Advertising remains unethical even in the digital age.
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Advertising↗
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[Factors associated with cancer screening participation, Korea].
OBJECTIVES: We wanted to identify those factors associated with stomach, colon, breast and cervix cancer screening. METHODS: A population-based telephone survey was conducted for 2 weeks (the 9th-23th of July, 2004) by trained interviewers with using a questionnaire. 2,598 respondents (females aged 30 years or over, and the males aged 40 years or over) were selected by random-digit dialing that was based on the 2000 Population and Housing Census. The data on socio-demographic, health behavior and enabling factors were collected. 2,571 respondents were included in analysis. The cancer screening rate was classified into 2 categories: the life time screening rate and the screening rate with recommendations. RESULTS: For the 2,571 respondents, the life time screening rate was as follows: 52.0% (Stomach), 25.3% (Colon), 55.9% (Breast) and 76.8% (Cervix). The screening rate with recommendation was as follows: 39.2% (Stomach), 20.6% (Colon), 42.5% (Breast) and 58.3% (Cervix). On a multiple logistic regression analysis of the life time screening, statistically significant relationships were observed for the screening intention, the health exam, the disease history, the age of the patients and the cancer screening rates. On a multiple logistic regression analysis of the screening with recommendation, statistically significant relationships were observed for the screening intention, the health exam, the age of the patients, the concern about the risk of cancer, the voluntary health insurance for cancer and the cancer screening rates. CONCLUSIONS: The results of this study suggest that the cancer screening intention, the health exam and the age of the patients are the most important factors to participate in life time cancer screening and also screening with recommendations. A positive association was also observed for the concern about the risk of cancer, the voluntary health insurance for cancer. It is hoped that this study will be a base line data for suggesting the representative cancer screening rate in Korea.
Adult↗
Nanotechnology slowly gives up its secrets.
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Air Pollutants, Occupational↗
Understanding nurses' information needs and searching behaviour in acute care settings.
UNLABELLED: We report the results of a pilot study designed to describe nurses' information needs and searching behaviour in acute care settings. Several studies have indicated that nurses have unmet information needs while delivering care to patients. AIM: Identify the information needs of nurses in acute care settings. METHODS: Nurses at three hospitals were asked to use an information retrieval tool (CPG Viewer). A detailed log of their interactions with the tool was generated. RESULTS AND CONCLUSIONS: Our findings suggest that nurses' information needs are different from what is reported in the literature in terms of physicians' information needs. Questions regarding a nursing procedure or protocol were the most common needs nurses had.
Attitude of Health Personnel↗
Digital doctors. Physicians are warming up to computers, with surprising results.
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Attitude of Health Personnel↗
The Internet: will this highway serve the digital library?
The future of the biomedical enterprise and the biomedical libraries that serve it is tied closely to digital information. The changing nature of this type of information will create new pressures on libraries, particularly in health care organizations. Libraries must learn to deal with these pressures. Currently, libraries depend on the Internet primarily for connections to resources and other libraries; thus enhancements to the Internet will impact the libraries of the present and future significantly. This paper provides an overview of the technical capabilities that will be available in the near to midterm, what libraries will be able to do with those capabilities, and how libraries can position themselves to take advantage of the impending changes.
Computer Communication Networks↗
E.T. Net for health science education.
E.T.Net electronic conferencing offers biocommunicators opportunities to link with others involved with interactive technology in health sciences education, development, implementation, evaluation, and research. Conferences, or asynchronous message areas, include: AVLINE, CAI, shareware, hardware, digital images, UMLS User, NUCARE, and general. E.T.Net may be accessed, free of charge to users, via Internet, SprintNet, and DATAPAC in the U.S. and in many other countries.
Computer Communication Networks↗
Bridging the gap between research and practice: The development of a digital library of research syntheses.
This article describes the development of a digital library as a resource for clinicians and researchers working with women with HIV infection. We wanted to find a new way of communicating the findings from the 114 studies that we used as the method case. The development of the SandBar Digital Library (http://sonweb.unc.edu/sandbar), a product of a 5-year project to develop the analytic techniques for qualitative metasynthesis, is described from its inception, including analyses of the potential users and how they might use such a resource. The Digital Library evolved over a 3-year period, with continuous feedback from a group of researchers and clinicians who are also experts in the care of HIV-positive people. It provides a concise and comprehensive compilation of findings in two major areas of concern for the seropositive women who were the participants in the studies: motherhood and stigma.
Attitude of Health Personnel↗
Relationship of age to factors influencing breast self-examination practice.
Although breast cancer is more prevalent in older women, breast self-examination (BSE) is often done less frequently. A correlational study was undertaken to investigate variables related to BSE behavior in women from three age groups: women 35 to 44, women 45 to 54, and women 55 and older. Attitudinal variables specified by several theoretical models (susceptibility, seriousness, benefits, barriers, health motivation, control, confidence, and knowledge) were assessed. The probability sample consisted of 322 women who were contacted via random-digit dialing; data were then collected via mailed questionnaires. Results indicated differences in significant variables depending on age group. In the oldest age group, barriers was the only significant variable, but for women 45 to 54, confidence and barriers were both significantly related to BSE. The youngest age group, women aged 35 to 44, showed significant relationships with susceptibility, seriousness, barriers, confidence, and knowledge. Results indicate there may need to be different approaches for increasing BSE depending upon the age of the woman.
Adult↗
Sonographic fatty liver, overweight and ischemic heart disease.
AIM: To demonstrate the prevalence of sonographic fatty liver, overweight and ischemic heart disease (IHD) among the male workers in Taiwan, and to investigate the possible association of these three factors. METHODS: From July to September 2003, a total of 2 088 male aircraft-maintenance workers aged from 22 to 65 years (mean 40.5) underwent an annual health examination, including anthropometrical evaluation, blood pressure measurement, personal medical history assessment, biochemical blood analysis, abdominal ultrasonographic examination and digital electrocardiography (ECG). The Student's t-test, chi(2) test and multivariate logistic regression analysis were utilized to evaluate the relationship between IHD and salient risk factors. RESULTS: The all-over prevalence of overweight was 41.4%, and that of fatty liver was 29.5% (mild, moderate and severe fatty liver being 14.5%, 11.3%, and 3.7%, respectively); while the prevalence of ischemic changes on ECG was 17.1% in this study. The abnormal rates for conventional IHD risk factors including hypertension, dyslipidemia, hyperglycemia and overweight increased in accordance with the severity of fatty liver. Overweight and severity of fatty liver were independently associated with increased risks for developing IHD. Overweight subjects had a 1.32-fold (95%CI: 1.01-1.73) increased IHD risk. Participants with mild, moderate, and severe fatty liver had a 1.88-fold (95%CI: 1.37-2.6), 2.37-fold (95%CI: 1.66-3.37) and 2.76-fold (95%CI: 1.62-4.72) increased risk for developing IHD. The prevalence of ischemic ECG for the fatty liver-affected subjects with or without overweight was 30.1% and 19.1%, while that of overweight subjects free from fatty liver was 14.4%. Compared to the subjects without fatty liver nor overweight, IHD risk for the three subgroups above was as follows: OR: 2.95 (95%CI: 2.31-4.09), OR: 1.60 (95%CI: 1.07-2.39) and OR: 1.11 (95%CI: 0.78-1.56), respectively. CONCLUSION: The presence of fatty liver and its severity should be carefully considered as independent risk factors for IHD. Results of the study suggest the synergistic effect between fatty liver and overweight for developing IHD. Abdominal sonographic examination may provide valuable information for IHD risk assessment in addition to limited report about liver status, especially for overweight males.
Adult↗
Telemedicine in pediatric surgery.
Telemedicine is a new academic specialty at the crossroads of medical informatics whose potential is still largely untapped by pediatric surgeons. Telemedicine aims to alleviate travel concerns associated with the delivery of health care, to bring expert pediatric surgeons to areas where currently none exist, and to improve coordination between pediatric surgeons, transcending all barriers. Today, it is possible to transmit all digitized data--roentgenograms, echocardiograms, radiologic images, intraoperative photographs, histologic images, etc., and to consult specific experts in the subspecialties of childcare. It is possible to train and guide surgical trainees by experts without their physical presence. In the future, telemedicine will constitute an integral part of the health care of children and the training of pediatric surgeons.
Child↗
Willingness to pay for preventive travel health measures among Hong Kong Chinese residents.
BACKGROUND: The effectiveness of preventive measures in combating travel-related illnesses is well recognized. However, there is a lack of information on the economic value of any travel-associated preventive measures in the literature. OBJECTIVES: The purpose of this article is to report the values of willingness to pay (WTP) to prevent travel health problems in Hong Kong's travelers. METHODS: A cross-sectional telephone survey for a sample of Hong Kong population was conducted in 1998 using a random digit dialing technique. The sample WTP values were elicited using an open-ended question. Logistic regression was performed to identify predictors of WTP. Mean WTP was estimated using Heckman's sample selection model on log-WTP. RESULTS: Of the subjects interviewed, 77% (285/369) offered positive values of WTP to prevent travel health problems. The observable WTP (zero excluded) had a higher mean (447 Hong Kong dollars) than did the zero-inclusive data (351 Hong Kong dollars). The median values were 200 Hong Kong dollars in both cases because there were a large number of protest responses. Age, travel frequency, ability to assess travel health risk, precautionary behavior, and previous exposure to health protection materials explained one's willingness to pay a positive amount for preventing travel health problems. Age, education level, and precautionary behavior were predictors of the WTP levels. CONCLUSION: The findings of this study suggest that Chinese travelers are willing to pay for the prevention of travel-related illnesses. The predictors of WTP identified could be used to suggest policy changes. However, future studies are needed to explore further the relationship between the experience of travel illnesses, the magnitude of travel health risks, and WTP.
Adolescent↗
Are smokers adequately informed about the health risks of smoking and medicinal nicotine?
The present study assessed smokers' beliefs about the health risks of smoking and the benefits of smoking filtered and low-tar cigarettes, and their awareness of and interest in trying so-called reduced-risk tobacco products. Results were based on a nationally representative random-digit-dialed telephone survey of 1,046 adult (aged 18 years or older) current cigarette smokers. Data were gathered on demographic characteristics, tobacco use behaviors, awareness and use of nicotine medications, beliefs about the health risks of smoking, content of smoke and design features of cigarettes, and the safety and efficacy of nicotine medications. In addition, respondents were asked about their interest in and perceived ability to stop smoking and about their desire for more information about the health risks of smoking. Smokers were least knowledgeable about low-tar and filter cigarettes (65% of responses were incorrect or "don't know") and most knowledgeable about the health risks of smoking (39% of responses were incorrect or "don't know"). The smokers' characteristics most commonly associated with misinformation when all six indices were combined into a summary index were as follows: those aged 45 years or older, smokers of ultralight cigarettes, smokers who believe they will stop smoking before they experience a serious health problem caused by smoking, smokers who have never used a stop-smoking medication, and smokers with a lower education level. Those who believed they would stop smoking in the next year were more knowledgeable about smoking. Some 77% of respondents reported a desire for additional information from tobacco companies on the health dangers of smoking. The present findings demonstrate that smokers are misinformed about many aspects of the cigarettes they smoke and stop-smoking medications and that they want more information about ways to reduce their health risks.
Adult↗
Valuation of arthritis health states across ethnic groups and between patients and community members.
OBJECTIVE: We sought to examine differences in valuation of health by individuals from different ethnic backgrounds and between patients and community members. RESEARCH DESIGN: We surveyed 193 community members identified by random-digit dialing (ie, 64 white, 65 black, and 64 Hispanic) and 198 patients with osteoarthritis (OA), 66 per ethnic group, drawn sequentially from clinic lists of an outpatient institution. MEASURES: Participants were interviewed and asked to rate 2 scenarios describing arthritis (mild and severe) using visual analog scale (VAS), standard gamble (SG), and time trade-off (TTO). Differences were adjusted for cohort, age, gender, and education. RESULTS: Members of the public had higher preference scores for the 2 health states than patients (SG severe state: 0.77 public, 0.66 patients; SG mild state: 0.90 public, 0.84 patients). The difference score between the mild and severe states was smaller for black than white subjects (P < 0.001) by SG and TTO. Scores for Hispanics and whites did not differ. Preference scores increased with age (SG, TTO). CONCLUSIONS: Significant differences were observed in the valuation of health between members of the public and patients, among ethnic groups, and in relation to educational status and age, with the difference between utilities of health states being a more efficient measure of preference than the utility of a single state. Utilities elicited through valuation of hypothetical health scenarios are dependent on sociodemographic traits, experience of disease, and method used. These findings suggest that utilities cannot be used interchangeably across populations, with implications for economic analyses.
Black or African American↗
Radiometric classification of alveolar bone health.
A radiograph-based classifier for discrimination between normal and diseased alveolar bone was developed. The alveolar bone health of dry mandibles was rated, by consensus of two trained observers, as normal or diseased. Bitewing radiographs of mandibular quadrants were digitized and regions of interest (ROIs) of the alveolar bone between the first and second permanent molars outlined. Gray-scale histograms for the ROIs were computed, and a classifier based on these histograms was developed. Two observers (independently) used only the classifier to rate the bone as being normal or diseased. These ratings were compared with the original ratings of trained observers who viewed and scored the actual alveolar bone. The sensitivity (the ability to detect diseased alveolar bone), specificity (the ability to detect normal alveolar bone), and accuracy were 0.90 or greater, indicating good agreement with subjective visual assessments of dry mandibles. These results suggest that this procedure may be applicable for evaluations of bone health in humans.
Adult↗
Are we getting the message out to all? Health information sources and ethnicity.
BACKGROUND: Over 80% of the excess deaths in minority and economically disadvantaged populations are from diseases with preventable or controllable contributing factors. However, mainstream health education targeting behavior change often fails to reach minority populations. OBJECTIVE: To identify the health and cancer information sources used by a multi-ethnic population and to determine whether information sources differ by ethnic group, age, gender, and socioeconomic status. METHODS: A multilingual, random-digit dial telephone survey of 2,462 Hispanic (Colombian, Dominican, Ecuadorian, and Puerto Rican) and black (Caribbean, Haitian, and U.S.-born) persons, aged 18-80 years, from a population-based quota sample, New York City, 1992. RESULTS: All ethnic and age groups cited a health professional as the most common source of health information (40% overall). The next most commonly cited sources overall were: television (21%), hospitals or doctor's offices (18%), books (17%), magazines (15%), brochures/pamphlets (11%), and radio (8%). Responses on sources of cancer information followed a similar pattern. Black subgroups were all significantly more likely than Hispanic subgroups to get their health information from a doctor or other health professional (p = 0.001). Use of the radio as a source of health information was highest among Haitians (20.8%) and Colombians (12.5%), and lowest among U.S.-born blacks (4.2%) (p = 0.001), but there was no difference in the use of television. Among immigrants, as the proportion of life spent in mainland U.S. rose, increasing percentages cited magazines (p = 0.001) and decreasing percentages cited radio (p = 0.025) as a health information source. Less educated persons and more recent immigrants were most likely to report inability to get health information (p = 0.001). CONCLUSIONS: Given the variation in sources of health and cancer information, identification of those most commonly used is important to health educators' and public health practitioners' efforts to target hard-to-reach ethnic minorities.
Adult↗
[Experiences with teleradiology in general practice in Oppland].
BACKGROUND: Our aim was to evaluate one year of operation of a newly established teleradiology service for people in Mid- and North Gudbrandsdalen (30,000 inhabitants). In Otta, one radiographer works with digital pictures (phosphorus plate technology). Pictures are sent to the local hospital in Lillehammer (115 kilometres away) by a broadband network (for health services only) for radiological evaluation. MATERIAL AND METHODS: We have measured the scope of the service, patient satisfaction, management stability and efficiency, and financial aspects (the latter are not included in this article). RESULTS: Over one year we have examined 3,081 persons (skeleton, thorax, sinuses). A majority of patients (90%) thought it was better for them to be examined at Otta. Waiting time was short, rarely more than one week. No re-examinations due to insufficient picture quality were required. Some expected and some unexpected problems occurred. Pictures from 37 patients were lost and could not be radiologically evaluated. The lead time from when pictures were taken to when the requisitioning doctor received the report, was too long (one to three weeks). The digital pictures are not easily available to hospital physicians. Copies must be made on film. INTERPRETATION: Our experience is positive. Most problems will be solved by storing copies at Otta, by better organisation of the radiologic service, and by establishing a digital picture archiving and communication system (PACS) at the hospital.
Cost Savings↗
Digital psychiatry.
The American managed care movement has been viewed as a big experiment and is being watched closely by the rest of the world. In the meanwhile, computer-based information technology (IT) is changing the practice of medicine, much more rapidly than managed care. A New World of digitized knowledge and information has been created. Although literature on IT in psychiatry is largely absent in peer-reviewed psychiatric journals, IT is finding its way into all aspects of medicine, particularly psychiatry. Telepsychiatry programs are becoming very popular. At the same time, medical information sites are flourishing and evolving into a new health-care industry. Patient-physician information asymmetry is decreasing as patients are gaining easy access to medical information hitherto only available to professionals. Thus, psychiatry is facing another paradigm shift, at a time when most attention has been focused on managed care. In this new digital world, knowledge and information are no longer the sole property of professionals. Value will migrate from traditional in-person office-based therapy to digital clinical products, from in-person library search and classroom didactic instruction to interactive on-line searches and distance learning. In this time of value migration, psychiatrists have to determine what their 'distinctive competence' is and where best to add value in the health-care delivery value chain. The authors assess the impact of IT on clinical psychiatry and review how clinical practice, education and research in psychiatry are expected to change in this emerging digital world.
Communication↗