality center. More than 50% of the subjects successfully completed two consecutive walking tests. This study indicated that the 2-km Walking Test is a feasible alternative as a measure of cardiovascular fitness for large population groups and could potentially be used in exercise related health promotion programmes.
Milk — a better drink?
Authors: Jacobsen Bjarne Koster , Stensvold Inger 
Published: February 2009

Milk — a better drink? Relationships with total serum cholesterol in a cross-sectional survey. The Nordland Health Study. Jacobsen B. K., Stensvold I. (Institute of Community Medicine, University of Tromsø, Tromsø, Norway, and National Health Screening Service, Oslo, Norway). Cross-sectional studies have not consistently shown a positive association between milk drinking and serum cholesterol. We studied this relationship in a cohort of 7506 men and women aged 40–42 years in the county of Nordland in northern Norway (72% of all subjects in the age-bracket living in the county). We found a positive relationship between the percentage of fat in the milk and total serum cholesterol, but no positive relationship between whole fat milk consumption (number of glasses per day) and serum cholesterol. The findings were, however, to some extent influenced by effects of present atherosclerotic disease, or perceived threat of this.