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PubMedDate not supplied

[Competent parenting: expectations of young parents of counseling on pregnancy and labor].

BACKGROUND: Are expecting parents prepared to change their lifestyle to benefit their unborn child? Do they see a need for more knowledge and competence to be good parents? What are the key expectations with respect to pregnancy, delivery conditions, and infant health care? To answer these questions, a study presented them to expecting and young parents in Germany. METHODS: 123 delivery units were selected to represent the 1120 delivery facilities of Germany identified in 1997 from all accessible sources. 109 participated, and of 7862 distributed questionnaires 5900 (75%) were filled-in completely by parents. RESULTS: Most parents (73%) expect information about pregnancy, birth and child health care in any instance. 25% would request information but only in problem situations. Preferred topics were prevention of diseases of the mother and her child (97%), intra-uterine development, preparation for delivery as well as breastfeeding, and nutrition of the infant (90% each). Although books had been the most frequent source of information, pediatricians, midwives, and gynecologists received the highest scores for satisfaction with their advice. The majority of expecting and new parents wished to get personal advice. For the choice of the delivery place, 59% had consulted friends and relatives, 43% their gynecologist. The most important criteria for their decision were high medical standards (95%), the hospital's attitude towards breast feeding and rooming-in (94% each), as well as the availability of neonatal care (89%). Also of prime interest were mother-child-contact immediately after delivery (99%), and well-rested personnel (96%). CONCLUSIONS: Across social classes, most expecting and new parents see a need of a broad spectrum of topics in health information and education related to pregnancy, delivery and the expected infant. As far as delivery is concerned, most expect a perfect combination of modern medical care and safety on the one hand, and the undisturbed humane experience of the birth on the other.

Adult↗
PubMed2003

The cytology of soft tissue tumours.

In the last few years, the primary diagnosis of soft tissue tumours has emerged as an important new target for fine needle aspiration (FNA). The purpose of this book is to facilitate the cytological evaluation of FNA smears from soft tissue tumours and to suggest cytological criteria for histotype diagnoses. Its primary aim is to describe and illustrate not only the most common types but also those rare tumours where cytological features have been largely described in case reports and in small series. The diagnostic use of ancillary methods is discussed and illustrated, and, in order to facilitate the diagnostic work-up in FNA samples, smears are also classified according to their principal microscopic patterns. The selection of entities presented, their diagnostic features and differential diagnostic considerations are mainly based on the experience with FNA in the primary diagnosis of soft tissue tumours in patients referred to the Musculoskeletal Tumour Centre at the University Hospital in Lund, Sweden over the last 30 years. The illustrations have mainly been culled from cases in the files of the Department of Pathology and Cytology, Lund University Hospital. Soft tissue tumours are relatively rare and often difficult to correctly diagnose in fine needle aspirates. Therefore, this publication should be welcomed by all cytopathologists involved in the FNA diagnosis of tumours as a valuable addition to their benchside textbooks.

Adipose Tissue↗
PubMed2001

Implementing evidence in Finnish primary care. Use of electronic guidelines in daily practice.

In Finland, electronic guidelines have provided general practitioners (GPs) with a source of up-to-date information at their fingertips since 1989. The Physician's Desk Reference and Database (PDRD) covers the majority of problems encountered in primary care with some 1,000 articles. These are available in electronic format, updated every 4 months, and as a book published in a fully revised edition every 2 years. Physicians use these guidelines as a routine part of their daily work. They seek information for both common and rare health problems and use it to plan diagnostic strategies as well as treatment and follow-up. In nearly 90% of cases the doctor finds the information she needs from the guidelines. The electronic version is user-friendly; typically the relevant article is found and read in 2 min. Patients find it reassuring when their doctor uses guidelines to select optimal treatment. Other Nordic countries are aslo producing several national guidelines, but Finland has so far the widest scope and longest experience in this area. An English version of the PDRD guidelines (Evidence-Based Medicine Guidelines) is available, and a Swedish-language version will be completed in 2002.

Decision Support Systems, Clinical↗
PubMed1976

[Prophylactic examination of infants (author's transl)].

In the mid sixties a medical work group developed a prophylactic programme for children which provided for repeated checkups to detect particularly those defects which are likely to seriously jeopardise the physical and mental development of the child. For the selection of the checkup dates that age of the child was decisive in which it was possible to inspect certain functional events. Since such examination programmes had to cover an entire class, a prerequisite to be met was to choose an as large a number of examiners as possible. This meant the prescription of methods of examination which were applicable to any private or paediatric practice. In view of the fact that the child's health is subject to quick changes it can never be the objective of such programmes to establish acute syndromes and detailed examination findings but to restrict prophylaxis to a selection of important diseases. Thus the medical objective remains limited to readily recognizable disturbances which undetected could severely interfere with the development of the child. It is also decisive for the extent of the examination that it is restricted to the search for such development disturbances as can be remedied effectively. A prerequisite for the effectiveness of the programme is the identity of examinations and the uniform documentation of the findings according to a compulsory scheme. These records will accompany the child during his first years of life. The examination book remains in the hands of the mother and is submitted to the physician at the time of a checkup so that the continuity in the establishment of findings is ensured even when the physician is changed. This prophylactic programme, which was introduced by the author to the German public in 1968, was meanwhile implemented and adopted by the German Social Sickness Fund by virtue of a Federal Act effective as on July 1st, 1971. At present the examination comprises 7 checkups during the first 4 years of life. Emphasis lies on the check for cerebral motor disturbances, congenital heart diseases, skeletal anomalies, metabolic disorders, auditory, logopaedic and visual defects and others. A report is given on the results, the critical evaluation and the possibility of improving the prophylactic programme.

Child Care↗
PubMed2005

Aerobic exercise interventions for adults living with HIV/AIDS.

BACKGROUND: The profile of HIV infection is constantly changing. Although once viewed as an illness progressing to death, among those with access to antiretroviral therapy, HIV can now present as a disease with an uncertain natural history, perhaps a chronic manageable disease for some. This increased chronicity of HIV infection has been mirrored by increased prevalence of disablement in the HIV-infected population (Rusch 2004). Thus, the needs of these individuals have increasingly included the management of impairments (problems with body function or structure as a significant deviation or loss, such as pain or weakness), activity limitations (difficulties an individual may have in executing activities, such as inability to walk) and participation restrictions (problems an individual may experiences in involvement in life situations, such as inability to work) (WHO 2001). Exercise is a key strategy employed by people living with HIV/AIDS and by rehabilitation professionals to address these issues. Exercise has been shown to improve strength, cardiovascular function and psychological status in seronegative populations (Bouchard 1993), but what are the effects of exercise for adults living with HIV? If the risks and benefits of exercise for people living with HIV are better understood, appropriate exercise may be undertaken by those living with HIV/AIDS and appropriate exercise prescription may be practiced by healthcare providers. If effective and safe, exercise may enhance the effectiveness of HIV management, thus improving the overall outcome for adults living with HIV. OBJECTIVES: To examine the safety and effectiveness of aerobic exercise interventions on immunological/virological, cardiopulmonary and psychological parameters in adults living with HIV/AIDS. SEARCH STRATEGY: To identify the appropriate studies, we conducted a search using MEDLINE, EMBASE, SCIENCE CITATION INDEX, AIDSLINE, CINAHL, HEALTHSTAR, PSYCHLIT, SOCIOFILE, SCI, SSCI, ERIC and DAI. We also reviewed both published and unpublished abstracts and proceedings from major international and national HIV/AIDS conferences such as the Intersciences Conference on Antimicrobial Agents and Chemotherapy (ICAAC), the Conference on Retroviruses and Opportunistic Infections (CROI), the Infectious Diseases Society of America Conference (IDSA) and the International AIDS Conference (IAC). Reference lists from pertinent articles and books were reviewed and personal contacts with authors were used, as well as Collaborative Review Group databases. Targeted journals were handsearched for relevant articles. There were no language restrictions. Searches for the original review covered the period from 1980 to July 1999. The first update of this review included an additional search of the literature, followed by identification of included studies that met the inclusion criteria from August 1999 to January 2001. For the second update, we conducted a search to identify additional studies published from February 2001 to August 2003. SELECTION CRITERIA: Studies were included if they were randomized controlled trials (RCTs) comparing aerobic exercise interventions with no aerobic exercise interventions or another exercise or treatment modality, performed at least three times per week for at least four weeks among adults (18 years of age or older) living with HIV/AIDS. DATA COLLECTION AND ANALYSIS: Data on study design, participants, interventions, outcomes and methodological quality were abstracted from studies that met the inclusion criteria onto specifically designed data collection forms by at least two reviewers. Meta-analysis was conducted using RevMan 4.2 computer software on outcomes whenever possible. MAIN RESULTS: A total of 10 studies (six from the original search, two from the first updated search and two from this second updated search) met the inclusion criteria for this review. Main results indicated that performing constant or interval aerobic exercise, or a combination of constant aerobic exercise and progressive resistive exercise for at least 20 minutes, at least three times per week for four weeks appears to be safe and may lead to significant reductions in depressive symptoms and potentially clinically important improvements in cardiopulmonary fitness. These findings are limited to those participants who continued to exercise and for whom there was adequate follow-up data. AUTHORS' CONCLUSIONS: Aerobic exercise appears to be safe and may be beneficial for adults living with HIV/AIDS. These findings are limited by the small sample sizes and large withdrawal rates of the included studies. Future research would benefit from an increased attention to participant follow-up and intention-to-treat analysis. Further research is required to determine the optimal parameters of aerobic exercise and stage of disease in which aerobic exercise may be most beneficial for adults living with HIV.

Adult↗
PubMed1977

Venereal disease education and a selected group of American college students.

Education is considered to be an important factor in the control and possible eradication of venereal diseases. A study was undertaken to discover what effect education had had on a selected group of university students so as to determine suitable avenues for future educational programmes. Many of the schools attended by the students had issued information on venereal diseases; most students considered that this information was useful. The study did not generally show a significant relationship between previous health education, current attitude and behaviour, and the contraction of venereal disease. However, the data did appear to reveal a correlation between the lack of education at junior high school and the acquisition of venereal disease. The university student health service, together with books and pamphlets made available outside the school of classroom, were regarded as being important in venereal disease education. These findings can help those planning venereal disease education for young adults.

Adolescent↗
PubMed2004

Laparoscopic cholecystectomy in acute cholecystitis: indication, technique, risk and outcome.

BACKGROUND: Laparoscopic cholecystectomy (LC) has become the treatment of choice for symptomatic cholelithiasis. However, the laparoscopic approach has remained controversial for patients with acute cholecystitis (AC) because of technical difficulties that, compared with open cholecystectomy (OC), might lead to higher complication rates, particularly common bile duct (CBD) injuries and infection. METHODS: We reviewed recent clinical findings on feasibility, safety and potential benefits of LC in patients with AC. An electronic search using the PubMed and MEDLINE databases was performed using the terms laparoscopic cholecystectomy, open cholecystectomy and acute cholecystitis. Pertinent references from articles and books not identified by the search engines were also retrieved. Relevant surgical textbooks were also reviewed. CONCLUSIONS: The early laparoscopic approach has been shown to be technically feasible and at least equally as safe as the open approach. However, extensive inflammation, adhesions and consequent increased oozing can make laparoscopic dissection of Calot's triangle and recognition of the biliary anatomy hazardous and difficult. Therefore, conversion to OC remains an important treatment option to secure patient safety in such difficult conditions. The question of whether intraoperative cholangiography (IOC) should be used routinely or only selectively has never been resolved. Proponents for each side have put forward compelling arguments.

Cholecystectomy, Laparoscopic↗
PubMed2003

Narrating survival and change in Guatemala and South Africa: the politics of representation and a liberatory community psychology.

Peace accords and international interventions have contributed to the suspension of armed conflict and the censuring of repressive regimes in many parts of the world. Some governments and their opposition parties have agreed to the establishment of commissions or other bodies designed to create historical records of the violations of human rights and foster conditions that facilitate reparatory and reconciliatory processes. This paper explores selected roles that community psychologists have played in this process of remembering the past and constructing new identities towards creating a more just future. With reference to two community groups (in Guatemala and South Africa) we show how efforts to "speak out" about one's own experiences of political and military repression involve complex representational politics that go beyond the simple binary opposition of silencing versus giving voice. The Guatemalan group consisted of Mayan Ixil women who, together with the first author, used participatory action research and the PhotoVoice technique to produce a book about their past and present struggles. The South African group, working within the ambit of the Truth and Reconciliation Commission and in collaboration with the third author and others, explored ways of speaking about their roles in apartheid and post-apartheid society. Although both these initiatives can be seen as moments in on-going struggles to overcome externally-imposed repressive practices that censor the voices of marginalized communities, they also serve to dispel overly romanticized notions of "univocal" communities now liberated to express themselves in an unmediated and unequivocal fashion. The paper discusses how each group of women instead entered into subtly nuanced relationships with community psychologists involving a continual interplay between the authenticity of their self-representational accounts and the requirements of the discursive technologies into which they were being inducted and the material conditions within their sites of struggle. In both cases the group's agenda also evolved over time, so that what emerged was not so much a particular account of themselves, or even the development of a particular "voice" for speaking about themselves, but an unfolding process--for the groups and for the community psychologists who accompanied them--of becoming active players in the postmodern, mediated world of self-representational politics and social struggle.

Culture↗
PubMed1984

[On the concept of "information"].

The recent approaches of generalization of "information" beyond the classical field of communication theory are characterized by explication and by first suggestions of generalized information theories. A critical assessment of the two books "Information I" and "Information II" written by H. VOLZ are given to what extent they may contribute to this discussion. Especially, the new definition of an all-embracing notion of information given in these books is criticized because it seems not to be suited as basis for a generalized theory. In contrast to this, the idea of information as a measure of structural differences between probability distributions in a state space is proposed for mathematical description of specific biological properties in general. In this view, the one distribution is that of the physical possibilities and the other is that which is connected with the realizations by the biological system. The latter consists of the states which are optimal for the function of the biological system. They are selected from the set of physically possible states. As abstract mathematical quantity the statistical entropy of a random experiment is used. Finally it is indicated that this information-theoretical description may contribute to the understanding of the connections between physics, cybernetics, and biology.

Information Theory↗
PubMed1994

Understanding asthma: patient survey.

Eight hundred and two adult patients attending five randomly selected polyclinics in Singapore were interviewed to assess their understanding of asthma. Knowledge of asthma mechanism and its medications was poor with a mean score of 1.4 (median: 1) out of a total score of 6. About a third knew that asthma is due to narrowing of airways and a quarter knew the action of bronchodilators. Only 4.4% (27) knew that steroids decrease airway swelling or inflammation. The best knowledge score was associated with subjects who had the highest education, who had a family history and who had been exposed to pamphlets and books. Incorrect use of prophylaxis was also evident with only one-third (37%) using steroid inhalers regularly as prescribed. Only half (54.5%) of those with no schooling used the correct inhaler technique. Doctors were a source of information for only 49.9% (400) of the patients and it was those with the highest education who were most likely to get information from the doctors. Pamphlets were a source of information for less than one-fifth (16.2%) of the subjects. Greater emphasis should be given to patient education by doctors to help patients understand asthma and its treatment. Important target groups are the older, lesser educated and the moderate or severe patients on steroid inhalers.

Adult↗
PubMed1998

Evaluation of antismoking advertising campaigns.

CONTEXT: Active and passive smoking are the first and third leading preventable causes of death. Many states are running or initiating antitobacco media campaigns. OBJECTIVE: To review research on the effectiveness of different antismoking messages and published evidence of the effectiveness of paid antismoking advertising. DATA SOURCES: Focus group studies conducted by professional advertising agencies that contract with California, Massachusetts, and Michigan to run their antismoking advertising campaigns, the Centers for Disease Control and Prevention's Media Campaign Resource Book, and copies of the advertisements. In total, we reviewed the results of 186 focus groups involving more than 1500 children and adults dealing with 118 advertisements that had actually been aired and additional concept advertisements that were not produced. Published literature was located using MEDLINE and standard bibliographic sources on the effectiveness of large, paid antitobacco media campaigns. We also reviewed reports and studies conducted by, or for, the California and Massachusetts health departments on program effectiveness, and conducted our own comparison of California vs Massachusetts using cigarette consumption data from the Tobacco Institute. STUDY SELECTION: All available studies. DATA SYNTHESIS: Eight advertising strategies to prevent people from starting to smoke and persuading them to stop were reviewed: industry manipulation, secondhand smoke, addiction, cessation, youth access, short-term effects, long-term health effects, and romantic rejection. These focus groups identified strategies that would be expected to be effective and ineffective. Regression analysis was used to compare the cost-effectiveness of the California and Massachusetts programs. CONCLUSIONS: Focus group participants indicated that industry manipulation and secondhand smoke are the most effective strategies for denormalizing smoking and reducing cigarette consumption. Addiction and cessation can be effective when used in conjunction with the industry manipulation and secondhand smoke strategies. Youth access, short-term effects, long-term health effects, and romantic rejection are not effective strategies. More aggressive advertising strategies appear to be more effective at reducing tobacco consumption.

Adolescent↗
PubMed1991

Sources of nutrition information of Chilean schoolers, metropolitan region, Chile, survey 1986-1987.

The purpose of the present study was to determine the relative importance of different sources of nutrition information used by Chilean schoolers to learn the basics of nutrition. In this respect, a representative sample of 4,509 elementary and high-school children was randomly selected and stratified according to grade, sex, type of school and geographic area. Schoolers were individually interviewed in order to collect data related with socioeconomic status (SES) and sociocultural conditions, as well as to learn as to what they considered to be the most important sources of nutrition information influencing their nutritional learning, gathering the necessary data through a questionnaire especially designed for this purpose. Results indicated that 87.8% schoolers mentioned their family (mainly the mother), as the most important source of nutrition information; 10.7% said the school teacher, and 1.5%, mass media (0.8% television, 0.5% books, 0.1% magazines and 0.1% radio) without significant differences by sex, age and geographic area. The role attributed to the family (mother) was important in all SES categories, but proved to be significantly higher in the high SES group (91.9%) than in the low SES group (84.6%). The role attributed to the school teacher, in contrast, was lower (6.7%) in the high SES group than in the low SES group (13.8%) (p less than 0.001). In relation to mass media, the influence attributed to books and magazines was high in the high SES group, but television and radio were more important in the low SES group. On the other hand, significant differences found by type of school were related to SES. These findings could be useful in the establishment of food and nutrition policies, as well as in educational planning focused on the Chilean school population, considering that few studies have been carried out along these lines.

Adolescent↗
PubMedDate not supplied

Combined spinal-epidural technique.

BACKGROUND: For the past 16 years the combined spinal-epidural (CSE) technique has been extensively researched and developed to the point where it is now in widespread use. Along with the use of low-dose mixtures of local anesthetics and opioids, and the introduction of fine-gauge pencil-point needles, CSE is being increasingly recognized as another important addition to the armamentarium of the anesthesiologist. METHOD: One hundred and forty-two publications focusing on the CSE technique, or on questions concerning CSE-related issues, were reviewed. Out of 33 double-blind or controlled studies, 23 directly investigated the CSE technique. Fifty-four prospective studies and letters made directly relevant points on advantages or problems with CSE. Twenty-one book chapters, reviews and editorials were included, 11 of them concerning the use of CSE technique. RESULTS: All CSE techniques which may be used for surgical anesthesia, for analgesia in labor or for postoperative pain management are described. Indications, advantages, disadvantages, and the various methods for performing CSE procedures, including sequential CSE block, are described and reviewed, along with the equipment currently available for their administration. CONCLUSION: The CSE technique offers many potential advantages over continuous epidural or subarachnoid methods alone, including a reduction in drug dosage, the ability to eliminate motor blockade and to achieve highly selective sensory blockade and optimize analgesia. These features hold great promise for minimizing the hazards and side effects of traditional epidural and subarachnoid techniques. Controversial fears, risks, and pitfalls of the CSE technique and of continuous epidural and subarachnoid methods are debated and discussed.

Anesthesia, Epidural↗
PubMed2004

Walter Laing Macdonald Perry KT OBE, Barron Perry of Walton, 21 June 1921 - 17 July 2003.

Lord Perry of Walton died suddenly on 17 July 2003, at the age of 82 years. Walter Laing Macdonald Perry was a native of Dundee, educated at Morgan Academy Dundee, Ayr Academy, Dundee High School and St Andrews University (MB ChB, MD and DSc), winning the Rutherford Silver Medal for his MD thesis and the Sykes Gold Medal for his DSc thesis. After Casaulty Officer and House Surgeon posts in 1943-44, he served as a Medical Officer in the Colonial Medical Service in Nigeria in 1944-46, then briefly as a Medical Officer in the RAF, 1946-47, before embarking on a scientific career on the staff of the Medical Research COuncil at the National Institute for Medical Research from 1947 to 1958, serving as Director of the Department of Biological Standards from 1952 to 1958. Professionally, he achieved MRCP (ED) in 1963 and was elected FRCPE in 1967, FRCP in 1978, FRSE in 1960 and FRS in 1985. In 1958 he came to Edinburgh as Professor of Pharmacology, holding the Chair from 1958 to 1968. During this time he also served as Dean of the Faculty of Medicine (1965-67) and Vice-Principal of the University (1967-68) before leaving to become the inaugural Vice-Chancellor of the Open University in 1968, a post he held until 1980. During this period at the Open University he developed a second distinguish career as a university administrator and a promotor and facilitator of open and distance learning, in which fields he later performed extensive work on behalf of the United Nations. A third career, in politics and public life, began with his ennoblement to a life peerage in 1979, taking the title of Walton in the County of Buckinghamshire, the initial base of the Open University. Latterly Walter sat as a Liberal Democrat, having twice been Social Democratic Party deputy leader in the Lords in the 1980s. He took an active role in the Lords' Select Committee on Science and Technology and held interests in and spoke on many areas of public policy, including fisheries policy. Recognition of his distinguished careers came with a succession of honours; OBE in 1957, Knight Bachelor in 1974 and Baron in 1979; 10 honorary degrees from UK, North American, College London; the Wellcome Gold Medal in 1993 and Inaugural Royal Medal of the Royal Society of Edinburgh in 2000. He was Chairman, President or member of numerous commercial, educational, public interest and scientific bodies. Lord Perry's publications included sole or part authorship of approximately 90 books, research papers and abstracts. Shining through of Walter Perry's careers are strengths of commitment and sheer hard work, rigorous analysis of scientific, educational and organizational problems, experimentation and pursuit of clear objectives. Against scepticism, elitism and ill-informed criticism he drove through the establishment of the Open University. It is today respected internationally, is by some orders of magnitude our largest university in terms of student enrollment and is demonstrably successful outcome from an experiment initiated 40 years ago. It represents a fine monument to Walter Perry.

Biomedical Research↗
PubMed1989

Nutrient analysis methodology: a review of the DINE developmental literature.

In 1986, a collaborative effort among professional associations resulted in the publication of Worksite Nutrition: A Decision Maker's Guide (The American Diabetic Association, 1986). The booklet describes nutrient analysis methodology as a good "promotional gimmick". The development of DINE was an effort to move nutrient analysis from the gimmick level to a viable educational component level. A few examples of the innovative effects of this methodology are (1) individuals' using their own data can learn energy balance by monitoring their food intake and physical activity, (2) individuals can learn the Dietary Goals for the United States (U. S. Senate Select Subcommittee on Nutrition and Human Needs, 1977) and are able graphically to compare how their diet approximates or is different from these goals, and (3) individuals can also learn, from verifications of their own food records, which of their food selections were high in calories, total fat, saturated fat, and cholesterol, and low in complex carbohydrates and dietary fiber. Alternative healthful food choices are identified and the effects of reducing or increasing portion sizes is described. The DINE development team has been working for the past eight years to decrease nutrient analysis variability so that the procedure can be used as an effective independent measure to improve nutritional behavior. Research has been conducted related to database validity and reliability. Formative and process evaluations have been conducted to improve interactive aspects of the software and related manuals and books. DINE procedures have been modified for ease of use, in general, and specifically for elementary students and university students.

Computer-Assisted Instruction↗
PubMedDate not supplied

Activating patients to practice skin cancer prevention: response to mailed materials from physicians versus HMOs.

OBJECTIVES: We investigated whether the source and emphasis of mailed messages about skin cancer would differentially activate patients to initiate skin cancer prevention by calling a toll-free number. METHODS: We mailed a questionnaire to 981 randomly selected patients of a large medical group to assess their concern about and risk for skin cancer: 48 were returned undeliverable (n = 933). The booklet was accompanied by a letter inviting patients to call a toll-free number. Patients received the letter from one of three sources: (1) their physician, (2) their HMO, or (3) a fictitious junk mail organization. Patients received one of three different messages emphasizing the effects of ultraviolet (UV) rays on (1) the risk of skin cancer, (2) aging and wrinkling of the skin, or (3) aging and wrinkling accompanied by a book further emphasizing these harmful effects of the sun. RESULTS: The overall activation rate was low (7%); nevertheless, the source of the preventive message significantly affected whether patients called in. Messages from physicians and HMOs were more activating than messages from the junk mail organization (odds ratio [OR] = 3.40, confidence intervals [CI] = 1.66, 6.97), but messages from physicians were not more activating than messages from HMOs (OR = 1.56, CI = .90, 2.72). The emphasis of the message did not significantly affect call-in rates. Risk for skin cancer was positively associated with patient activation, but attitudes and beliefs about skin cancer prevention were unrelated to activation. CONCLUSIONS: These results should encourage HMOs and physicians to continue their preventive health outreach as one aspect of multicomponent prevention efforts. The results also suggest that HMOs and physicians can activate patients most at risk for skin cancer by emphasizing both risks of cancer and aging and wrinkling when they deliver a skin cancer preventive message.

Adult↗
PubMed2006

Perceptions of eye health in schools in Pakistan.

BACKGROUND: Research exploring children's and their teachers' perceptions of eye health is lacking. This paper reports for the first time on perceptions of primary schoolchildren and their teachers of healthy and diseased eyes, things that keep eyes healthy and damage them, and what actions to be taken in case of an eye injury. METHODS: Using draw and write technique, 160 boys and girls (9-12 years old) attending four primary schools in Abbottabad district, northern Pakistan, were invited to draw pictures in response to a set of semi-structured questions and then label them. Sixteen teachers who were currently teaching the selected students were interviewed one-on-one. RESULTS: Analysis of text accompanying 800 drawings and of the interview scripts revealed that most children and teachers perceived healthy eyes to be those which could see well, and diseased eyes to be those which have redness, watering, dirty discharge, pain, and itching; or those which have "weak eyesight" and blindness. Among things that students and teachers thought damage the eyes included sun, television, and sharp pointed objects, particularly pencils. Teachers noted that children with eye problems "have difficulty seeing the blackboard well", "screw up their eyes", and "hold their books too close". CONCLUSION: We conclude that schoolchildren and their teachers had a good knowledge of eye health, but many of them had serious misconceptions e.g., use of kohl, medicines and eye drops keeps eyes healthy. Kohl is an important source of lead and can reduce children's intelligence even at low blood levels. Health education in schools must take into account children's existing knowledge of and misconceptions about various aspects of eye health. Such steps if taken could improve the relevance of eye health education to schoolchildren.

Art↗
PubMedDate not supplied

[Model for an epidemiological study of the health status of a population of health workers].

The authors describe a model of retrospective research on the state of health in a sample of the staff in a big hospital. The sample was composed of selected sub-groups taken from professional categories notoriously exposed to risk at work. The aim was to help define a model in simple ad versatile epidemiologic research and by applying it to a sample population of health operators, to verify the extent, the prevalence and incidence, the evolution in pathologies in order to make comparisons with the normal population, thus making it easier, for future research, to study casual phenomena and correlate between them. General criteria of retrospective "control case" have been adopted and the anamnestic data gather in has been done by filling in the "health book of individual risk", together with special questionnaires for this investigation. The originality of this work consists in its having abandoned the concept of pre-determine the nature and size of the test sample. In fact, considering the large number of variables, they should have made use of much bigger dimensions than the ones of the population examined with the elaborated original model. Which mean it is possible to obtain significant and reliable results by operating on a reduced but statistically valid sample, chosen with random method and whose entity has been determined with support from others experience in different sector. Therefore it is reasonable to consider the described model as a simple, agile and economic instrument adaptable to other cases, although still to be perfected. In particular it underlines the possibility of testing the state of health of categories at risk before stating complicated analysis (and organi) or big populations, thus improving instruments ad organization. To accomplish a continuous system of data in a short time thus verifying the stages of development and application of more complex projects of epidemiologic research aimed at entire populations. To obtain useful information wherever it's not possible to conduct complete and rapid research on workers' health in an on going way.

Epidemiologic Methods↗