Postal Inquiry Research Articles

Belgian General Practitioners on their Vocational Training: A Postal Inquiry

Vocational training of general practitioners in Belgium consists--among others--of 34 seminars to be followed in small groups during a period of two years. The purpose of this study was to develop an instrument for continuing evaluation of this system, and to gather evaluative data. 58% of 177 young general practitioners responded to our postal inquiry, in which ten open-ended questions were put, and 50 statements were to be rated on a six-point-scale. The inquiry revealed that the Belgian vocational training has a large influence on the evolution from inexperienced young doctor to self-confident general practitioner. Factor analysis on the scores of the 50 statements uncovered three dimensions: (1) working climate, (2) learning results, and (3) identification. The reliability of the scales, constructed for each of these factors, was between 0.80 and .86 (Cronbach's alpha). Mean scores on these scales were all high. The Belgian vocational training seems to be accepted and appreciated by the young GPs, but improvements might be suggested.

Retirement, aging, psychosocial adaptation and mental health. Findings of the TURVA project.

This article deals with certain preliminary findings obtained in a long-term prospective study begun in 1982 using the interview method; the first follow-up was carried out in 1986, the method consisting of a postal inquiry and the collection of recorded data. The sample consists of 200 randomly selected inhabitants of Turku born in 1920 and 189 individuals of the same age living in rural municipalities in the vicinity of Turku. During the 4-year follow-up period the subjects' biopsychosocial situation remained almost unchanged, showing that, for most people, retirement is not a stressor of crucial importance or a life crisis. Of the variables relating to the initial survey, poor subjective physical health, self-assessed work disability, poor financial situation, change into a taciturn and timid individual in adolescence, the spouse's poor mental equilibrium, an excess of leisure time and general dissatisfaction with life were associated with subsequent mental disturbance as measured by use of the General Health Questionnaire.

Exposure to Hydrazine and its Control in Power Plants

Abstract The use of hydrazine in power plants was surveyed with a postal inquiry to detect differences in exposure when alternative technical procedures were used in the handling of hydrazine. The exposure level of employees in eight plants was estimated based on the concentration of hydrazine in the air and the potential absorption through the skin. The questionnaire was sent to 288 power plants and 264 were returned, 100 of which used hydrazine. About 500 employees dosed and diluted strong (15% or 35%) hydrazine solution. The dosing was usually done with a pump or an ejector in bigger plants and with a measure in small plants. The airborne hydrazine concentrations in the rooms where hydrazine was handled were: < 0.01–0.06 ppm (mean < 0.02 ppm) for dosing with measure; < 0.01–0.37 ppm (mean 0.12 ppm) for dosing with pump; < 0.01–0.33 ppm (mean 0.09 ppm) for dosing with ejector, tank not closed; and < 0.01–0.04 ppm (mean 0.02 ppm) for dosing with ejector, tank closed and equipped with exhaust. The time-we...

A follow-up study of 222 anorexia nervosa and bulimia nervosa patients, 1960-1983

Two hundred and twenty-two patients (205 females and 17 males) with anorexia nervosa and bulimia were re-examined 2-23 years (average, 8 years) after their first contact with the Department of Child and Youth Psychiatry or Department of Psychiatry of the University Hospital. Lund, Sweden. Of the 222 patients selected, 7 had died (3.2%), 5 of suicides and 2 of severe malnutrition. Two hundred and fifteen were asked to answer a postal inquiry consisting of psychometric instruments and one self-report check list. One hundred and twenty-eight answered and were statistically compared with the non-responders. On various items from hospital records no differences were found. The follow-up age for the 128 responded was 27.7 years. On basis of the recommended cut-off point for EAT-26 scores the responders were divided into two groups: one recovered and one symptomatic. There were statistical differences for all psychometric instruments between these two groups. The recovered group had a shorter delay and were thus...

Valeur prédictive des tests intradermiques aux curarisants

A restrospective postal inquiry was carried out to find out a possible relation between the results of intradermal tests carried out for a previous anaesthetic and the course of a second anaesthetic performed afterwards. This study included 350 patients who have had an intradermal test to vecuronium, alcuronium, suxamethonium, gallamine, pancuronium, thiopentone, fentanyl and droperidol between March 1984 and November 1986. Eighthy-nine did not reply (25.4 %), 183 (52.3 %) dit not undergo new general anaesthetic since the skin tests, whilst 78 (22.3 %) did. The inquiry was then sent to the 73 anaesthetists corresponding to the last group of patients. The 51 complete answers included 62 anaesthetics. Twenty-four patients had negative intradermal tests before the new anaesthetic, the other 27 having had a test positive to at least one muscle relaxant. Of these latter, 16 were given a muscle relaxant during their general anaesthetic, selected among those resulting in a negative intradermal test. Thirteen had undergone skin testing because of an anaphylactic reaction during induction. No new anaphylactic reaction was observed. Three anaesthetists only were not aware of the results of the intradermal tests at the time of the new anaesthetic. These data tend to demonstrate that a muscle relaxant could be injected in a patient who has had a previous anaphylactic reaction with positive intradermal tests, provided that the drug chosen for the new anaesthetic does not give a positive intradermal reaction.

Group training of general practitioners: evaluation based on participants' expectations of an educational programme

Since 1985, the Norwegian Medical Association (NMA) has offered a 5-year specialist training programme in general practice. For two of these years the doctors take part in a group-based educational programme with bi-weekly meetings of 3 hours' duration. The evaluation study reported here had a dual purpose: to provide the groups with a method for exploring the group members' expectations of the programme, and to measure to what extent the programme had actually met these expectations within the first of the 2 years. Thirty-one of 38 groups, first established in spring 1986, responded on a postal inquiry where they were asked to list up to 10 features they expected to find in the educational programme. These expectations were rated by the groups on a five-point scale, where 5 denoted a fully met expectation. The four most frequent features analysed were: (1) increased comprehension of the characteristics and practice of general medicine; (2) good group collaboration; (3) facilitating the acquisition of medical knowledge; and (4) evaluation of clinical problems and patient management. Expectations for the first two of these features were nearly fully met, while the two others were met to a lesser degree. This type of evaluation seemed to be a useful tool for improving the group's way of functioning.

The period prevalence of musculoskeletal complaints among Swedish professional drivers.

The aim of the investigation was to survey the period prevalence of musculoskeletal complaints among Swedish professional drivers. 460 out of 570 male drivers answered a postal inquiry. The period prevalence of musculoskeletal complaints was highest for the low back, the shoulders, the knees and the neck, in that order. For some parts of the musculoskeletal system the period prevalence of complaints tended to increase with age. A subdivision of the examined group of drivers according to task revealed--after standardizing for age (SRR)--different relative risk of complaints in various anatomical regions of the body. The interaction among some variables was studied by means of Automatic Interaction Detection Analysis. The analysis showed that the variables age and task reduced the variance of the period prevalence of musculoskeletal complaints most.

ACUTE HEPATITIS B ASSOCIATED WITH GYNÆCOLOGICAL SURGERY: REPORT OF A COLLABORATIVE STUDY BY THE COMMUNICABLE DISEASE SURVEILLANCE CENTRE AND THE EPIDEMIOLOGICAL RESEARCH LABORATORY OF THE PUBLIC HEALTH LABORATORY SERVICE TOGETHER WITH A DISTRICT CONTROL-OF-INFECTION SERVICE

In a district in England, seven patients in whom acute hepatitis B (AHB) developed between January and July, 1978, had had major surgery by the same gynæcological team within six months of onset. Hepatitis B surface antigen (HBsAg) at high titre, hepatitis B e antigen, and Dane particles were found in the serum of the team registrar. The HBsAg subtype of the registrar and patients was ad. A postal inquiry of family doctors revealed an additional patient who had been jaundiced and had probably contracted AHB within six months of major surgery performed by the same registrar. Among this registrar's patients AHB arose in 8 (5%) of 153 who had had major operations, but in none of 300 who had had minor operations and in none of 136 obstetric patients. No cases were found in 188 major-surgery, 425 minor-surgery, and 130 obstetric control patients. Infection was probably transmitted by sharp instruments after accidental puncture of the surgeon's glove and skin.

Subarachnoid spinal analgesia

A postal inquiry into the current use of subarachnoid spinal analgesia obtained replies from approximately 70% of consultants in both Scotland and Sweden. Although medico-legal anxiety was still an important feature of Scottish practice, the publication of large series with a low incidence of complications had also exerted some influence, and 40% of consultants employed the technique. In contrast, 70% of Swedish replies indicated current use of spinal analgesia and the individual frequency of administration was considerably higher. The present popularity of epidural analgesia has contributed to some decline in the use of subarachnoid spinal analgesia in Sweden, particularly in the case of longer surgical procedures. Anaesthetists in both countries expressed dissatisfaction with the limited choice of available spinal agents and considered their duration of action to be inadequate. In Scotland, conditional indications, such as diabetes mellitus and respiratory disease, were of major importance, whereas Swedish users more often specified surgical procedures for which subarachnoid spinal analgesia was considered to be the anaesthetic of choice. Few anaesthetists had experience of complications and no major neurological sequelae were reported. More than 80% of replies indicated that subarachnoid spinal anaesthesia had a useful place in anaesthetic practice.

Career intentions of senior registrars in general psychiatry.

A postal inquiry of all senior registrars in general psychiatry in the United Kingdom gave a nearly 90 per cent response rate. Between a quarter and a fifth of the respondents will not be pursuing general psychiatry at consultant level in this country, most of these opting for a psychiatric specialty. Nearly all the overseas graduates will probably remain in this country. Slightly fewer women than men are aiming for a consultancy in general psychiatry, the rest of the women proposing to switch to one of the specialties. Some of the implications of these findings are discussed, including a proposal for a yearly follow-up of the respondents.

Epidemiology of secondary amenorrhea: II. A retrospective evaluation of etiology with special regard to psychogenic factors and weight loss

A random sample of 41 women aged 18 to 35 years with secondary amenorrhea within Uppsala County, Sweden, were compared to 82 age-matched nonamenorrheic women with respect to a number of background variables of etiological interest, especially psychogenic factors and weight loss. Social-hygiene factors and gynecologic data were also considered. The study was retrospective and performed by a postal inquiry. In the amenorrheic group significant differences were obtained (p less than .05) for the following items: a higher proportion of unmarried women and women with intellectual occupations; a higher proportion with a greater incidence of stressful life events; more consumption of sedatives or hypnotic drugs; and more underweight. Previous menstrual irregularity was also more common. Amenorrhea following use of oral contraceptive agents was reported by 9 women, most of whom also showed pronounced underweight. Symptoms characteristic of anorexia were present in 2 amenorrheic women. There may have been others among those reporting marked underweight. The estimated prevalence of anorexia nervosa is 1 per 1000. The findings may be interpreted as either a true increase in incidence of the disorder or perhaps the method of investigation.

Exhibitionism outside Europe and America

This article reports the results of a postal inquiry into the occurrence of exhibitionism in countries outside Europe. Psychiatrists were contacted and reports received from 24 non-European countries. Experience in these countries suggests that exhibitionism is in general very rare, particularly in African societies, although most respondents knew of isolated cases. A surprising result was that in Japan, which has many features in common with Western industrialized society, exhibitionism is virtually unknown. It is concluded that the available evidence suggests that exhibitionism is commoner in Western Europe than in the non-European countries considered and that this difference cannot be explained in terms of the effects of industrialization or “civilization.” Various aspects of sexual attitudes and behavior of possible relevance to further cross-cultural studies are considered.

Epidemiology of secondary amenorrhea: I. Incidence and prevalence rates

In a postal inquiry a 1 in 15 sample of the female population aged 18 to 45 years within Uppsala County, Sweden, was interviewed with regard to the occurrence of secondary amenorrhea, use of oral contraceptives, and smoking habits. In addition, population register data on residence, marital status, and socioeconomic distribution were used. Ninety-three per cent of the sample answered. The one-year incidence rate of secondary amenorrhea of more than 3 months' duration was 3.3 per cent, as calculated on an estimated population at risk. The one-year period prevalence rate was 4.4 per cent and the point prevalence rate at the time of interview 1.8 per cent. Oral contraceptive agents were used by 37 per cent of the sample during the last 12 months. A marked covariation between use of oral contraceptives and smoking habits was found. A plausible causal relationship between previous use of oral contraceptive agents and the occurrence of secondary amenorrhea was found in about 16 per cent of the women with amenorrhea.

Comparison of personal interview and postal inquiry methods for assessing prevalence of angina and possible infarction

The cardiac pain questionnaire administered by a postal inquiry was answered by 773 Norwegian men in a stratisfied sample of the interviewed on the same questions almost 3 yr previously. Median age was 57 at interview and 60 at the postal inquiry. Response rate was 86 per cent. Prevalence of angina (AP) and possible infarction (PI) was assessed from the symptom questions. The estimates of postal inquiry symptom prevalence of the interviewed population presented higher rates by the postal inquiry than from the interview: AP increased from 4.4 to 8.6, PI from 5.0 to 7.9, and AP only from 2.4 to 5.9 per 100. The conversion to symptom positives at postal inquiry was higher among interview non-specifics than other negatives. As much as 41 per cent of men with AP only status at interview converted to PI at postal inquiry. The conversion of interview symptom positives to negatives at postal inquiry was 19 per cent; lower among AP and PI than among PI only or AP only. It is concluded that though both methods seem to have a high ability to identify groups liable to excess mortality, the postal inquiry method is yielding higher prevalence rates of angina and possible infarction than the personal interview method in a Norwegian male population.

Psychiatrists' interest in community mental health centers

A postal inquiry among psychiatrists in New York State revealed a high level of interest in working in community mental health centers. The majority of those interested only wanted to work part-time in a center. The amount of time they would like to spend in the center and the types of work they would like to do were related to their present occupation and practice. Recruitment of personnel for these new services is very likely to aggravate the present staffing problems in state mental hospitals.

SED Research Report No. 11: Status of Refuse Collection and Disposal

A preliminary survey was completed during 1955-1956 both by direct discussion and postal inquiry concerning the present status of refuse collection and disposal as well as future needs for additional research and development in this field. The results of this investigation are summarized and evaluated.