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Biomedical subjects

A Girgis

Publications and source records attributed to A Girgis.

50 records · Page 3Linked to original sources

Screening for melanoma: a community survey of prevalence and predictors.

Australian cancer councils recommend the practice of regular self screening of the skin or screening by another person for signs of melanoma and other skin cancers. They also recommend that medical practitioners screen adult patients annually. This study examined the prevalence and predictors of self screening (or screening by another person) and screening by a general practitioner in 1344 individuals from randomly selected households. The results indicated that 48% of the sample either regularly checked their own skin or had it checked by another person (such as a spouse), and 17% had been screened by a general practitioner in the preceding 12 months. Overall, this indicates that 50% of the sample had their skin adequately screened as recommended. Individuals were less likely to have been screened if they were male; of lower occupational status; unemployed or too ill to work; and had only a primary school education. Those who had only basic medical insurance were also less likely to have been screened. A higher prevalence of screening was reported in individuals at greater risk of developing melanoma, in those who perceived themselves as more susceptible to developing melanoma, and in those who believed that there were greater benefits associated with the early detection of melanoma. The implications of these results for the development of effective public health education programmes, and for increasing the role of general practitioners in the education and screening of the public, are discussed.

Adolescent↗

Solar protection issues for schools: policy, practice and recommendations.

This study presents findings on solar protection policies and practices in primary and secondary schools in New South Wales, Australia. The findings suggest that policies have been more fully articulated in primary schools than in secondary schools and that there is wide scope for further public health initiatives to protect children from the risk of skin cancer. Little attention has been given to the potential benefits of timetable changes and provision of shade in school environments, although school principals considered the latter would be a successful means of increasing protection. The level of solar education provided in the schools surveyed in our study was minimal, suggesting that urgent attention should be given to incorporating these issues in the school curriculum. Observations of school children's solar protection behaviours suggest that the majority of children used some form of protection in the middle of the day, but the form of protection changed with age. Consideration of more structural and environmental changes is needed to maximise the opportunities for solar protection in schools.

Australia↗

A community study of delay in presenting with signs of melanoma to medical practitioners.

In the absence of more effective treatment for advanced tumors, early diagnosis and treatment of localized tumors is the most effective way of reducing the burden of illness associated with melanoma. This study examined the following factors: prevalence of signs of melanoma (a mole changing in size, shape, appearance, or color, itching or tingling, bleeding or weeping, becoming raised) in 1344 individuals in a randomly selected sample of 1075 households; the length of delay in seeking medical advice; the factors associated with either going to a medical practitioner or not going/delaying; and the actions of the medical practitioners when first presented with these signs. The results indicate that a large proportion of the sample (11.9%, n = 156) had observed signs of melanoma in the previous 12 months. Of the sample reporting signs that had first appeared in the previous 5 years, only 32% sought medical advice about the signs within the recommended period. Of the sample either not seeking advice at all or delaying, 49% reported that they thought the sign "wasn't serious/would clear up." Furthermore, 30% of the sample either did not known or underrated the importance of early detection and treatment of lesions. These results indicate that there is a deficit in the knowledge of the general public about the signs of melanoma, the severity of the disease, and the possible risks associated with delay.

Adolescent↗

How valid is adolescents' self-report as a way of assessing sun protection practices?

BACKGROUND: The accurate assessment of sun protective behaviors can assist in the effective targeting of preventive strategies. METHODS: This study explored the validity of self-report by adolescents in relation to parental/guardian reports using a scale to determine whether adolescents were accurately classified as adequately protected or not during the preceding weekend. The study sample was drawn from a school population and provided 53 matched adolescent and parental/guardian responses from 115 subjects (consent rate 46%). The validity of self-reports in relation to the level of protection afforded to a range of body parts (face, neck, shoulders, torso, etc.) was calculated. Calculations of sensitivity, which represented the proportion of cases in which the body part was classified as adequately protected by both the criterion reference and the self-report, and specificity, in which inadequate protection was confirmed by both the criterion reference and the self-report, were completed. In instances in which fewer than five observations fell into a cell, thereby limiting the accuracy of results, no measures were calculated. RESULTS: Measures of sensitivity for the use of sun protection were legs (59%), neck (79%), feet (79%), face (92%), and shoulders, torso, and upper arms (98%). In contrast measures of specificity were face (61%), legs (80%), and neck (87%). CONCLUSIONS: Although further studies of self-report methodologies with larger samples are required to verify these findings, the results suggest that adolescent self-report of solar protection is relatively valid and has the potential to be utilized with a degree of confidence to assess behavior.

Adolescent↗

The prevalence and predictors of solar protection use among adolescents.

BACKGROUND: Adolescence has been identified as a critical period in the etiology of subsequent melanoma and nonmelanocytic skin cancer. This study examines the prevalence and predictors of solar protection use among adolescents. METHODS: A total of 3,642 adolescents between the ages of 11 and 16 years were recruited from a random sample of 27 schools in an Australian state. The participants completed a validated survey that provided information on a range of demographic, knowledge, attitudinal, and behavioral factors. Sun protection practices adopted during the preceding weekend were assessed using a validated self-report diary. A formula that quantifies protection status was then employed to categorize adolescents into those who were using adequate versus low levels of solar protection. RESULTS: Overall 54% of males and 44% of females were classified as adequately protected during the preceding weekend. Logistic regression analyses identified the following as significant predictors of having an adequate level of sun protection--gender (males more likely to be protected), age (11 to 13 year olds more likely to be protected than 14 to 16 years olds), ownership of a broad-brimmed hat or cap, attitudes relating to the discomfort associated with wearing a hat, image to peers, "hassle" associated with the use of sun protective measures, school attended, and sun protective policies of the school. CONCLUSIONS: Implications of these findings for future preventive strategies are discussed and include improved targeting of sun protection programs to non-adopters, modification of attitudes relating to suntans and image to peers, reducing the level of perceived difficulty associated with utilizing sunscreen, and the potential role that schools may play in fostering sun protection.

Adolescent↗

Community action for health promotion: a review of methods and outcomes 1990-1995.

OBJECTIVE: Our objective was to explore the effectiveness of community action as a strategy for health promotion, through a critical review of five years of community action evaluation literature. METHODS: Community action was defined as a health promotion, program that involved the community in implementation and control of the process of the program. Criteria for scientific evaluation of programs were proposed for sampling and control procedures, reliability and validity of instruments, analysis techniques, and specification of details of the intervention. A critical review of the literature, located by an on-line and related reference search, was undertaken for community action aimed at reducing cancer and cardiovascular disease, between January 1990 and May 1995. RESULTS: None of seven community action studies (17 articles) that examined cancer risk factors fulfilled all the criteria for rigorous scientific evaluation. The most methodologically adequate cancer study, the COMMIT intervention, had only a moderate degree of success in reducing community smoking rates. Similarly, none of the six studies (25 articles) on cardiovascular disease fulfilled all the criteria. The results for the most methodologically adequate study, the Minnesota Heart Health Program, were disappointing, with strong secular trends preventing adequate assessment of the intervention effect. CONCLUSIONS: The finding that none of the reviewed studies met all evaluation criteria was due to several factors, including political considerations, feasibility, and the continued evolution of the science of evaluation in health promotion. Some important questions are posed for researchers by the failure of methodologically superior projects, such as COMMIT, to show major gains in reducing health risk behaviors.

Cardiovascular Diseases↗