A comparison of costs and data quality of three health survey methods: mail, telephone and personal home interview

Three survey modes--a self-administered mailed questionnaire, a telephone interview, and a home interview--were assessed for survey costs, adequacy of completion, test-retest reliability, validity of responses to medical questions and estimates of morbidity. Costs per household for each mode were $A42.75, $A74.33, and $71.89, respectively. Item omission was confined virtually to the mail mode and averaged 5.5% over 84 questions assessed, while telephone and home interview modes averaged 0.4% and 0.2%, respectively. "Don't knows" were virtually absent for all questions except those about precise details (names, places, etc.) of events occurring often 10-15 years before the survey; no mode differences were observed. The mail mode produced less reliable responses to questions about environmental exposure to hazardous chemicals or activities when considered question-by-question, but differences were not significant among modes when all questions were grouped. Reliability was high to medical questions and no mode differences were observed. Medical conditions which would require a medical diagnosis for subjects to be able to report them were more reliably answered than conditions described in broad or lay terms. Validity of answers to medical questions varied across modes and types of questions; underreporting of medical conditions was highest in the mail mode and was lowest for conditions requiring a diagnosis. Overreporting was lowest in the mail mode and highest for conditions requiring a diagnostic opinion.

Reversible myocardial perfusion defects during cold challenge in scleroderma

Myocardial perfusion was studied using 201thallium scintigraphy in patients with Raynaud's phenomenon undergoing cold challenge. Ten patients with systemic sclerosis and 10 with other systemic rheumatic diseases were selected. Patients with clinical features of cardiac disease were not included. Both groups of patients had similar cold-induced elevations of pulse rate and systolic and diastolic blood pressure. Reversible perfusion abnormalities suggesting cold-induced ischaemia were seen in four of the ten patients with systemic sclerosis, but in none of the patients with other rheumatic diseases. This study supports the suggestion that the vascular disorder in scleroderma differs from that seen in other rheumatic diseases which are associated with Raynaud's phenomenon.

Cation-Ratio and Accelerator Radiocarbon Dating of Rock Varnish on Mojave Artifacts and Landforms

The first accelerator radiocarbon dates of rock varnishes are reported along with potassium/argon ages of lava flows and conventional radiocarbon dates of pluvial lake shorelines, in an empirical calibration of rock varnish K(+) + Ca(2+)/Ti(4+) ratios with age in the Mojave Desert, eastern California. This calibration was used to determine the cation-ratio dates of 167 artifacts. Although cation-ratio dating is an experimental method, some dates suggest human occupation of the Mojave Desert in the late Pleistocene.

Stable-carbon isotopic composition of maple sap and foliage

The (13)C/(12)C ratios of Acer grandidentatum sap sugar collected during the dormant period are compared to those of buds, leaves, and wood developed over the following growing season. As the primary carbon source for cellulose manufacture at initiation of annual growth in deciduous trees, sap sucrose would be expected to have an isotopic composition similar to first-formed cellulose. Although constancy in concentration and (13)C/(12)C ratios of the maple sap sugar suggests any gains or losses (e.g. to maintenance metabolism) do not appreciably alter composition, the (13)C/(12)C ratios of cellulose of the enlarging buds in the spring are quite distinct from those of the sap sugar, seemingly precluding a simple direct biochemical pathway of sap sucrose-->glucose-->cellulose in favor of a more complex pathway with greater likelihood of isotopic fractionation. The (13)C/(12)C ratios of the leaves and in the growth ring were initially similar to the sap sugar but decreased steadily over the growing season.

Observations on the feeding habits of the Greater Broad-nosed Bat, Nycticeius rueppellii (Chiroptera: Vespertilionidae)

Nycticeius rueppellii were found to kill and eat other bats when caught in harp-traps and when confined with other species in captivity. The deaths of at least 26 individuals of seven bat species were attributed to N. rueppellii. Such predatory behaviour was also observed both in small cages and in a large outdoor enclosure and appeared not to be induced by starvation. Feeding trials in captivity showed a more immediate response by N. rueppellii to the presence of live bat prey than to other prey types including mealworms, baby mice and adult mice (Mus musculus). In the field, free-flying N. rueppellii attacked other bats entangled in mist-nets. These observations suggest that the natural diet of this bat may not be restricted to invertebrate prey but may also include vertebrates.

Ergonovine-induced esophageal spasm in patients with chest pain resembling angina pectoris

We studied the effect of ergonovine maleate (EM) on esophageal motor activity in 18 consecutive patients with angina-like chest pain. Significant coronary artery disease was excluded in each patient by cardiac catheterization studies. Baseline esophageal motility was abnormal in 12 patients (66%). After injection of EM, ten patients developed their typical chest pain at the onset of repetitive contractions. Thus, chest pain and esophageal dysfunction were clearly linked. Compared with saline injection, only the repetitive contractions were significantly increased after AM in these patients (P less than 0.01). Amplitude and duration of contractions were increased after EM, but not significantly. Due to potentially serious adverse effects, however, EM cannot be recommended for routine use as a provocative agent.

Documentation of change in problem behaviors among anxious and hostile-aggressive children enrolled in a therapeutic preschool program

A relatively simple, straightforward procedure is utilized to identify and document changes in problem behaviors among children enrolled in a therapeutic preschool program. Results of two outcome measures indicated a significant overall reduction in problem behaviors for the total group. When subgroups of anxious and hostile/aggressive children were considered, however, there was a significantly greater probability that anxious children would benefit more from the program than hostile/aggressive children. The need to consider subgroups of patients when documented treatment effectiveness is emphasized, and the advantage of building documentation techniques into the record-keeping system is discussed.

High-performance UHF SQUID magnetometer

We describe a lumped-component stabilized point contact SQUID magnetometer, biased at 430 MHz and utilizing a cooled (4.2 K) GaAs FET preamplifier. The system incorporateds a full-bandwidth (5-10 MHz) flux-locked loop and has an overall flux sensitivity of 1x10(-5) Phi0/(Hz)(1/2), corresponding to an energy sensitivity approximately 4.5x10(-31) J/Hz.

Health administration: guide to epidemiology

Continuing our series from the Nuffield Centre, author looks at the broadening concern of epidemiology today as it embraces chronic disease and non-medical aspects of disease and argues that it could be a great help to the health service planner.

Implementation of a personalized clothing policy for long stay psychiatric patients: a study of communication

This study raises the following question. Should the policy maker be responsible for ensuring adequate monitoring of policy implementation? A policy lays down a course of action for achieving a particular end. Implementation of a policy implies adherence to the course of action stated in the policy. This study was concerned with the relationship between a policy of personalized clothing and the implementation of a particular scheme. Divergence from the original policy occurred because of inadequate communication between those who formulated the policy, those who implemented the policy and the staff who were responsible for day-to-day management associated with the policy. The finding of this study was that the way policy was implemented did not relate to the original objective of the policy. Policy relating to a particular area of health cannot progress scientifically unless evaluation of the implementation of formulated policy occurs. This research therefore advocates that the policy maker should be responsible for ensuring adequate monitoring of the policy when it is implemented.