Boosting women consultants.
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Consultants↗
Biomedical subjects
J Cockburn
Publications and source records attributed to J Cockburn.
Failure of prospective memory after acquired brain damage: preliminary investigation and suggestions for future directions.
This paper investigates the premise that the greater frequency of errors after acquired brain damage will facilitate identification of essential components of successful prospective memory. It examines performance by patients with recent acquired non-progressive brain damage and age-matched control subjects on two experimental measures of prospective memory. A significant different between patients and control subjects arises mainly from performance on a time-based prospective memory task. Results from patients on tests of time- and event-based prospective memory are compared with scores on tests of episodic memory and executive skills. A relationship is identified between event-based prospective memory and retrospective episodic memory but not between time-based prospective memory and executive skills. Premorbid intelligence and current mood state are identified as variables that should be considered when investigating prospective memory under experimental conditions.
Adult↗
Do patients prefer women doctors?
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Attitude to Health↗
Morphological classification of facial features in adult Caucasian males based on an assessment of photographs of 50 subjects.
Fifty sets of photographs showing facial features of Caucasian males aged 18 to 60 years were examined to establish a morphological classification of the face. It is suggested that such a classification could assist facial identification by photocomparison. The selection criteria stress the importance of interassessor agreement and discrimination among feature subset units in formulating the proposed classification.
Adolescent↗
Correlation of fornix damage with memory impairment in six cases of colloid cyst removal.
We studied six patients in whom colloid cysts had been removed surgically from the third ventricle. The patients were selected simply by availability for the study, not on grounds of clinically diagnosed amnesia or its absence. The outcomes of operation ranged from one patient who had postoperatively resumed a normal life without complaint of memory disorder at any stage, through four who complained of memory disorder since operation, to one who was so severely amnesic as to require constant supervision. Each patient was given psychometric tests of memory, and was also scanned by magnetic-resonance imaging. One of us examined the six scans and assessed the extent of damage to the fornix, and any other brain damage, in ignorance of the outcomes of the psychometric tests. The fornix in the right hemisphere had been destroyed in all six cases, and all showed evidence of moderate or severe impairment in nonverbal memory. The fornix in the left hemisphere was intact in only one patient; this was the patient who had resumed a normal life without complaint of memory disorder. The left fornix was damaged with some sparing in one further patient, and the remaining four patients showed destruction of the fornix in the left as well as in the right hemisphere. The severity of impairment in verbal memory in these six cases was related to the severity of the damage to the left fornix. No other evidence of brain damage appeared to be systematically related to memory ability. These results add to the evidence that bilateral fornix damage produces amnesia, and that sparing of the left fornix alone is sufficient to ensure a more favourable outcome.
Adult↗
Task interruption in prospective memory: a frontal lobe function?
Prospective memory involves remembering an intention to do something as well as remembering the content of the task. It also shares common features with executive skills that are argued to be mediated by the frontal lobes. This paper describes performance on tests of prospective memory by a subject with bilateral frontal lobe infarcts and good retrospective memory but who displayed impairments of planning, initiation and inhibition of ongoing behaviour. The results lend some support to the suggestion that separate neuroanatomical pathways underly retrospective and prospective memory. They also indicate dissociable features within prospective memory that may reflect differences in utilisation of attentional resources and inhibitory control mechanisms.
Attention↗
Acceptance of screening for colorectal cancer by flexible sigmoidoscopy.
OBJECTIVE: To determine the acceptance rate of screening by flexible sigmoidoscopy in a sample of general practice patients aged 50 to 60, and the acceptability of the procedure among those undergoing the test. SETTING: Recruitment took place in selected general practices in Melbourne, Australia. Flexible sigmoidoscopies were performed at the local public hospital. PATIENTS AND METHODS: 187 patients aged between 50 and 60, and without bowel symptoms, were seen by one of 12 non-randomly selected general practitioners during the study period. At the conclusion of routine consultation general practitioners discussed colorectal screening with eligible patients and recommended that they attend a free screening clinic at the local hospital. The patients who attended the clinic underwent flexible sigmoidoscopy performed by experienced endoscopists. Clinic attenders completed a questionnaire which measured perceptions of the screening visit. RESULTS: The attendance rate was 49%. All clinic attenders were satisfied with the care received at clinic. Sixty five per cent of people experienced either no discomfort or mild discomfort, while 15% of people experienced moderate or severe pain. A bloated feeling was common (80%), with around 36% of people experiencing moderate or extreme bloating. Most people said that they were not at all embarrassed (64%), though 9% reported moderate or extreme embarrassment. Seventeen people (19%) were found to have polyps. CONCLUSIONS: Although the procedure was acceptable to those who underwent the screening test, further research on effective recruitment strategies is required if a full scale flexible sigmoidoscopy screening programme is to be considered feasible.
Age Factors↗
Public understanding of medical screening.
AIM: To estimate the extent of public understanding of mass screening for disease and of the benefits and limitations of screening. METHODS: Telephone interviews were conducted with a national sample of 835 Australians. RESULTS: Of total respondents, 68% claimed to have heard of screening tests, but only 21% correctly understood that screening tests are for asymptomatic people. This understanding was related to education. The most frequently named tests were mammography (51%) and Pap tests (33%), and for all age groups these were mentioned by more women than men. Around 27% of respondents thought that the Pap test would detect 95% or more of case, 45% thought the test would detect 90% or more, while 60% of respondents thought the test would detect 80% or more of cases. Around 29% of respondents thought that mammography would detect 95% or more of cases, 49% thought the test would detect 90% or more, while 65% of respondents thought the test would detect 80% or more of cases. Of all respondents, 33% favoured compensation when cases were "missed" by screening provided people were warned beforehand, 58% were not in favour, and 9% were unsure. CONCLUSIONS: There are misconceptions among the public concerning the purpose of screening and the accuracy of screening tests. However, most people accept that some cases of disease will be missed by screening and that if people are adequately informed beforehand compensation should not automatically follow for those whose disease is missed.
Adolescent↗
Early detection of skin cancer. Knowledge, perceptions and practices of general practitioners in Victoria.
OBJECTIVE: To determine the current knowledge, perceptions and practices of general practitioners (GPs) in Victoria in the diagnosis and management of skin cancer. METHOD: A stratified random sample of 666 Victorian GPs was surveyed by postal questionnaire (a colour photographic quiz on 12 examples of benign and malignant skin tumours). RESULTS: GPs were better at recognising the 12 skin tumours as suspicious or benign than they were at providing the correct diagnosis. They were better at providing the correct diagnosis for benign lesions (75%) than for skin cancers (61%) or dysplastic lesions (61%). They had more difficulty in recognising early melanoma than late melanoma and were more likely to manage benign lesions (85%) and dysplastic lesions (34%) than skin cancers (4%). Knowledge of appropriate management was high for GPs who correctly identified tumours. Most perceived skin cancer as an important public and individual health concern. CONCLUSIONS: Overall, GPs had a good knowledge of diagnosis and management of skin cancer and related benign tumours. Several gaps in knowledge and practice were apparent and need specific targeting for educational programs.
Adolescent↗
A comparative study of the fetal electrocardiogram recorded by the STAN an Nottingham systems.
OBJECTIVE: To compare the T:QRS ratio recorded by the STAN and Nottingham fetal electrocardiogram (FECG) monitors. DESIGN: Prospective observational study. SETTING: London teaching hospital delivery suite and research unit. METHODS AND SUBJECTS: The T:QRS ratios generated by the STAN and Nottingham FECG monitors were simultaneously recorded and compared using signals generated from a computer-produced ECG signal and signals from 11 term fetuses recorded during labour. RESULTS: There was an acceptable level of agreement between the two systems with the computer-generated signals, but it was not clinically acceptable with the signals from the fetuses recorded during labour. Disagreements in the T:QRS values were probably due to differences in the reference points for the measurement of the S-T segment and T-wave height. CONCLUSION: The different points of reference for measurement of S-T segment and T-wave height can explain poor agreement between the two methods of FECG waveform analysis. The suggested adopted points of reference are those corresponding to adult electrocardiographic methodology.
Delivery, Obstetric↗
Undiagnosed breech.
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Breech Presentation↗
Anxiety and errors of prospective memory among elderly people.
Understanding the relationship between age and prospective memory may be increased by studying the distribution and constituents of incorrect responses. Failure to perform the right activity at the right time may manifest itself as an 'error of omission', in which no response is made at the critical moment, or an 'error of commission', in which the intended action is replaced by a related one. These may, in turn, result from breakdown of encoding/storage or from retrieval failure. Which error is made may depend on the nature of the task, the context or the available processing resources of the performer. Responses of a group of elderly people to the appointment item of the Rivermead Behavioural Memory Test were examined for frequency of occurrence of different types of error and their relationship to other variables. Logistic regression analysis was used to explore the contribution made by variables of anxiety, age and current intelligence to performance on the task. The results suggest that the relationship is a complex one, in which there is an inverse relationship between anxiety and intelligence, and error type is differentially related to low and high anxiety and to age.
Age Factors↗
Psychological consequences of screening mammography.
OBJECTIVE: To examine the psychological consequences at a number of stages in the screening process for women attending a screening mammography programme. SETTING: A pilot mammographic screening programme in Melbourne, Australia. METHOD: The psychological consequences questionnaire (PCQ; a reliable and valid measure of the psychological consequences of screening mammography) was used to measure the emotional, social, and physical functioning of women in a mammographic screening programme and a control community sample. A screening group (in whom no abnormality was detected at initial screen; n = 142) had four measurements: at screening clinic; before results were received; one week after all-clear results were received; and eight months after initial visit. The recall group (who were recalled for further investigation which showed the detected abnormality to be benign; n = 58) had measurements at the same points as the screening group and an additional measurement while waiting at the recall assessment clinic. A randomly selected community control group (n = 52) had measurements one week, two weeks, three weeks, and eight months after consenting to participate. RESULTS: Emotional, social, and physical functioning of women in the screening group did not change over time and at no point differed significantly from that of community controls. The profiles of emotional and physical dysfunction of women in the recall group differed significantly from those of the screening and control groups. The level of emotional and physical dysfunction in the recall group was highest while waiting at recall assessment clinic, and scores were still significantly higher than scores obtained at comparable times from screening and control groups one week after obtaining notification that there was no sign of cancer (emotional P < 0.001; physical P < 0.05). This difference had disappeared eight months after the screening visit, when the level of emotional and physical functioning was similar to that of the screening and control groups. Social dysfunction scores did not change significantly over time and were similar for all three groups. CONCLUSIONS: Given that up to 10% of women are recalled for further investigations on first round screening, significant numbers of women may have psychological consequences. This speaks for the necessity for accurate reading of mammograms to minimise the false positive recall rate, and for counselling services to be available at recall assessment centres.
Attitude to Health↗
Encouraging attendance at a screening mammography programme: determinants of response to different recruitment strategies.
OBJECTIVES: To predict attendance at a mammographic screening programme after a community health promotion campaign and attendance after a personal invitation in addition to that campaign. SETTING: A pilot mammographic screening programme in Melbourne, Australia. METHODS: Attendance was encouraged by a community health promotion campaign and one year later, a personal invitation was sent to all women who had not yet attended. Drawn from two regions of a defined area (close to and distant from the screening centre), 618 women were interviewed before the programme started, and subsequent attendance at the programme was recorded. RESULTS: Over half of the women (58%) in the sample residing close to the screening centre and 44% of women in the more distant sample attended. The personal invitation boosted attendance, particularly in the distal sample where attendance was predicted by ease of access to the programme; positive intention to attend; moderate experience of, perceived susceptibility to, concern about, and knowledge of breast cancer; adoption of other preventive health behaviours; having a job; and older age. Proximity to the programme, positive initial intentions, having heard of a mammogram, no concern about radiation from a mammogram, high personal control over health, and belonging to a club were associated with attendance after exposure to only the health promotion campaign. A personal invitation encouraged attendance among women without these characteristics. CONCLUSION: A personal invitation in addition to a community promotion campaign seems to overcome many barriers to attendance. Attendance may be further increased by informing women of the benefits of early detection and improving access to the screening centre.
Age Factors↗
The acceptability of personal invitations to a mammographic screening program.
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Aged↗
A strategy for evaluating a novel smoking intervention device.
The Victorian Smoking and Health Program (VSHP) was established in 1985 to (1) determine the views of smokers making a quit attempt regarding the acceptability and usefulness of a novel self-help smoking cessation device (the QUITZ pack), (2) define a potential market by determining the correlates of use of the QUITZ pack, and to (3) determine how the QUITZ pack compared to existing resources with proven acceptability and usefulness. Telephone interviews were conducted of 120 smokers who rang the QUITZ office for resources to help in a quit attempt. The results showed that most people found the QUITZ pack to be acceptable, both on first receiving it (68% acceptable) and after they had had the resource for at least a week (61% acceptable). The QUITZ pack was used in some way by 58% of the people to whom it was sent. No significant associations were found between the use of the pack and any of the demographic, smoking history, or motivational factors examined. Around a third of smokers to whom it was sent rated the QUITZ pack as being either quite or very useful in their cessation attempt. Of those who reported using the QUITZ pack, 61% rated it as being quite or very useful. For those who used the pack and made a quit attempt, more respondents rated a self-help guide (the CanQuit book) (87%) and any other personally chosen strategy (87%) as being quite or very useful, than rated any components of the QUITZ pack in this way.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Satisfaction of attenders during the establishment of an Australian mammography screening program.
We aimed to examine the satisfaction and the predictors of reported satisfaction with the service offered by a pilot mammography screening service. Information was collected from 481 attenders at the screening clinic and from 318 consecutive attenders at the recall clinic using two different standard self-administered questionnaires covering respectively six and five dimensions of satisfaction. For the screening clinic attenders, mean scores on most subscales indicated quite high levels of satisfaction. There were no significant differences among different samples over time for the perceptions of technical competence of the staff. Decreases in reported level of satisfaction were found for subscales measuring interpersonal skills, information giving, physical surroundings, convenience and accessibility, and general satisfaction. Waiting times, age and marital status were predictors in most satisfaction subscales. For those attending the recall clinic, mean satisfaction scores for most scales were high, except for the scale measuring satisfaction with the way the results were received. The median time between screening and recall visits for women in this study was 27 days (range 3 to 112 days). Attenders were most dissatisfied with the delay in getting results, an area where the service might improve.
Aged↗
Correlates of everyday memory among residents of Part III homes.
Performance on the Rivermead Behavioural Memory Test (RBMT) of 43 residents of Part III homes was compared with performance on Raven's Coloured Progressive matrices and the National Adult Reading Test (NART). Health, medication, selfcare and social activity were also measured. Results show that although Raven's score was the best predictor of memory test performance, it had a high refusal rate. Age was not a significant predictor of overall memory test score but results were complicated by age of entry into Part III, with older people performing better on some items. Medication, in particular drugs acting on the central nervous system, enhanced performance on some items.
Age Factors↗