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PubMedDate not supplied

Parental knowledge and practice of primary skin cancer prevention: gaps and solutions.

Over the past two decades there have been significant efforts in the United States to heighten awareness about skin cancer. Our goal was to assess parental knowledge, practice, and source of information about sun protection for their children. A questionnaire was administered to 158 parents of children at a dermatology clinic and 96 parents of children at a pediatric clinic (n=254). The survey included four parts: demographics, knowledge about skin cancer, sun protection practices, and sources of sun protection information. The mean knowledge score was 61% correct. Independent predictors of a higher score were fewer children and being a health care or other professional (p < 0.03). Independent predictors of parental sunscreen use were higher knowledge score, younger age, and fewer lifetime sunburns (p < 0.03); predictors of sunscreen use for children were higher knowledge score and fairer skin (p < 0.03). The top sources of sun protection information ranked by respondents were television and magazines; the top desired sources were primary care physicians and dermatologists. The knowledge results suggest the need for increased education about skin cancer prevention. Because the media is a major information source, it is important to ensure that messages about sun risks/protection are correct. The respondents' desire to learn more from primary care physicians emphasizes the need to educate physicians about sun protection.

Child↗
PubMed2002

When home care ends--changes in the physical health of informal caregivers caring for dementia patients: a longitudinal study.

OBJECTIVES: To verify the change in health variables and parameters of health service utilization in a group of active caregivers for older persons with dementia in comparison with former caregivers who had ceased to provide home care for at least 6 months (death of the patient or institutionalized care). DESIGN: A prospective longitudinal study with 1-year follow-up. Active and former caregiver groups originated from a sample of active caregivers at baseline. SETTING: Participants were recruited mainly via advertisements placed in two magazines with large, nationwide circulation. The questionnaires were sent on request. PARTICIPANTS: Seven hundred twenty primary caregivers of dementia patients living in the community. All patients had a medical diagnosis of dementia and had a score of 20 or greater on the mental-mnestic disturbances factor of the Sandoz Clinical Assessment--Geriatric scale. Their care needs covered at least one of four activities of daily living (personal hygiene, eating, toilet use/excretion, mobility). After 12 months, 681 caregivers were reinterviewed. MEASUREMENTS: The physical complaints were assessed with the 24-item Giessen Symptom List (subscales: aching limbs, stomach complaints, heart complaints, physical exhaustion). Other key variables were the number of illnesses, number of somatic and psychotropic medications, and number of physician visits. RESULTS: Although the somatic symptoms of the active caregivers (n = 427) remained stable at a high level, they decreased significantly (24%) in the group of former caregivers (n = 121). Simultaneously, the number of visits former caregivers made to physicians almost doubled. The reason why home care was terminated (death or institutionalization) did not influence health variables or health service utilization. CONCLUSION: The physical health of former caregivers improves in the long term once they cease to provide home care. The fact that former caregivers go to the doctor much more frequently is to be interpreted as an indication that they take the time to attend to their own physical and medical needs.

Aged↗
PubMed2002

Pain site and impairment in individuals with amputation pain.

OBJECTIVE: To determine the association between pain site and pain interference with activities of daily living (ADLs) among persons with acquired amputation. DESIGN: Survey. SETTING: Community-based survey from clinical databases, flyer postings, and an advertisement in the inMotion magazine. PARTICIPANTS: Persons with lower-limb amputations (N=478). INTERVENTIONS: Six or more months after lower-limb amputation, participants completed an amputation pain questionnaire that included several standardized pain measures. MAIN OUTCOME MEASURES: Numeric rating scale measures of average phantom limb, residual limb, and back pain and pain-related impairment as measured by a modified version of the Pain Interference Scale of the Brief Pain Inventory. RESULTS: Phantom limb, residual limb, and back pain intensity ratings, as a group, accounted for 20% of the variance in pain interference. The pain intensity ratings associated with each individual pain site made a statistically significant contribution to the prediction of pain interference with ADLs even after controlling for the pain intensity of the other 2 sites. CONCLUSIONS: Pain in each of 3 sites (phantom limb, residual limb, back) appears to be important to pain-related impairment and function. Measurement of the intensity of pain at each site appears to be required for a thorough assessment of amputation pain-related impairment.

Adult↗
PubMed2001

Additional medical information: prevalence, source, and benefit to parents.

PURPOSE: The aim of this study was to (1) characterize the source of additional medical information acquired by parents and (2) to verify how much information is correctly interpreted and remembered correctly. METHODS: A cross-sectional prospective study was made of parents of 108 children with surgical diseases consecutively admitted to a children's hospital in 1999. The median age of the children was 3 years (range, 0.01 to 16), and that of parents was 34 years (range, 18 to 54). Parental knowledge and understanding of their child's illness, operation, potential operative risk, and long-term outcome were scored on the basis of (1) parents' self appraisal (questionnaire) and (2) objective evaluation (interview) performed by one investigator not involved in the child's care. RESULTS: Parents' education included a university degree (15%), entry examination for university (13%), basic educational qualification (47%), and no educational qualification (15%). Additional medical information was obtained by 77% of the parents (63% from general practitioner, 46% from books, 31% from popular magazines, 24% from internet). Inadequate knowledge of illness and treatment was highlighted in 12% and 19% of the assessment made by interview, respectively, compared with 8% and 14% of the self appraisals. Inadequate knowledge of operative risk was higher in the assessment made by interview (42%) compared with self appraisal (9%; P <.0001). Similarly, inadequate knowledge of long-term outcome was higher in the interview (28%) compared with self appraisal (13%; P <.05). Acquisition of additional medical information irrespective of the source did not affect the accuracy of parental knowledge. Medical knowledge was more accurate in parents of children who required major operations and in those with higher educational qualifications (P <.05). CONCLUSIONS: Parents commonly obtain additional medical information. However, this information does not necessarily improve parents' understanding of the child's operative risk and long-term problems. Parents' perception of having adequate medical information often is incorrect.

Adolescent↗
PubMed2002

Control of cancer: the promise of the future.

OBJECTIVES: To review the progress being made against cancer and a new legislative approach, the National Cancer Act of 2002, to renew the nation's resolve towards eliminating cancer. DATA SOURCES: Government reports, books, and newspaper and magazine articles. CONCLUSIONS: The major issues affecting cancer have to do with the economy, the status of employment, the environment, and the health care delivery system and access to it. IMPLICATIONS FOR NURSING PRACTICE: Nurses can participate in the major issues affecting cancer and influence the political process to eradicate cancer as a major public health problem.

Adult↗
PubMed2000

What do we know about herbal morning sickness treatments? A literature survey.

OBJECTIVE: A literature survey investigating the use of herbs to treat morning sickness, with particular reference to what is known about their safety. DESIGN: All major English language medical, nursing and scientific databases as well as 300 World Wide Web sites, Internet newsgroups, books and magazines were searched for information about the use and safety of herbs in pregnancy. FINDINGS: A search of medical databases failed to locate any articles which specifically reported investigations of the safety of herbs used during pregnancy. Of 300 non-medical sources studied 75 cited the use of herbs in pregnancy. The most commonly cited herbs for morning sickness were ginger, chamomile, peppermint and raspberry leaf (55, 37, 44 and 63% cited respectively). There was no consensus in the popular literature about whether or not each of these herbs was safe for use in pregnancy. Seven sources (6%) cited chamomile and peppermint as unsafe, while 16 (12%) cited the use of ginger and 11 (15%) the use of raspberry leaf as unsafe during pregnancy. CONCLUSIONS: Herbal remedies are often seen as safe, 'drug-free' treatments for morning sickness. However, the contradictory information and dearth of original research related to their safety indicates that these compounds should be used with caution.

Female↗
PubMedDate not supplied

[Prof. Carl Wilhelm von Zehender (1819-1916)--first professor of ophthalmology and co-founder of the ophthalmological clinic at the University of Rostock--commemorative lecture at the 100th DOG meeting in Berlin from 26.9 to 29.9.2002].

The Grand-ducal University Eye Department in Rostock was solemnly inaugurated 16 May 1892. According to many years of studies in Europe and on efforts to build this clinic, construction was outlined by Professor Carl Wilhelm v. Zehender, but the drafts were executed by the "Grossherzoglich-Mecklenburgisch-Schwerinschen Medicinalcommission" and Landbaumeister Schlosser in winter 1888/89. Professor v. Zehender, who originated from a very ancient Swiss family, was born in Bremen, 21 May 1819. He studied medicine in Goettingen, Jena, Prague, Paris and Vienna. During this time he developed a lifelong friendship with Albrecht v. Graefe. 1856 he took over the medical care for the hereditary duke Georg von Mecklenburg-Strelitz and published the "Correspondenzblatt für Aerzte im Grossherzoglichen Mecklenburg-Strelitz". 1857, during a conference in Heidelberg, his initiative led in the long run to the establishment of the "Heidelberger Ophthalmologische Gesellschaft", the forerunner of the "Deutsche Ophthalmologische Gesellschaft", which was founded in 1920. In 1863 the first edition of "Klinische Monatsblaetter für Augenheilkunde" was published as a periodical; the cover page bore its name as the founder of the magazine. In 1866, after the death of the hereditary duke and a professorship in his hometown Berne, he became honorary professor of the Rostock University, and from 1869 onwards he chaired the clinic as a regular professor. After all his efforts to build his own hospital had failed, he demonstratively and finally resigned from his professorship in 1889. He went to Munich and became editor of the " Klinische Monatsblaetter für Augenheilkunde". In 1907 he moved with his wife via Eutin to Warnemuende. There the nestor of world ophthalmologists died at the age of 98. His burial place without gravestone is situated in today's landscape park "Stephan Jantzen". So far all efforts of the author and of the Rostock University Eye Department taken after 1980 to create a worthy note to this exceptional ophthalmologist in the Baltic Sea resort Warnemuende were unsuccessful, also for financial reasons. But on 2.9.2002 with the help of the Lighthouse Club of Warnemuende a memorial plaque to Prof. C. W. v. Zehender was mounted on the guest house "Margarete". This plaque commemorates Professor Zehender's merits in establishing the DOG, planning and building the eye clinic of the university of Rostock.

Germany↗
PubMed2005

Demographics and respiratory illness prevalence of sport scuba divers.

This study aimed to establish epidemiological data on diving habits and outcome of subjects with respiratory diseases who are considered at increased risk for diving injuries. We conducted a cross-sectional demographics and prevalence study by distribution of an anonymous questionnaire with an issue of a widespread sport diving magazine. The questionnaire was designed to obtain medical and diving history data with an emphasis on respiratory diseases and complaints. The investigational population comprised sport scuba divers of any age and gender from Austria, Germany, and Switzerland. Two hundred and twenty-six male and 96 female divers sent completed questionnaires. Of the respondents 8.7 % indicated that they currently have asthma. Two thirds of asthmatics complained about regular dyspnoea. However, only 42.4 % used drugs relieving or controlling their symptoms regularly and 27.3 % used them in a prophylactic manner before diving. Five percent and 4.7 % of all divers reported a history of respiratory disease other than asthma or dyspnoea respectively. The divers with respiratory illness or complaints had logged a total of 17,386 dives. There were no cases of serious diving injuries. Despite the well-known limitations of postal surveys assessing self reported data, this study indicates that there is a population of subjects diving uneventfully with respiratory diseases that are considered medical contraindications to diving. These subjects deserve particular guidance on related risks and disease management.

Adult↗
PubMed2005

[Knowledge of colorectal cancer prevention in the Bavarian population above 50 years--survey in two districts].

PURPOSE: Colorectal cancer is the second main cause of cancer death in Germany, although several measures related to primary prevention are described, and the utilisation of existing diagnostic tools (faecal occult blood test = FOBT, colonoscopy) is known to significantly decrease incidence and mortality. However, screening rates remain low in Germany, and insufficient knowledge of prevention possibilities is assumed to be responsible. The aim of this study was to investigate the knowledge related to colorectal cancer prevention in a Bavarian population, in the context of a regional public awareness campaign ("Active against Colorectal Cancer"). METHODS: 618 individuals between 50 and 90 ys of age participated in a telephone survey (m: 219, f: 399, 63.2 +/- 9.17 ys); the participants were inhabitants of two Bavarian districts. The questionnaire consisted of open-ended questions concerning preventive behaviour, colorectal cancer screening, risk factors, early warning signs and knowledge of colorectal cancer information. RESULTS: More than 80% of participants recalled healthy diet as a possible protective factor against colorectal cancer; a distinctly smaller percentage, however, could correctly define concrete dietary factors: e. g., fruit and vegetables were named by 54.5%. 66% of participants knew that unusual rectal bleeding might be a warning sign of cancer. Colonoscopy was the screening test that was most frequently recalled (61.5%); fewer participants named FOBT (32.8%) and rectal examination (11.5%). The results demonstrate that for many knowledge items, females proved to be significantly better informed than males. The most frequent sources of colorectal cancer information were newspapers, magazines, television and/or radio (named by 76.7%), as well as physicians and pharmacies (45.1%). 11.5% of participants attended the regional public awareness campaign "Action against colorectal cancer"; this subgroup had a better knowledge of some aspects related to colorectal cancer prevention. CONCLUSION: Evidently, the interviewed Bavarian population of 50 years or older lack knowledge of risk or protection factors for colorectal cancer. Knowledge of existing screening tests was also poor. These findings can serve as starting point for information campaigns tailored for target groups.

Age Factors↗
PubMed2006

A new technique of endoscopic full-thickness resection using a flexible stapler.

There is a significant need for a safe and easy technique for endoluminal endoscopic resection of gastrointestinal lesions, but such procedures are usually restricted to resection of the mucosal layer in order to preserve the integrity of the wall of the gastrointestinal tract. We present two patients, one with early cancer and one with a carcinoid tumor, who were treated by endoscopic full-thickness resection. We used a stapling device, consisting of a flexible shaft, which was positioned intraluminally, and a remote control. After pilot investigations in pigs and in human anatomical preparations, we performed a full-thickness resection of the gastric wall in these patients, using the flexible stapling device under gastroscopic control. Gastric wall specimens up to 4 cm x 4 cm in size were resected with the use of two to three stapler magazines. Both procedures followed an uneventful course and the patients made an uncomplicated recovery. Further studies are necessary to test the applicability of the technique in the management of other gastric neoplastic lesions.

Aged, 80 and over↗
PubMed2006

The beauty mystique.

Physical beauty is symbolic, and a highly valued and powerful attribute, of the self. Yet it is also controversial--its value negated as a myth by many proverbs, religious authorities, and feminists alike. Here we explore some of the practices of beauty, from beauty competitions to cosmetic surgery, and also some of the thinking about beauty from Homer and Plato through Darwin and Freud to PEOPLE magazine. The beauty mystique, defined here as the widespread equation of beauty with goodness, together with other virtues imputed to beauty, has the reverse application to ugliness. Both processes are evident in our literature, media, popular culture, and our attitudes and behaviors; both are applied primarily to the face--the principal locus of both beauty and character. The mystique and the myth have their value and their limits.

Art↗
PubMed1980

On the readability of surgical consent forms.

A great deal of attention has been paid to ensuring that surgical consent forms have valid content, but little effort has been made to ensure that the average patient can read and understand them. Five representative surgical consent forms were analyzed with two standardized readability tests. The readability of all five was approximately equivalent to that of material intended for upper-division undergraduates or graduate students. Four of the five forms were written at the level of a scientific journal, and the fifth at the level of a specialized academic magazine. I suggest that few consent forms currently in use could pass readability tests. The implication of these findings is that thousands of persons may be undergoing surgery each year on the basis of inadequate consent. The problem has a reasonably simple solution: analysis of all consent forms for readability, and rewriting of those found excessively difficult.

California↗
PubMed2005

Tobacco industry opposition to designating environmental tobacco smoke through E-codes.

This manuscript examines the public policy importance of 1993, United States Department of Health and Human Services actions to require doctors and hospitals to report a new external cause of injury code or E-code for environmental tobacco smoke related to causes of death such as lung cancer and severe heart disease. Methods included a qualitative archival analysis of all previously internal tobacco industry documents, pertinent newspaper and magazine articles, Americans for Nonsmokers' Rights database, and pertinent websites regarding environmental tobacco smoke and E-codes from 1993 to 1998. The E-code has continued to the present because of scientific and administrative recognition that environmental tobacco smoke is conclusively linked to illness and death. The industry argued that the E-code was unnecessary because of costs to business and no conclusive scientific evidence linking environmental tobacco smoke with pulmonary and cardiovascular deaths. This regulatory action based on current scientific evidence and medical decision-making contradicts the industry's claim that no deaths are conclusively associated with environmental tobacco smoke.

Cardiovascular Diseases↗
PubMed2005

Alcohol advertising and youth: a measured approach.

Where alcohol industry self-regulation is the primary protection against youth exposure to alcohol advertising, independent, systematic monitoring of youth exposure can promote public awareness of and greater accountability in the industry's practices. Using commercially available databases, the Center on Alcohol Marketing and Youth has combined occurrence and audience data to calculate youth (aged 12-20 years) and adult (above the United States legal drinking age of 21 years) exposure to alcohol advertising on television and radio, in magazines and on the Internet. This research in the United States shows that alcohol companies have placed significant amounts of advertising where youth are more likely per capita to be exposed to it than adults. Further analyses by the Center have demonstrated that much of this excess exposure of youth to alcohol advertising in the United States could be eliminated if alcohol companies would adopt a threshold of 15% (roughly the proportion of 12-20-years-old in the population 12 and above) as the maximum youth audience composition for their advertising. Although adoption of such a threshold would still leave much youth exposure to alcohol marketing in such "unmeasured" activities as sponsorships, on-premise promotions and campus marketing, it would assist alcohol companies in reaching their intended audiences more efficiently while reducing overall youth exposure to their advertising.

Adolescent↗
PubMed1997

Post acute care: can hospitals do better with less?

Judging by reports in medical magazines and journals, 'early discharge schemes', better termed 'post acute care', are not popular with doctors. However, government policy encourages earlier discharge from hospital, so that the choice facing clinicians is to discharge patients early with support, or early without support, or deal with the consequences of length of stay overruns. Fortunately, government funding for post acute care is increasing. There is a strong rationale for post acute care based on better patient outcomes and cost-effectiveness, but these desirable results will only be achieved if scrupulous attention is paid to detail, as embodied in the 10 principles of post acute care. To function optimally, post acute care should be coordinated by the hospital which provided the acute care.

Australia↗
PubMed1982

Mortality among health-conscious elderly Californians.

In an attempt to obtain epidemiologic evidence regarding the mortality rate among vitamin supplement users, a prospective study was made of 479 elderly Californian respondents to a 1974 questionnaire carried in Prevention, a health magazine that advocates vitamin supplement usage. Based on self-reported questionnaire data obtained in 1974 and 1977, this cohort does indeed consume large quantities of vitamin and mineral supplements. In addition, the cohort is quite health conscious and appears to have taken up a "Prevention life-style" in recent years. For instance, these individuals are primarily nonsmokers, although about 50% formerly smoked cigarettes. Most of them eat meat, poultry, or fish but do so in moderation; and they consume only modest amounts of alcohol, whole milk, white bread, salt, and sugar. Their socioeconomic status is somewhat higher than the national average. Because this group differs from the general population in many ways it is difficult to separate the various factors that might influence their health. During 6 years of follow-up, a total of 107 deaths occurred. Based on comparison with 1977 United States whites, the standardized mortality ratio (SMR) is 78% for the males, 54% for the females, and 68% for both sexes combined. All three SMR values are significantly less than 100% (P less than 0.05). For both sexes combined, the SMR is 86% for cancer, 62% for total cardiovascular diseases, and 73% for all other causes. Only the cardiovascular SMR is significantly lower than 100%. The death rate for the males is approximately the same as that reported among other healthy nonsmoking questionnaire respondents. but the death rate for females is significantly less (P less than 0.01). The only notable relationships between questions asked in 1974 and subsequent mortality are those indicating a higher mortality rate associated with inactivity, heart trouble, and very low and very high levels of vitamin E intake. For this highly selected cohort, the overall "Prevention life-style" appears to be a healthy one, but the cohort experiences no clear reduction in total mortality because of high levels of vitamin intake per se.

Age Factors↗
PubMed1997

Permissive role of nitric oxide in endothelin-induced migration of endothelial cells.

Endothelin (ET) synthesis is enhanced at sites of ischemia or in injured vessels. The purpose of this study was to explore the possibility of autocrine stimulation of endothelial cell migration by members of the endothelin family. Experiments with microvascular endothelial cell transmigration in a Boyden chemotactic apparatus showed that endothelins 1 and 3, as well as a selective agonist of ETB receptor IRL-1620, equipotently stimulated migration. Endothelial cell migration was unaffected by the blockade of ETA receptor, but it was inhibited by ETB receptor antagonism. Based on our previous demonstration of signaling from the occupied ETB receptor to constitutive nitric oxide (NO) synthase (Tsukahara, H., Ende, H., Magazine, H. I., Bahou, W. F., and Goligorsky, M. S. (1994) J. Biol. Chem. 269, 21778-21785), we next examined the contribution of ET-stimulated NO production to endothelial cell migration. In three independent cellular systems, 1) migration and wound healing by microvascular endothelial cells, 2) wound healing by Chinese hamster ovary cells stably expressing ETB receptor with or without endothelial NO synthase, and 3) application of antisense oligodeoxynucleotides targeting endothelial NO synthase in human umbilical vein endothelial cells, an absolute requirement for the functional NO synthase in cell migration has been demonstrated. These findings establish the permissive role of NO synthesis in endothelin-stimulated migration of endothelial cells.

Animals↗
PubMed2002

Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults.

There is preliminary clinical evidence to support the contention that the anti-inflammatory and analgesic properties of bromelain help to reduce symptoms of osteo- and rheumatoid arthritis. However, there have been no controlled studies of its effects on joint health in healthy subjects who lack such diagnosis. The current study investigated the effects of bromelain on mild acute knee pain of less than 3 months duration in otherwise healthy adults. The study was an open, dose-ranging postal study in volunteers who had been recruited through newspaper and magazine articles. Two validated questionnaires (WOMAC knee health Index and the Psychological Well-Being Index) were completed at baseline and after one month's intervention with bromelain, randomly allocated to volunteers as either 200 mg or 400 mg per day. Seventy seven subjects completed the study. In both treatment groups, all WOMAC symptom dimension scores were significantly reduced compared with baseline, with reductions in the final battery (total symptom score) of 41 and 59% (P = 0.0001 and <0.0001) in the low and high dose groups respectively. In addition, improvements in total symptom score (P = 0.036) and the stiffness (P = 0.026) and physical function (P = 0.021) dimensions were significantly greater in the high-dose (400 mg per day) compared with the low-dose group. Compared to baseline, overall psychological well-being was significantly improved in both groups after treatment (P = 0.015 and P = 0.0003 in the low and high dose groups respectively), and again, a significant dose-response relationship was observed. We conclude that bromelain may be effective in ameliorating physical symptoms and improving general well-being in otherwise healthy adults suffering from mild knee pain in a dose-dependant manner. Double blind, placebo-controlled studies are now warranted to confirm these results.

Acute Disease↗