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PubMed2002

Neonatal jaundice and scientific fraud in 1804.

In 1785 the University of Paris issued a prize challenge: "Describe neonatal jaundice and distinguish between those circumstances in which jaundice needs professional help and those in which one only needs to await the course of nature." The prize was awarded to Jean Baptiste Timothée Baumes for a paper, published as a pamphlet in 1788, in which he described 10 jaundiced neonates and discussed his theories on the causes and mechanisms. In a revised edition published in 1806 Baumes accused François Bidault of plagiarism in his 1804 thesis submitted for the MD degree at the University of Paris. Herein, Baumes' 1788 original is compared with Bidault's thesis as well as Baumes' 1806 revision. It is clear beyond doubt that the 10 cases discussed by Bidault were the same as those Baumes had published 16 y earlier. Parts of Bidault's descriptions and discussions were verbatim transcripts of Baumes' original. However, Bidault had economized with paper, ink and effort by significantly reducing the overall length of Baumes' original. In his second edition Baumes denounced Bidault in strong terms and suggested that the University of Paris take strong action to punish him for his dishonesty. Unfortunately, university records from that period are incomplete, and it is not clear what, if anything, was done about the matter. Baumes had a very distinguished career and achieved a great reputation as both a teacher and clinician.

France↗
PubMed2001

Australian dentists' educational needs for smoking cessation counseling.

BACKGROUND: Australian dentists' continuing educational needs and their attitudes towards and self-reported practices related to smoking cessation counseling were examined. METHOD: Self-administered questionnaires were received from 149 dentists (83% response rate). RESULTS: Many dentists were aware that smoking is a risk factor for the development of oral cancer (n = 128, 86%). Most considered smoking cessation counseling to be part of their professional role (n = 105, 70%). However, few "always" asked about the smoking status of their patients (n = 21, 14%). The dentists' use of specific behavioral techniques known to assist patients to quit also was low. Furthermore, the dentists were as likely to use ineffective (advice to "cut down") as effective (advice to "quit") (p > 0.05) strategies. The respondents were significantly more interested in self-help pamphlets for their patients than in either evidence-based guidelines (McNemar's chi2 = 9.76, df = 1, p < 0.01) or a self-study module about smoking cessation (McNemar's chi2 = 42.0, df = 1, p < 0.001). CONCLUSIONS: Continuing education for dentists that combines skills training, patient materials, and epidemiology is likely to be acceptable and effective.

Adult↗
PubMed1998

Information sources and barriers to cancer treatment by racial/ethnic minority status of patients.

BACKGROUND: This study examined the sources used by cancer patients to obtain helpful information regarding their treatment options and side effects and the major predictors that facilitated usage of information. METHODS: The survey was administered to a representative sample of cancer patients in Texas. The cancer treatment facilities from which the patients were sampled were part of the University of Texas M. D. Anderson Cancer Center's Texas Community Oncology Network. A total of 593 patients (65%) out of 910 contacted responded to the survey. RESULTS: The patients reported that providers such as physicians and nurses were the most helpful sources of information. White patients tended to use books and reference materials more heavily to gather additional information regarding their treatment, while black patients relied on pamphlets and television. Educational level appeared to have a major influence on the black patient's use of printed materials. CONCLUSIONS: The results document the important role that providers play in influencing patients' treatment decisions. Effective ways to communicate with cancer patients are different for patients with different racial backgrounds. Implications for the future development of patient education materials and cancer prevention initiatives targeting ethnic minorities are addressed.

Adult↗
PubMed2005

Access to appropriate information on HIV is important in maximizing the acceptance of the antenatal HIV antibody test.

The universal HIV antibody testing programme was implemented in Hong Kong in September 2001. A survey on acceptance of the test was conducted in the territory's maternal and child health centres in a two-month period. The response rate was 98.2% and 2,669 valid questionnaires were analysed. Seventy per cent (n=1,825) of the respondents indicated their acceptance of the test. A significant association was noted between clients' acceptance and access to HIV information (adjusted odds ratio (OR)=10.45, 95% confidence interval (CI)=6.33-17.26) by means of posters, pamphlets, videos and group talks. Perceived benefits and health care workers' recommendation were the main reported reasons for acceptance, whereas no or low perceived susceptibility was the main reason for refusal. Acceptance was also positively correlated with level of education (adjusted OR=3.99, 95% CI=2.15-7.43) and HIV knowledge (adjusted OR=3.61, 95% CI=2.19-5.93). A high uptake rate (99.6%) reflects that most had the test done eventually despite some initial uncertainty. It is concluded that access to appropriate HIV information was important to maximize the acceptance of the programme.

Adolescent↗
PubMed2006

The role of remote community stores in reducing the harm resulting from tobacco to Aboriginal people.

The objective of this study was to assess the potential for reducing the harm resulting from tobacco use through health promotion programmes run in community stores in remote Aboriginal communities. The Tobacco Project utilised data from 111 stakeholder interviews (72 at baseline and 71 at follow-up after 12 months) assessing presence of sales to minors, tobacco advertising, labelling and pricing. It also involved the assessment of observational data from community stores and comments obtained from 29 tobacco vendors derived from community surveys. Sales of tobacco to minors were not reported in community stores and all stores complied with requirements to display the legislated signage. However, tobacco was accessible to minors through a vending machine and through independent vendors. Only one store displayed tobacco advertising; all stores had displayed anti-tobacco health promotion posters or pamphlets. Pricing policies in two stores may have meant that food items effectively subsidised the cost of tobacco. All stores had unofficial no-smoking policies in accessible parts of the store. Remote community stores complied with existing legislation, aside from allowing access of minors to vending machines. There may still be potential for proactive tobacco education campaigns run through community stores and for a trial assessing the effect of changes in tobacco prices on tobacco consumption.

Adolescent↗
PubMed1997

General practitioners' views and knowledge about anabolic steroid use--survey of GPs in a high prevalence area.

The aim of this study was to assess GPs' attitudes, clinical behaviour, information needs and contact with anabolic-androgenic steroid (AAS) users in an area reported to have a high prevalence of AAS use. It was a cross-sectional study of GPs using a self-administered questionnaire. The sample comprised of 202 GPs practising in the Central Business District and inner city area of Sydney took part. Of 164 eligible GPs, 143 responded (87% response rate). Fifty-three per cent of respondents reported that they had seen at least one patient in the last year who told them they had used AASs for non-medical purposes; 6% indicated that they had seen more than 20 patients who mentioned AAS use. Two per cent of respondents reported prescribing AASs for body-building purposes and 6% indicated a willingness to do so in a hypothetical situation. Forty per cent of respondents reported that they would be willing to provide harm minimization advice to AAS users; 77% of respondents were interested in obtaining more information about AAS use, most frequently requested in the form of a fact sheet or pamphlet. Most GPs in the area surveyed had some contact with AAS users in their practice. Some GPs had favourable attitudes towards prescription of AASs for non-medical purposes. These attitudes require further exploration. The results of this survey invite a reappraisal of many policy initiatives involving GPs aimed at reducing AAS-related harm.

Journal Article↗
PubMed2005

Information-seeking behavior of minority breast cancer patients: an exploratory study.

Few population-based studies have been conducted with minority breast cancer patients in the United States to understand their information-seeking behaviors. We examined the resources minority breast cancer patients used and the extent to which the Internet was being utilized by Hispanic and African American breast cancer patients. A random sample of 388 Hispanic and African American breast cancer female patients was obtained from the Sacramento Cancer Surveillance Program in California. Various survey and data collection tools were researched and adapted to create the 44-item questionnaire. Subjects were asked to participate in a telephone interview. Of the 388 cases, 74% (n = 287) consented to participate in our study. Sixty-three percent (n = 181) received cancer-related information at the time of their diagnosis; 58% reported that a health care professional provided them with this information. Only 17% of study respondents had ever used the Internet. The top 3 sources for cancer information were books, brochures, and pamphlets (98%); doctor or other health professionals (97%); and spouse or partner, family members, friends, or all of these (62%). None of the respondents indicated accessing the National Cancer Institute's cancer.gov website. Minority breast cancer patients were using the Internet for cancer-related information at a very low rate.

Adult↗
PubMed2002

Knowledge of stroke risk, signs of stroke, and the need for stroke education among children with sickle cell disease and their caregivers.

OBJECTIVES: This study assessed stroke knowledge and the need for stroke education among children with sickle cell disease (SCD) and their caregivers. METHODS: A cross-sectional study was conducted and includes: (1) structured interviews of 44 children with SCD and their 50 caregivers, and (2) a self-administered survey completed by medical directors of 22 SCD centers. The participants were interviewed regarding stroke knowledge and stroke educational materials. RESULTS: Among the caregivers, only 34% named stroke as a complication associated with SCD, 36% were aware that their children were at higher risk, and 46% were not able to identify any warning signs of stroke. Only 11% of the children could accurately describe a stroke. Although 82% of the medical directors provided stroke information to caregivers, only 50% provided stroke educational materials to children. Caregivers and children were interested in receiving information about stroke. The preferred format for the educational material was a pamphlet for adults and a video for the children. CONCLUSIONS: Children with SCD, caregivers, and healthcare providers need and desire educational materials about stroke. Educational materials to improve knowledge about stroke may be an important strategy to increase completion of stroke screening tests.

Adolescent↗
PubMed2004

'Honoring tradition, accepting new ways': development of a hepatitis B control intervention for Vietnamese immigrants.

BACKGROUND: Chronic hepatitis B infection rates among Vietnamese-American adults range from 7 to 14%. Carriers of HBV are over 200 times more likely to develop liver cancer than non-carriers, and Vietnamese males have the highest liver cancer incidence rate of any ethnic group in the USA (41.8 per 100,000). Culturally and linguistically appropriate interventions are necessary to increase hepatitis B knowledge, serologic testing, and vaccination rates among Vietnamese immigrants. METHODS: The authors engaged in qualitative data collection to inform the development of intervention materials including a video, pamphlet, and barrier-specific counseling guidelines. Bilingual research assistants conducted 25 open-ended qualitative interviews and six focus groups focusing on hepatitis B and liver cancer with a convenience sample of Vietnamese-American men and women living in the Seattle area. RESULTS: Qualitative findings include beliefs about liver illness and health influenced by traditional Vietnamese and traditional Chinese medicine theory; beliefs about hepatitis B transmission and causes embedded in personal experiences and socio-historical circumstances; and the value of health and a positive attitude. The video portrays a Vietnamese immigrant family struggling with the new knowledge that their healthy-appearing son is a hepatitis B carrier. Print materials address knowledge resources and misconceptions about hepatitis B revealed in the qualitative data. DISCUSSION: Qualitative research provides valuable insight into unanticipated issues influencing health beliefs and behaviors relevant to specific populations and is essential to the development of effective health education materials, which necessarily draw upon local social and cultural contexts. The methods used in this study to develop culturally informed hepatitis B intervention materials for Vietnamese-Americans translate well for the development of education outreach programs targeting Vietnamese and other immigrants elsewhere.

Adult↗
PubMed1997

It's more than literacy: the assimilation effect of the translation model.

Availability and access to correct information is a pre-requisite for people to be able to make informed decisions about their health. This paper will examine the effect of the sole reliance on translation in producing health promotion materials for people from Non English Speaking Background (NESB). In Australia since 1978 there has been a considerable quantitative increase in health-related information translated from English into other languages. The translation of pamphlets from English into other languages presents health educators with a number of problematic issues which often drastically undermine the material's effectiveness. One of the main concerns this paper sets out to explore is that translated information is decontextualised from the sets of knowledge and meanings of the population group to whom the information is directed. Thus, the cultural context underpinning the original version is transferred to different cultural contexts which are treated as homogeneous groups. The paradox here is that the translation model developed as a means of redressing the inequities created by the assimilation policy of the Australian post-war period, in practice maintains the philosophy that underpinned that policy. This can result in a disempowering experience for the community.

Acculturation↗
PubMed2002

Evolution and status of bone and marrow dose models.

Investigations at the University of Leeds under the direction of F.W. Spiers in the early 1960s through the late 1970s established the first comprehensive assessment of marrow dose conversion factors (DCFs) for beta-emitting radionuclides within the volume or on the surface of trabecular bone. These DCFs were subsequently used in deriving radionuclide S values for skeletal tissues published in MIRD Pamphlet No. 11. Eckerman re-evaluated this work and extended the methods of Spiers to radionuclides within the marrow to provide DCFs for fifteen skeletal regions in computational models representing individuals of six different ages. These results were used in the MIRDOSE3 software. Bouchet et al. used updated information on regional bone and marrow masses, as well as 3D electron transport techniques, to derive radionuclide S values in skeletal regions of the adult. Although these two efforts are similar in most regards, the models differ in three respects in: (1) the definition of the red marrow region, (2) the definition of a surface source of activity, and (3) the assumption applied in transporting electrons through the trabecular endosteum. In this study, a review of chord-based skeletal models is given, followed by a description of the differences in the Eckerman and Bouchet et al. transport models. Finally, new data from NMR microscopy and radiation transport in trabecular bone is applied to address item (1) above. Dose conversion factors from MIRD 11, the Eckerman model, the Bouchet et al. model, and a revised model are compared for several radionuclides important to internal emitter therapy.

Animals↗
PubMed1997

Compliance to a low-salt diet.

Community intervention projects, efforts at single centers, and multicenter, prospective, dietary salt-restriction trials suggest that such an intervention is neither easy to achieve nor simple to maintain. Community-wide interventions based on advertisements, pamphlets, posters, radio messages, instructions in schools or other institutions, and cooperation from food suppliers such as butchers and bakers resulted in a slight decrease in salt consumption, mostly in normotensive women. A demonstration project at a single center showed that lowering salt intake long-term by 50% in hypertensive patients was feasible. That study included self-administered, positive-feedback devices to indicate adherence and a role for a household partner in achieving compliance. Multicenter intervention trials also indicate that reducing salt intake in the long term is feasible. However, in all intervention trials the subjects were highly selected, stable, generally married male volunteers. An elaborate training program involving many health care professionals was necessary and recidivism was common. Successful intervention requires specific goals and delegated responsibilities on the part of the health care team, careful assessment of the patient and the risk factors, as well as motivation for behavioral change, a specific plan for implementation, repetitive educational efforts, and a built-in monitoring mechanism.

Cross-Over Studies↗
PubMed1999

Strategies to improve cancer screening in general practice: are guidelines the answer?

BACKGROUND: GPs are ideally placed to recommend appropriate cancer screening for their patients. However, opportunities to discuss screening are often missed and screening procedures are not always recommended in accordance with national policy. The development of clinical practice guidelines represents one strategy for improving cancer screening in general practice. OBJECTIVE: We aimed to ascertain Australian GPs' ratings of current clinical practice guidelines and their views of the likely usefulness of 18 strategies to improve cancer screening in general practice. METHOD: A self-administered questionnaire was mailed to a national random sample of 1271 GPs in May 1996. Responders rated the usefulness of each of eight clinical practice guidelines current at the time of the survey. They then rated the usefulness of each of 18 strategies for support of cancer screening. RESULTS: We received 855 completed questionnaires (a 67% response rate). There was greatest support for guidelines already available on breast and cervical cancer. The most popular strategy to improve cancer screening was seminars with experts in preventive care, rated as 'very useful' by 658 (77%), followed by NHMRC guidelines (597, 70%) and pamphlets for patients (587, 69%). There was less support for more innovative strategies including assessment and feedback (35%), case finding by nurse practitioners (11%) and academic detailing (10%). CONCLUSION: Responders indicated that strategies involving passive dissemination of information would be most useful for improving cancer screening in general practice. Identification of an effective combination of acceptable initiatives is needed.

Attitude of Health Personnel↗
PubMed1995

Village-based AIDS prevention in a rural district in Uganda.

OBJECTIVE: To design, implement and evaluate a village-based AIDS prevention programme in a rural district in north-western Uganda. A baseline KAP survey of the general population was carried out to design a district-wide information campaign and condom promotion programme. Eighteen months later the impact achieved was measured through a second KAP survey, using the same methodology. METHODS: Anonymous structured interviews were conducted in March 1991 and October 1992 with 1486 and 1744 randomly selected individuals age 15-49, respectively. RESULTS: At 18 months, 60% of respondents had participated in an information session in the past year (47% women, 71% men) and 42% had received a pamphlet about AIDS (26% women, 58% men). Knowledge about AIDS, high initially (94%), reached 98%. More respondents knew that the incubation period is longer than one year (from 29% to 40%), and were willing to take care of a PWA (from 60% to 77%). Knowledge about condoms increased from 26 to 63% in women and 57 to 91% in men. Ever use of condoms among persons having engaged in casual sex in the past year increased from 6 to 33% in women, and 27 to 48% in men. Fifty per cent of condom users criticized lack of regular access to condoms. CONCLUSIONS: This is the first documented example of the impact a village-based AIDS prevention programme can achieve in a rural African community. Critical areas to be improved were identified, such as: women must be given better access to information, more attention must be paid to explain the asymptomatic state of HIV infection in appropriate terms, and condom social marketing must be developed.

Acquired Immunodeficiency Syndrome↗
PubMed1983

John Snow, the broad street pump and modern epidemiology.

John Snow was a genius in epidemiology. His achievement was to evolve an elegant, internally and externally consistent theory which concerned the mechanisms and processes involved in every aspect of the subject he had chosen to study. In order to do this he did not restrict himself to any method. He used all skills available to himself and his colleagues. He published his theory, and practical suggestions for the prevention of cholera arising out it, both internally in medical meetings and to the medical press, and to the public in the form of pamphlets and in reports addressed to the appropriate authority. This surely should be the objective of all epidemiological work.

Cholera↗
PubMed2002

A randomized controlled trial of interventions to promote cervical cancer screening among Chinese women in North America.

BACKGROUND: North American Chinese women have lower levels of Papanicolaou (Pap) testing than other population subgroups. We conducted a randomized controlled trial to evaluate the effectiveness of two alternative cervical cancer screening interventions for Chinese women living in North America. METHODS: Four hundred and eighty-two Pap testing underutilizers were identified from community-based surveys of Chinese women conducted in Seattle, Washington, and Vancouver, British Columbia. These women were randomly assigned to one of two experimental arms or control status. Several Chinese-language materials were used in both experimental arms: an education-entertainment video, a motivational pamphlet, an educational brochure, and a fact sheet. Women in the first experimental group (outreach worker intervention) received the materials, as well as tailored counseling and logistic assistance, during home visits by trilingual, bicultural outreach workers. Those in the second experimental group (direct mail intervention) received the materials by mail. The control group received usual care. Follow-up surveys were completed 6 months after randomization to ascertain participants' Pap testing behavior. All statistical tests were two-sided. RESULTS: A total of 402 women responded to the follow-up survey (83% response rate). Of these women, 50 (39%) of the 129 women in the outreach group, 35 (25%) of the 139 women in the direct mail group, and 20 (15%) of the 134 women in the control group reported Pap testing in the interval between randomization and follow-up data collection (P<.001 for outreach worker versus control, P =.03 for direct mail versus control, and P =.02 for outreach worker versus direct mail). Intervention effects were greater in Vancouver than in Seattle. CONCLUSION: Culturally and linguistically appropriate interventions may improve Pap testing levels among Chinese women in North America.

Adult↗
PubMed2005

Prevalence of chronic renal failure in adults in Delhi, India.

BACKGROUND: Chronic renal failure (CRF) is a debilitating condition responsible for high morbidity and mortality and is a financial burden on government and society. Because of its costs and the complexity of its treatment, proper care is available to very few patients in India. A community-based study has not been done to determine the prevalence of CRF in India. METHODS: We used a multi-stage cluster sampling method in the South Zones of Delhi. In each area, we first contacted the local social leader and explained the study and the medical information pamphlets. On pre-scheduled days, the study team canvassed the study zone. The individuals contacted responded to a detailed questionnaire, and had a physical examination, a dipstick urine test for albumin and sugar and a blood test for serum creatinine. A serum creatinine >1.8 mg% defined renal failure. A repeat test for serum creatinine was done after 8-12 weeks to confirm chronicity of renal failure. If it was >1.8 mg% after 3 months in the absence of reversible factors, CRF was diagnosed. The person found to have CRF was asked to attend a hospital renal clinic for further investigations and individualized management. RESULTS: A total of 4972 persons were contacted for the study. Their mean age was 42+/-13 years; 56% were males. Out of the 4972 who were initially approached, 4712 agreed to give the blood sample, and thus were included for the evaluation of CRF. CRF was found in 37 of them. Thus, the prevalence of CRF in that adult population was 0.785% or 7852/million. CONCLUSIONS: The prevalence of CRF in India makes it a serious problem in need of urgent efforts to contain it.

Adult↗
PubMed1996

Patients' expectations of information provided at cancer hospitals in Japan.

In order to survey patients' views on disease and treatment information that should be provided at hospitals, an anonymous self-administered questionnaire was distributed to patients at Aichi Cancer Center Hospital in 1995. All eligible first-visit outpatients (97 persons), randomly selected revisit outpatients (99 persons; about one in ten refused), and all except six eligible inpatients in good condition at discharge (97 persons) responded. Out of 293 patients (115 males, 174 females and 4 unspecified), 74% answered that they wanted to be informed of their diagnosis irrespective of circumstances, 20% answered that they would want to be informed only in certain circumstances, and 2% did not want to be informed at all. There were no significant differences in response among the three sources of patients. Inpatients wanted more (81%) to be explained about recommended therapy than either first-visit outpatients (67%) or revisit outpatients (67%). The majority considered that about a 30-minute explanation was needed using pamphlet-like written materials or video. When asked what information was needed when choosing a cancer hospital, 71% specified information on the specialty of the hospital, 57% the content of the care provided, 23% the name and specialty of the doctors, 20% the waiting period before scheduled admission, 13% the average admission period, 11% the number of patients with the same disease, 10% the waiting time at the outpatient clinic, 6% the meal menu, and 4% the number of private wards. Forty-three percent wanted an information service covering all hospitals in the region through an information center. The results revealed that patients at this cancer hospital required information on their disease, treatment, and hospital specialty.

Adult↗