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Biomedical subjects

A Amos

Publications and source records attributed to A Amos.

At least 19 recordsLinked to original sources
PubMed2005

Determinants of false positive recall in an Australian mammographic screening program.

We conducted a case-control study (n=30128) to assess the importance of clinical (e.g., family history, age, hormone replacement therapy (HRT) use and duration) and service-related characteristics (e.g., time since introduction of Kodak MINR2000 film, year of screen) for false positive (FP) recall at BreastScreen Victoria, Australia. There was an age-adjusted upward trend in FP recall rates with year of screen at first (odds ratio (OR) 1.11, 95% confidence interval (95% CI) 1.08-1.13) and subsequent rounds (OR 1.04, 95% CI 1.01-1.06). In the multivariate analysis, the upward trend only remained for first round and age and family history also remained statistically significant at first round. At subsequent rounds the time since introduction of MINR2000, age, strong family history of breast cancer, use of HRT, recall at previous screen and previous screen at more than 27 months were all important predictors of FP recall. The rise in FP rates with year of screen at first round screening is of concern and may require further training of radiologists to improve confidence when viewing films when there a no films for comparison.

Age Factors↗
PubMed2003

Evaluation of the organised mammographic screening programme in Australia.

An organised approach to mammographic screening in Australia commenced in 1992 as a free service for asymptomatic women in the target age range 50-69 years and accessible to all women aged >/=40 years. Screening is performed by two-view mammography, women aged 50-69 years being sent reminders every 2 years for repeat screens. National Accreditation Standards have been agreed and BreastScreen Australia has developed mechanisms to monitor and report performance including systems and standards for data collection. The national report includes participation rates, small cancer detection rates and programme sensitivities. These indicate that BreastScreen Australia is meeting its accreditation standards with respect to most measures. Routinely collected outcome data reflect an increasing trend in the proportion of women receiving breast conserving surgery; a decline in the proportion of women diagnosed with ductal carcinoma in situ undergoing axillary dissection and an increasing use of combination therapies with a corresponding decrease in the use of hormonal therapy alone. There have been increases in breast cancer incidence and falls in mortality with the largest changes in women aged 50-69 years. As the BreastScreen Australia database is routinely linked in future to population cancer registries, the mortality reduction due to mammographic screening may be estimated more precisely.

Age Distribution↗
PubMed2001

"They're doing people a service"-qualitative study of smoking, smuggling, and social deprivation.

OBJECTIVES: To examine the behaviour and attitudes related to smoking and contraband tobacco products among smokers in two socially deprived areas. DESIGN: Cross sectional study with qualitative semistructured interviews, augmented by smokers' day grid. SETTING: Two areas of socioeconomic deprivation in Edinburgh. PARTICIPANTS: 50 male and 50 female smokers aged 25-40 years randomly selected from general practitioners' lists from two health centres, each located in an area of deprivation. RESULTS: Most smokers wanted to quit but felt unable to because of the importance of smoking in their daily routine and their addiction to nicotine. Strategies for maintaining consumption levels in the face of increasing cigarette prices and low income included purchasing contraband cigarettes and tobacco. Vendors were contacted through social networks, family, and friends as well as common knowledge of people and places, particularly pubs where contraband was available. Most users of contraband considered that smugglers were providing a valuable service. Purchasing contraband tobacco was viewed as rational in the face of material hardship. Many smokers criticised the government for its high tobacco taxation and the lack of local services to help them to stop smoking. CONCLUSIONS: Smokers in deprived areas perceive a lack of support to help them to stop smoking. Cigarette and tobacco smuggling is therefore viewed positively by low income smokers as a way of dealing with the increasing cost of cigarettes. Smokers in areas of deprivation may thus show little support for tackling smuggling until more action is taken to deal with the material and personal factors that make it difficult for them to quit.

Adult↗
PubMed2000

A computational model of information processing in the frontal cortex and basal ganglia.

Performance on the Wisconsin Card Sort Test (WCST) of patients with schizophrenia, Parkinson's disease (PD), and Huntington's disease (HD) was simulated by a neural network model constructed on principles derived from neuroanatomic loops from the frontal cortex through the basal ganglia and thalamus. The model provided a computational rationale for the empirical pattern of perseverative errors associated with frontal cortex dysfunction and random errors associated with striatal dysfunction. The model displayed perseverative errors in performance when the gain parameter of the activation function in units representing frontal cortex neurons was reduced as an analog of reduced dopamine release. Random errors occurred when the gain parameter of the activation function in units representing striatal neurons was reduced, or when the activation level was itself reduced as an analog of a striatal lesion. The model demonstrated that the perseveration of schizophrenic, Huntington's, and demented Parkinsonian patients may be principally due to ineffective inhibition of previously learned contextual rules in the frontal cortex, while the random errors of Parkinson's and Huntington's patients are more likely to be due to unsystematic errors of matching in the striatum. The model also made specific, empirically falsifiable predictions that can be used to explore the utility of these putative mechanisms of information processing in the frontal cortex and basal ganglia.

Basal Ganglia↗
PubMed1999

Continuities and changes: teenage smoking and occupational transition.

Rates of cigarette smoking among young people in the U.K. remain high and may be increasing. However, few studies have explored smoking behaviour during the mid- to late teens. This paper reports the third wave of a longitudinal study that followed 106 15-year-olds from their last compulsory year at school for 22 months. Using a mixture of qualitative and quantitative methods, the study shows that this is a period of considerable flux in smoking behaviour. Becoming a regular smoker is not a straightforward progressive process. The role of friendship groups and social context is highlighted. Smoking prevention programmes should be developed to meet the needs of young people in this transitional period.

Adolescent↗
PubMed1998

Health related behavioural change in context: young people in transition.

Post-modern theorists have highlighted the impacts of rapid social and economic change in lessening structural constraints, arguing that the concepts of "gender" and "social class" are now less useful in understanding people's life chances and choices. While the epochal nature of such changes has been questioned, increasing levels of individualisation and reflexivity have been widely recognised. Agency is prioritised and structural disembeddedness increasingly assumed: people are held to construct their identities and biographies reflexively from a diverse range of experiences and opportunities. When used in relation to understanding health related behaviours this theorising has led to an increasing focus upon the symbolic significance of consumption (and indeed risk) in defining lifestyles and identities. Here we report on the health related behaviours of 106 young people (15/16 yr) during their transition from school to employment, training or further education. This period is arguably central in the process of creating adult identities and accordingly should involve considerable lifestyle choice, reflexivity and symbolic consumption as identities are formed. By drawing on two rounds of data (semi-structured interviews and structured questionnaires) we consider how smoking and drinking behaviours related to the wider social transitions towards adulthood. We provide a situated account of health related behaviours which acknowledges both subjective experience and social location. We argue that the current challenge is to integrate the different levels of structural constraint and individual agency within the context of current rapid social and economic change and suggest that it is only through empirical investigation which embraces an analysis both at the level of structure and individual experience that the conditions of late modernity can be more thoroughly understood.

Adolescent↗
PubMed1997

Girls, pecking order and smoking.

Against a background of growing concern about the failure to reduce cigarette smoking amongst young people, particularly girls, this paper attempts to unravel the complex interrelationships between smoking, peer group structure and gender. We were particularly intrigued to explore a recent hypothesis in the literature that suggests that girls who smoke, far from lacking self-esteem, are more self-confident and socially skilled than their non-smoking peers. Sociometric and qualitative analyses revealed that smoking behaviour was indeed shaped by gender, and that the psychosocial processes involved in smoking uptake may be different for boys and than for girls. Peer group structure, consistently described by young people as hierarchical, was closely related to smoking behaviour. Girls at the top of the social pecking order who projected an image of high self-esteem were identified as most likely to smoke, while only a small minority of girls fitted the stereotype of the young female smoker who has poor social skills and low self-esteem. Boys of high social status were less vulnerable, since sport and a desire to be fit to some extent protected them. Our findings raise fundamental questions about the meaning of self-esteem in relation to smoking uptake, arguing instead for an exploration of the term "self-worth". They suggest the need for health education programmes which are sensitive both to gender and to peer group structures.

Adolescent↗
PubMed1997

Healthy or druggy? Self-image, ideal image and smoking behaviour among young people.

Recent research indicates that there is an important, though complex, relationship between the social image of smoking and young people's self- and aspirational images. This study explored how young people see themselves (self-image), how they would like to be (ideal image), and whether these differ according to age, gender and smoking status. Focus groups were used to elicit attributes which young people use to describe smoking and non-smoking images taken from fashion pages in youth magazines. These attributes were incorporated into a self-completion questionnaire which was administered to 897 young people from three age groups (12-13 years, 15-16 years and 18-19 years). The respondents rated their self- and ideal images on each of these attributes. Overall, there were few differences between the rank order of attributes by age, sex or smoking status. However, there were differences in the trait scores, with males and smokers tending to rate themselves more positively. The two traits which most clearly differentiated smokers and non-smokers were druggy/takes drugs (self- and ideal image) and healthy (self-image). It appears that smokers in general, and male smokers in particular, embraced certain dimensions of self- and aspirational image of which druggy, tough and tarty are signifiers. In contrast, the differences between female smokers and non-smokers were less consistent and differed with age. The implications for health promotion are discussed.

Adolescent↗
PubMed1996

Women and smoking.

Smoking kills over half a million women each year and is the most important preventable cause of female premature death in several developed countries. However, in many countries, cigarette smoking still tends to be regarded as a mainly male problem. This paper explores the reasons why more attention needs to be paid to issues around smoking and women, even in countries which currently have low levels of female cigarette smoking. The article includes an overview of current patterns and trends of smoking among women, and the factors which influence smoking uptake and cessation in women compared to men. The experience of countries with the longest history of widespread female smoking is used to identify some of the key challenges facing developed and developing countries. Tobacco companies have identified women as a key target group, therefore particular attention is given to the ways in which they have attempted to reach women through advertising and other marketing strategies. It is concluded that in order to halt and ultimately reverse the tobacco epidemic among women, tobacco control policies need to encompass both gender-specific and gender-sensitive approaches. Examples are given of the types of action that are needed in relation to research, public policy and legislation, and education.

Adolescent↗
PubMed1995

Is a telephone helpline of value to the workplace smoker?

This paper reports the findings of the evaluation of a national smokers' helpline which was set up by British Telecom (BT) for its employees. The helpline formed part of a new comprehensive smoking policy for all BT staff. Over 1000 employees, more than 3.0% of all smokers, phoned the helpline during the first three months of its operation. Two-thirds of callers tried to quit smoking after calling the helpline, and a quarter were still successful three months later. One in six callers reduced the number of cigarettes that they smoked on working days. While the helpline and other cessation support services were evaluated positively by callers, it appears that helplines only appeal to a small minority of smokers. However, they do seem to be an effective mechanism for a nationwide company to identify those smokers who want support, and a useful means of centralizing the administration of support services. They are potentially a cost-effective option for larger employers.

Adolescent↗
PubMed1995

Assessing personal process learning in a health promotion module for medical students.

This paper describes the development and evaluation of an assessment method for personal process learning in a student-centred health promotion module. Personal process learning refers to students' awareness and understanding of their learning about personal values and attitudes, their skills for planning change, and their communication skills. The assessment forms part of the professional examination in public health. The paper documents and critically reviews the assessment method in the light of student feedback. The problem of student acceptability is highlighted and we describe the adjustments that have been made in response to this and how they have been received. It is concluded that medical students are open to innovative forms of assessment as long as they perceive them to be valid, fair and equitable.

Adult↗
PubMed1994

Annual recertification: fun? Wow!

Learning is critical to fostering a knowledge base required for maintaining currency and furthering professional development. In the ever-changing field of nephrology, most skills practised in nursing are considered to be sanctioned medical acts or added nursing skills. Therefore, annual recertification of the skills designated as sanctioned medical acts is an expectation of the College of Nurses of Ontario. The Wellesley Hospital policy indicates one time only or annual approval of the added nursing skills. The article will discuss the use of games as a creative, non-threatening educational tool in the recertification/re-approval process currently in place at The Wellesley Hospital, renal programs. In the past two years, several games or alternative teaching strategies have been utilized to assist the staff in preparing for recertification. This paper will examine the advantages and disadvantages of utilizing alternative teaching formats. Commentary regarding the response of staff nurses, nursing management and education will be highlighted.

Certification↗
PubMed1991

Cigarette advertising policy and coverage of smoking and health in British women's magazines.

A survey of cigarette advertising and coverage of health aspects of smoking in 86 British magazines with a large female readership was done in 1989. The findings were compared with the results of a 1985 survey which had led to the introduction of new voluntary restrictions in 1986 on cigarette advertising in magazines. Although there was a decrease in the proportion of magazines accepting cigarette advertising (64% to 42%), the new restrictions failed to cover the most popular magazines, so that an estimated collective readership of 7 million women aged 15-24 years were still exposed to cigarette advertising. Revenue from cigarette advertising by women's magazines increased by 10% in real terms between 1985 and 1988. There was a small decrease in the coverage given to health aspects of smoking; a third of magazines were willing to use pictures of people smoking in their editorial pages. The findings show that the voluntary restrictions introduced in the UK in 1986 have had a small effect on cigarette advertising and have failed to achieve their aim of protecting young women.

Adolescent↗
PubMed1991

A comparison of the consistency of self-reported behavioural change within a study sample--postal versus home interviews.

Much health promotion research is directed towards increasing our understanding of the process of health-related behavioural change. However, little is known about the validity of self-reported changes in behaviour. This study aimed to assess the validity of self-reported changes in five behaviours--diet, cigarette smoking, alcohol consumption, weight control and physical activity--by comparing reports obtained from the same people through postal questionnaires and face-to-face interviews. It was found that overall there was a consistency between self-reports with interviewers confirming that in most cases change had taken place. However, in a large number of cases changes were reported that had occurred before the period specified in the questionnaire. The nature of the change, whether discrete or incremental, as well as the behaviour in question, were found to be related to the accuracy of self-reporting. The possible reasons for the observed discrepancies are discussed.

Adolescent↗