Found 226 related files. Current in page 2
WLM-1 2010-006 Medical Symptoms Questionnaire Initials Visit # Number # Date Rate each of the following symptoms based on the last 48 hours: Point Scale HEAD 0 1 2 Never or almost never have the symptom Occasionally have it, effect is not severe Ocasionally have it, effect is severe ________ Headaches ________ Faintness ________ Dizziness ________ Insomnia DIGESTIVE TRACT TOTAL EYES ________ Watery or itchy eyes ________ Swollen, red or sticky eyelids ________ Bags or dark circles under eyes ________ Blurred or tunnel vision (does not include nearor far-sightedness) TOTAL EARS ________ Itchy ears ________ Earaches, ear infections ________ Drainage from ear ________ Ringing in ears, hearing loss ________ Stuffy nose ________ Sinus problems ________ Hay fever ________ Sneezing attacks ________ Excessive mucus formation TOTAL Chronic coughing MOUTH/ ________ Gagging, need to clear throat THROAT ________ ________ Sore throat, hoarse, loss of voice ________ Swollen or discolored tongue, JOINTS / MUSCLE WEIGHT HEART LUNGS ________ Irregular or skipped heartbeat ________ Rapid or pounding heartbeat ________ Chest pain TOTAL ________ Pain or aches in joints ________ Arthritis ________ Stiff or limitation of movement ________ Pain or aches in muscles ________ Feeling of weakness or tired ________ Binge eating/drinking ________ Craving certain foods ________ Excessive weight ________ Compulsive eating ________ Water retention ________ Underweight TOTAL ENERGY / ACTIVITY ________ Fatigue, sluggishness ________ Apathy, lethargy ________ Hyperactivity ________ Restlessness TOTAL MIND ________ Acne ________ Hives, rashes, dry skin ________ Hair loss ________ Flushing, hot flashes ________ Excessive sweating TOTAL ________ Nausea, vomiting ________
Bruley Center Medical Symptoms Questionnaire Name _____________________________ Date _________________ Rate each of the following symptoms based upon your typical health profile for: Past 30 days Past 48 hours Point Scale 0 1 2 3 4 HEAD ________ ________ ________ ________ Headaches Faintness Dizziness Insomnia EYES ________ ________ ________ ________ Watery or itchy eyes Swollen, reddened or sticky eyelids Bags or dark circles under eyes Blurred or tunnel vision (does not include near or far-sightedness) Total ________ EARS ________ ________ ________ ________ Itchy ears Earaches, ear infections Drainage from ear Ringing in ears, hearing loss Total ________ ________ ________ ________ ________ ________ Stuffy nose Sinus problems Hay fever Sneezing attacks Excessive mucus formation Total ________ ________ ________ ________ ________ ________ Chronic coughing Gagging, frequent need to clear throat Sore throat, hoarseness, loss of voice Swollen or discolored tongue, gums, lips Canker sores Total ________ ________ ________ ________ ________ ________ Acne Hives, rashes, dry skin Hair loss Flushing, hot flashes Excessive sweating Total ________ ________ ________ ________ Irregular or skipped heartbeat Rapid or pounding heartbeat Chest pain Total ________ NOSE MOUTH/THROAT SKIN HEART - Never or almost never have the symptom Occasionally have it, effect is not severe Occasionally have it, effect is severe Frequently have it, effect is not severe Frequently have it, effect is severe Applying Functional Medicine in Clinical Practice Total ________ 2 Chest congestion Asthma, bronchitis Shortness of breath Difficulty breathing Total ________ Nausea, vomiting Diarrhea Constipation Bloated feeling Belching, passing gas Heartburn Intestinal/stomach pain Total ________ ________ ________ ________ ________ ________ Pain or aches in joints Arthritis Stiffness or limitation of movement Pain or aches in muscles Feeling of weakness or tiredness Total ________ ________ ________ ________ ________ ________ ________ Binge eating/drinking Craving certain foods Excessive weight Compulsive eating Water retention Underweight Total ________
FROM PAIN TO WELLNESS, LLC MEDICAL SYMPTOMS QUESTIONNAIRE NAME:________________________________ DATE:_______________________ Rate each of the following symptoms based on your typical health profile: □ Past 30 days Point Scale: 0-Never or almost never have the symptom 3-Frequently have it, effect is not severe 1-Occasionally have it, effect is not severe 4-Frequently have it, effect is severe 2-Occasionally have it, effect is severe ________________________________________________________________________ HEAD EYES EARS NOSE MOUTH/THROAT SKIN HEART LUNGS ________ Headaches (G) _______Total ________ Faintness ________ Dizziness ________ Insomnia (MH) ________ Watery or itchy eyes _______Total ________ Swollen, reddened or sticky eyelids ________ Bags or dark circles under eyes ________ Blurred or tunnel vision (does not Include near-or-far sightedness) ________ Itchy Ears _______Total ________ Earaches, ear infections ________ Drainage from ears ________ Ringing in ears, hearing loss ________ Stuffy nose _______Total ________ Sinus problems ________ Hay fever ________ Sneezing attacks ________ Excessive mucus formation ________ Chronic coughing _______Total ________ Gagging, frequent need to clear throat ________ Sore throat, hoarseness, loss of voice ________ Swollen or discolored tongue, gums, lips (G) ________ Canker sores ________ Acne _______Total ________ Hives, rashes, dry skin (G) ________ Hair loss (MH) ________ Flushing, hot flashes (MH) ________ Excessive sweating (MH) ________ Irregular or skipped heartbeat _______Total ________ Rapid or pounding heartbeat ________ Chest pain ________ Chest congestion _______Total ________ Asthma, bronchitis ________ Shortness of breath ________ Difficulty breathing (G)
Shirley Mulvaney, Simon Attard Montalto Abstract Aim: To assess the concordance of treatment of children attending with tonsillitis in Paediatric Accident and Emergency with established guidelines, and subsequent review of the management of this condition after a simple educational exercise. Methods: An audit on children with tonsillitis was carried out amongst doctors working in the Paediatric Accident and Emergency Department during a three month period in 2009. Eleven doctors completed an anonymous questionnaire requesting details on presentation, symptoms, investigations and treatment of children presenting with acute tonsillitis. The results obtained from this questionnaire were compared to NICE guidelines and modified Centor (McIsaac) criteria, and fed back to the participating doctors together with copies of these guidelines via a simple, structured educational exercise. Three months later, a second identical questionnaire was again completed by the same cohort of doctors. Shirley Mulvaney MD Simon Attard Montalto MD (L’pool), FRCPCH, FRCP * Chairman, Department of Paediatrics NPICU Mater Dei Hospital ,Malta. firstname.lastname@example.org *corresponding author Malta Medical Journal Volume 25 Issue 03 2013 Results: The first questionnaire showed that there was a tendency towards unnecessary prescription of antibiotics and investigations in children with acute tonsillitis, when compared to recommendations in the guidelines. Following educational feedback, the second questionnaire showed a reduction in antibiotic prescriptions by 9% (p=0.5) and investigations by 37% (p=0.1). Compliance with guidelines had improved significantly with regard to non-prescribing of antibiotics with a fever of <38oC (Phi -0.76, p=0.0005), and with tonsillar pus but no fever (Phi -0.68, p=0.002). Increased compliance was observed when prescribing antibiotics in the presence of pus plus a fever, lymphadenopathy >1cm and presence of underlying disease although these changes were not statistically significant. Conclusion: Although doctors were initially only partly compliant with established guidelines for children with acute tonsillitis, compliance improved significantly after a simple educational exercise.
At the trivial level the screen is what the respondent is looking at. In the context of an online survey, the term ‘screen’ refers to that section of the questionnaire which the respondent can see in their browser window without scrolling.
Abstract Aims/hypothesis The role of diet in the prevention of diabetes remains uncertain. The aim of this study was to investigate two different dietary aspects, i.e. adherence to the Mediterranean diet and glycaemic load (GL), in relation to diabetes occurrence. Methods We analysed data from the Greek cohort of the population-based European Prospective Investigation into Cancer and Nutrition (EPIC). From a total of 22,295 participants, actively followed for a median of 11.34 years, 2,330 cases of incident type 2 diabetes were recorded. All participants completed a validated, interviewer-administered semiquantitative food frequency questionnaire at enrolment. From this information, we calculated a ten point Mediterranean diet score (MDS), reflecting adherence to the traditional Mediterranean diet, as well as the dietary GL. We estimated HRs and the corresponding 95% CIs of diabetes using Cox proportional hazards regression models adjusted for potential confounders. Results A higher MDS was inversely associated with diabetes risk (HR 0.88 [95% CI 0.78, 0.99] for MDS ≥6 vs MDS ≤3). GL was positively associated with diabetes (HR 1.21 [95% CI 1.05, 1.40] for the highest vs the lowest GL quartile). A significant protection of about 20% was found for a diet with a high MDS and a low GL. Conclusions/interpretation A low GL diet that also adequately adheres to the principles of the traditional Mediterranean diet may reduce the incidence of type 2 diabetes. C. La Vecchia and A. Trichopoulou share senior co-authorship Keywords Cohort study . Glycaemic load . Mediterranean diet . Risk . Type 2 diabetes Electronic supplementary material The online version of this article (doi:10.1007/s00125-013-3013-y) contains peer-reviewed but unedited supplementary material, which is available to authorised users. M. Rossi : F. Turati : C. La Vecchia (*) Department of Epidemiology, IRCCS—Istituto di Ricerche Farmacologiche Mario Negri, via La Masa, 19, 20156 Milan, Italy e-mail: email@example.com M. Rossi : C. La Vecchia Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy P. Lagiou : D. Trichopoulos Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA P. Lagiou : A. Trichopoulou Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece L. S. Augustin Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada ...
About the survey In December 2012, the Economist Intelligence Unit carried out a global survey on behalf of KPMG International. This survey gathered data from 1,092 respondents around the world in a closed-ended online questionnaire. All were C-level executives: 28 percent were Chief Executive Officers or equivalent and 18 percent were Chief Financial Officers, the two largest groups. Five percent were Chief Risk Officers. If you combine those in the risk function and departments that work most closely with risk (legal, compliance and audit), the number comes to 131 people, or 12 percent of the total. Responses were evenly spread among companies of different sizes. Fortysix percent came from companies with annual revenues of US$500 million or less. There were a lot of large companies: 37 percent reported revenues of US$1 billion or more. Most of the responses came from North America (25 percent), Europe (25 percent) and Asia-Pacific (23 percent). The remainder was from the rest of the world, including Latin America (15 percent), Africa (8 percent) and the Middle East (4 percent). The survey was answered by people from more than 21 industries. To make it easier to drill down into individual categories, we grouped respondents into sectors; Financial Services (including banking, insurance and so on) comprised 17 percent; Technology, Media & Telecommunications made up 16 percent; Healthcare comprised 15 percent; and Energy and Natural Resources comprised 14 percent. Another large category was Diversified Industrials (including manufacturing, automotive and aerospace) which made up 15 percent of the total. This left 23 percent from other industries such as consumer goods and chemicals. ..
The Journal of Otolaryngology, Volume 35, Number 4, 2006 Objective: The purpose of this study was to evaluate the variation in tonsil size and prevalence of asymmetric tonsils in 4- to 17-year-old schoolchildren and the relationships between tonsillar hypertrophy and frequent tonsillitis, frequent fever, and sleep-related symptoms observed by parents. Design: Cross-sectional study. Setting: Six daycare centres, four primary schools, and four high schools. Methods: Questionnaire and physical examination. Main Outcome Measures: The size of the tonsils was evaluated and scored on a 4-point scale. The interrelationships between tonsillar hypertrophy and other studied symptoms were examined. Results: In the study, the parents of 1784 children, consisting of 803 (45%) boys and 981 (55%) girls, completed the questionnaires. The prevalence rates of snoring, habitual snoring, observed apnea, and habitual observed apnea were 24.6%, 4.1%, 3.8%, and 0.9%, respectively. The results of tonsil scoring were grade 1, 62.7%; grade 2, 28.4%; grade 3, 3.3%; and grade 4, 0.1%. The prevalence rate of grade 1 tonsils was increasing, whereas the prevalence rates of grade 2 and 3 tonsils were decreasing with increasing age. Tonsil size peaked in 4- to 8-year-old children. The prevalence rates of tonsillar hypertrophy and asymmetric tonsils were 3.4% and 1.7%, respectively. Tonsillar hypertrophy was found to be significantly associated with male gender, a history of frequent tonsillitis, a history of frequent fever, often or always snoring, and often or always observed apnea. Conclusions: A tonsil size curve was developed in 4- to 17-year-old schoolchildren. Children aged 4- to 8 years with oropharyngeal symptoms and particularly male gender should undergo consultation with otorhinolaryngology and pediatric pulmonology pliysicians for the evalution of adenotonsillar tissue.Sommaire Objectif: Le but de cette etude etait d'evaluer les variations dans le volume des amygdales et la prevalence d'une asymetrie amygdalienne chez les enfants de 4 a 17 ans et d'evaluer la relation entre l'hypertrophie amygdalienne et l'amygdalite recidivante, la fievre recidivante et les symptomes relies au sommeil notes par les parents. Devis: Etude de cohorte Localisation: Six garderies, 4 ecoles primaires et 4 ecoles secondaires. Metbodes: Questionnaire et examen physique. Variables evaluees: Le volume des amygdales a ete evalue sur une echelle en 4 points. Nous avons aussi evalue la relation entre l'hypertrophie amygdalienne et les autres symptomes. Resultats: Les parents de 1784 enfants (803 gar9ons (45%) et 981 filles (55%)) ont complete le questionnaire. La prevalence de ronflement, de ronflement regulier, d'apnee documentee et d'apnee reguliere documentee etait de 24.6%, 4.1%, 3.8%, 0.9% respectivement. Le volume des amygdales se presentait comme suit: grade 1, 62.7%; grade 2, 28.4%; grade 3, 3.3% et grade 4, 0.1%. La prevalence des grade 1 augmentait avec l'age a I'inverse de la prevalence de grade 2 et 3...
Form West Virginia Department of Tax and Revenue Total amount of West Virginia sales (wholesale or retail) and /or gross receipts attributable to West Virginia. $ Offices and other places of business owned or maintained in West Virginia during the taxable year: Locations (include full address if different from above) Number of officers, employees, independent contractors, representatives or other agents with business activity in West Virginia on behalf of your business. Attach a brief job description for each officer and type of agent and indicate the number of each with any activity in this State regardless of whether they reside or are regularly stationed in West Virginia. Derive income or other receipts from any financial transactions in West Virginia, including: loans secured by real or tangible property; consumer loans; commercial loans and installment obligations; syndication and participation loans; credit card service charges and fees; credit card merchant discount income; performance of financial or fiduciary services; travelers checks and money orders; and any other receipts not attributable to another state where the organization is taxable. Explain all "yes" answers in detail on a separate sheet. You may also be required to answer a West Virginia nexus questionnaire or otherwise provide additional information if your explanations do not provide a clear picture of your taxability. By my signature I hereby certify that this report, including any accompanying material, is true, correct and complete to the best of my knowledge and belief. Signature of officer or partner Filing Requirements All corporations and partnerships are required to file Form BAR-0, West Virginia Business Activity Report, with the West Virginia Department of Tax and Revenue if they carry on any business activity or own or maintain property in West Virginia during the year, unless they are exempt. (See below.) The filing of this report will not be a factor in determining whether your business is subject to taxation. Carrying on business activity or maintaining property within West Virginia includes, but is not limited to: ■ maintaining an office or other place of business in West Virginia; ■ the presence of employees, agents, representatives or independent contractors in West Virginia, if they are conducting business on behalf of the corporation or partnership, regardless of whether the individual or person is residing or regularly stationed in West Virginia; ■ owning or maintaining real property,...