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Biomedical subjects

A Elkind

Publications and source records attributed to A Elkind.

10 recordsLinked to original sources
PubMed1990

How district health authorities organise cervical screening.

OBJECTIVES: To examine how district health authorities organised cervical screening with respect to Department of Health guidelines and to determine their assessment of the problems encountered. DESIGN: Postal questionnaire sent to all 190 district health authorities in England in 1989. PARTICIPANTS: 190 District health authorities in England. MAIN OUTCOME MEASURES: Population coverage of screening, quality of smear testing, and follow up of abdominal test results in comparison with national guidelines for district cervical screening services, and problems encountered by districts. RESULTS: Replies were received from 178 (94%) of districts, in 143 of which the person named as responsible for cervical screening contributed. All districts implemented a computer managed scheme, 150 by the target date of 31 March 1988, but not all of these conformed with the guidelines. At the time of the survey only just over half called women in the target age group of 20-64 and only 70% expected to meet the target date of 13 March 1993 for completing the call. Considerable variation was evident among the schemes with regard to how they dealt with issues related to population coverage, quality of testing, and follow up of abnormal results. The problems most commonly identified by the districts (n = 174) were laboratory workload (107, 61%), computer software (104, 60%), availability of resources (78, 45%), non-attendance (77, 44%), rate of opportunistic screening (62, 36%), and investigation and treatment (60, 34%). CONCLUSIONS: Current practice in running cervical screening schemes needs to be examined to determine the extent to which it contributes to the goal of reducing mortality from cervical cancer.

Adult↗
PubMed1990

A pilot study of attendance for breast cancer screening.

Previous research has identified some characteristics related to attendance for breast cancer screening, but few research findings carry practical implications for the optimum organisation of the service. The present study describes the reactions of women attending one of the first breast screening units to be established in the U.K. following government directives. Responses to the invitation to be screened and reasons for attendance suggest ways in which the idea of screening can be conveyed in health education. Practical problems were few, but some negative features of the design of the screening unit and of the experience of being screened were identified. Recommendations for the organisation of breast cancer screening are presented using the typology of factors influencing health behaviour developed by Green et al.

Anxiety↗
PubMed1990

Consumer satisfaction with breast screening: a pilot study.

One hundred and forty-six women registered with a general practice and 84 members of health authority staff, who had attended a breast screening unit by invitation, completed a postal questionnaire about their reactions to screening. The staff of the unit also recorded their observations. The letter of invitation and accompanying health education leaflet were favourably received, and most women were glad of the opportunity offered, although some experienced anxiety. Few practical problems were reported with regard to attending the clinic. In general, the facilities in the clinic were thought to be of a high standard but specific criticisms included problems with access and privacy and feelings of claustrophobia. Some women experienced anxiety or discomfort when the mammogram was being taken, but many favourable comments were made about the helpfulness of staff. Almost all women said that they would return for screening if invited again.

Anxiety↗
PubMed1990

Trends in the organization of cervical cancer screening.

Cervical cytological screening has been available in the UK for several decades, but has not achieved a significant reduction in the incidence of and mortality from cervical cancer. In this paper we describe past problems of cervical screening, discuss the impact of recent innovations to computerize call and recall, and suggest further improvements for the future.

Appointments and Schedules↗
PubMed1989

Computer-managed call and recall for cervical screening: a typology of reasons for non-attendance.

Three pilot studies looked at women who had not attended for cervical screening following a computer-generated invitation to a health authority clinic. From these a typology of reasons for non-attendance for computer-managed screening has been developed, specifying inaccessibility, ineligibility, unsuitability, failure of communications, misclassification and refusal because of practical problems, inappropriate beliefs or attitudinal barriers. Underlying the typology are issues connected with the inaccuracy of the database, service organization and provision, and the characteristics of the women themselves.

Appointments and Schedules↗
PubMed1989

Safety and effectiveness of cranial electrotherapy in the treatment of tension headache.

One hundred patients were enrolled in a multicenter double-blind study to evaluate the safety and effectiveness of the Pain Suppressor Unit, a cranial electrotherapy stimulator for the symptomatic treatment of tension headaches. Treatment consisted of extremely low level, high frequency current applied transcranially. Pain scores before and after 20 minute treatments of individual headaches as well as patient and physician global evaluations were the primary efficacy variables. Following use of the active unit, patients reported an average reduction in pain intensity of approximately 35%. Placebo patients reported a reduction of approximately 18%. The difference was statistically significant (p = 0.01). The active unit was rated as moderately or highly effective in 40% by physicians, and in 36% by patients. Both physicians and patients scored the placebo unit moderately or highly effective for only 16%. The difference in ordered outcomes was statistically significant (p = 0.004). Approximately 10% of patients in each group reported at least one minor adverse experience. Cranial electrotherapy stimulation is distinct from TENS, and is safe and often effective in ameliorating the pain intensity of tension headaches. It should be considered as an alternative to the chronic usage of analgesics.

Adult↗