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In order to assess how much disability is caused by vertigo, health status scores of patients referred with dizziness or vertigo were compared with local population normative data and with the severity of illness, measured by a disease-specific questionnaire. The questionnaires were administered by post to patients awaiting an ENT out-patient appointment. There was a strong correlation (P = 0.001) between the eight dimensions of the SF-36 (Mos 36 item short-form health survey) and disease severity, measured by the Dizziness Handicap Inventory questionnaire. Compared with the general population, vertigo sufferers had significant role limitation due to physical problems and social functioning (men) and physical problems and vitality (women). General health status is significantly affected by both the presence and severity of vertigo and the SF-36 may prove useful in assessing outcomes.

electronic medium. This medium is well suited to being searched, updated, and copied. We are currently exploring this option locally. 5 Any electronic method of dissemination will require careful management and will in itself only be a further tool to aid decision making.Contributors: AH and DK designed, initiated, and coordinated the study. DP assisted with the design, interpretation, and direction of the study. FP collected the data and assisted with their analysis and interpretation. The paper was written jointly by AH, DK, DP, and FP. AH and DK are guarantors for this study.Funding: Cambridge and Huntingdon Health Authority. Conflict of interest: None. Subjects, methods, and resultsWe contacted the staff in three main settings-the health authority headquarters, an accident and emergency department, and various departments in another hospital-and asked them to complete a form that contained boxes for the respondent's name, the 26 letters of the alphabet, and the digits 0-9. They were told that examples of handwriting were needed to test computer software for optical character recognition and were asked to write as neatly as possible. All 92 staff present in the three settings were asked to participate, and none refused. We analysed their responses with Teleform, a software package that allows handwritten replies on standard forms to be scanned and translated into text for computer analysis.3 Any unrecognised characters are highlighted, and an error score is generated.For the analysis, the staff were divided into three groups: doctors, nurses plus other medical professions, and administrative staff. We collated the results with the spss statistical program. As the error scores were not normally distributed, we used median values when comparing each group and used the Kruskal-Wallis or Mann-Whitney U test to test any observed differences for significance. In order to control for possible confounding we examined the effects of sex, setting, and age separately.The table shows the median legibility error score for each professional group. Numeric legibility was similar for all groups and not considered further. For letters there was a significant difference between the groups (P = 0.006). The doctors had a higher median score compared with the other two groups individually (P = 0.01 for nurses plus other medical professions, P = 0.005 for administrative staff) or combined (P = 0.001). Analysis of female respondents alone revealed a similar pattern, with the doctors having a higher median error score than the other two groups (P = 0.032 for nurses plus other medical professions, P = 0.09 for administrative staff, P = 0.036 for the groups combined).The doctors had a slightly higher median age (37.5 years) than did the other two groups (33.0 years and 31.5 years respectively), but this difference was not significant (P = 0.78), nor was there any significant effect of age on legibility for all respondents or for doctors alone. The doctors in each of the three main settingshealth authority headquarters, accident and ...

SUMMARYAir flow through a human upper airway (central part) has been carried out using a realistic geometry. In addition to explaining the anatomy, problems and importance of patient-specific study of human upper airways, this article also presents some qualitative and quantitative simulation results. As expected, the shear and pressure forces are large in the oropharynx and laryngopharynx, where the flow passage is narrow. This clearly indicates that these locations should be the focus of any study aimed at understanding the human upper airway collapse in a patient-specific manner.

An experiment was performed using low-level ultrasound in an attempt to inhibit tinnitus during and after stimulation. The method used a double-blind crossover technique with a placebo. Forty subjects were tested, and they generally reported little or no change in their tinnitus, the results from placebo and ultrasound not being statistically different. It cannot be concluded, therefore, that the ultrasound we were using has any beneficial effect on tinnitus. These results do not confirm the findings of the pilot study using the same ultrasound devices (Carrick et al., 1986).