PubMed Health⌕ Search

Biomedical subjects

J Cockburn

Publications and source records attributed to J Cockburn.

At least 37 records · Page 2Linked to original sources
PubMed1997

Predictors of attendance at a relocatable mammography service for rural women.

This study aimed to identify factors that predicted attendance at a relocatable screening mammography service in a rural centre in Victoria. A cohort design was used whereby 180 women from the target population were interviewed by telephone two weeks before the service moved to the area for a 10-week period of operation. Attendance data were ascertained from service records. Fifty per cent of the sample attended the service. Significant predictors of attendance were: mammographic history, with women who reported previous screening mammography being less likely to attend than women who had not had a previous mammogram (odds ratio (OR) 0.38, 95% confidence interval (CI) 0.17 to 0.83); perception of personal risk for breast cancer, with women who perceived at least some risk being more likely to attend than women who perceived no risk (OR 2.73, CI 1.07 to 6.99); stated intention of attending (OR 2.01, CI 1.49 to 2.71); knowing the correct location of the service (OR 3.08, CI 1.37 to 6.89); and education, with higher education being associated with a lower likelihood of attending (OR 0.65, CI 0.44 to 0.96). Our study raised some issues, including the high prevalence of rural women who reported a previous screening mammogram, although BreastScreen services had not previously been available in their area; factors underlying perceptions of personal risk for breast cancer; and the generalisability of our finding of an inverse relationship between higher education and attendance for screening.

Aged↗
PubMed1997

Predictors of returning for second round screening at a population based mammographic screening programme in Melbourne, Australia.

OBJECTIVE: To examine factors associated with returning for second round mammography screening. SETTING: This was a population based mammographic screening programme in Melbourne, Australia. DESIGN: A cohort design was used whereby 668 women were interviewed before the screening programme began and attendance for both first and second round screening was ascertained from programme records. The cohort sample was drawn from two regions of a defined area (close to and distant from the screening centre). MAIN RESULTS: Of the 315 women who attended for first round screening, 75% from the proximal sample and 70% from the distal sample returned for second round screening. Attendance at the second round was predicted by the following: the method of recruitment for first round screening, with women who required a letter of invitation and a reminder being less likely to reattend than those who initially attended in response to a community campaign (OR = 0.34; CI 0.19, 0.61); mammographic history before the initial screen, with women who reported previous diagnostic mammography being more likely to reattend than those who did not (OR = 2.97; CI 1.01, 8.9); stated intention of attending for the initial screen, with those with weakest intention of attending for their first round being less likely to attend for second round (OR = 0.44; CI 0.23, 0.85); and increasing scores on a scale that measured preventive orientation to health (OR = 1.24; CI 1.02, 1.50). CONCLUSION: Our findings corroborate other findings of reduced long term attendance for screening from people who are "reluctant participants" initially.

Aged↗
PubMed1997

Behavioural dynamics of a clinical trial of sunscreens for reducing solar keratoses in Victoria, Australia.

OBJECTIVE: To determine whether the behaviour of participants based on perception of treatment group in a randomised trial contributed to clinical outcome. DESIGN: A double blind randomised controlled trial of the effect of daily application of SPF 17 broad spectrum sunscreen cream (or placebo) on solar keratoses. SETTING: A rural city in Victoria, Australia. Residents aged 40 years or over were invited by letter to attend for a skin cancer screening check. Of these, 588 people with between one and 30 solar keratoses enrolled in the trial and 431 completed the trial, which extended over a six month period that included summer. Participants' perceptions of their treatment allocation, adherence with the treatment regimen, adoption of other sun protection behaviours, side effects, and perceptions of change in condition were measured at two monthly intervals. RESULTS: There were no significant differences between those who completed the study and those that did not for sex, age, treatment group, skin type, number of solar keratoses or correct perception of treatment group. Thirty per cent of those completing the study correctly guessed their treatment allocation, and people were just as likely to be right as to be wrong when they stated their opinion about their treatment allocation (z = 1.04; p = 0.15). Study group, skin type, amount of time spent outdoors, presence of side effects, perceptions of change in skin condition did not significantly predict correct perception of treatment allocation. Multivariate analysis of variance indicated that adoption of other sun protection and adherence with cream use were not significantly affected by actual treatment allocation, correct perception of treatment allocation nor by their interaction. Poisson regression analysis showed a significantly lower difference ratio of solar keratoses in the sunscreen group compared with the placebo base cream group (OR 0.55; CI = 0.46, 0.64), and for women compared with men (OR = 0.76; CI = 0.63, 0.93) but no independent effect of any of the indices of other sun protection or adherence. CONCLUSIONS: A sufficient level of commitment to study procedures was achieved, so that trial participants did not adopt other behaviours that affected treatment outcomes. It is recommended that the potential threat to validity posed by the behaviour of participants be recognised at an early stage in planning of clinical trials, so that strategies to deal with this can be integrated into study protocols.

Adult↗
PubMed1997

An evaluation of educational outreach to general practitioners as part of a statewide cervical screening program.

OBJECTIVES: The purpose of this study was to determine the acceptability, effectiveness, and cost of a face-to-face educational outreach intervention in the context of a program aimed at increasing cervical screening in Victoria, Australia. METHODS: All identified general practitioners in a specified intervention area were offered a visit by a general practitioner educator. Practitioners completed a questionnaire evaluating the acceptability of the visit. Odds ratios for a woman being screened in the 3 months following the visits were determined. RESULTS: Fifty-nine general practitioners (69.4%) accepted the offer of a visit. Most found both the process and the content of the intervention to be acceptable. The intervention and nonintervention regions did not differ either before or after the intervention. In both regions, there was a statistically significant increase in number of Pap tests performed. There was no difference in the change in screening between the two regions. Costs were estimated at Au$34 per general practitioner visited. CONCLUSIONS: This strategy cannot be recommended for widespread use in a cervical screening program.

Adult↗
PubMed1996

Failure of prospective memory after acquired brain damage: preliminary investigation and suggestions for future directions.

This paper investigates the premise that the greater frequency of errors after acquired brain damage will facilitate identification of essential components of successful prospective memory. It examines performance by patients with recent acquired non-progressive brain damage and age-matched control subjects on two experimental measures of prospective memory. A significant different between patients and control subjects arises mainly from performance on a time-based prospective memory task. Results from patients on tests of time- and event-based prospective memory are compared with scores on tests of episodic memory and executive skills. A relationship is identified between event-based prospective memory and retrospective episodic memory but not between time-based prospective memory and executive skills. Premorbid intelligence and current mood state are identified as variables that should be considered when investigating prospective memory under experimental conditions.

Adult↗
PubMed1996

Morphological classification of facial features in adult Caucasian males based on an assessment of photographs of 50 subjects.

Fifty sets of photographs showing facial features of Caucasian males aged 18 to 60 years were examined to establish a morphological classification of the face. It is suggested that such a classification could assist facial identification by photocomparison. The selection criteria stress the importance of interassessor agreement and discrimination among feature subset units in formulating the proposed classification.

Adolescent↗
PubMed1995

Correlation of fornix damage with memory impairment in six cases of colloid cyst removal.

We studied six patients in whom colloid cysts had been removed surgically from the third ventricle. The patients were selected simply by availability for the study, not on grounds of clinically diagnosed amnesia or its absence. The outcomes of operation ranged from one patient who had postoperatively resumed a normal life without complaint of memory disorder at any stage, through four who complained of memory disorder since operation, to one who was so severely amnesic as to require constant supervision. Each patient was given psychometric tests of memory, and was also scanned by magnetic-resonance imaging. One of us examined the six scans and assessed the extent of damage to the fornix, and any other brain damage, in ignorance of the outcomes of the psychometric tests. The fornix in the right hemisphere had been destroyed in all six cases, and all showed evidence of moderate or severe impairment in nonverbal memory. The fornix in the left hemisphere was intact in only one patient; this was the patient who had resumed a normal life without complaint of memory disorder. The left fornix was damaged with some sparing in one further patient, and the remaining four patients showed destruction of the fornix in the left as well as in the right hemisphere. The severity of impairment in verbal memory in these six cases was related to the severity of the damage to the left fornix. No other evidence of brain damage appeared to be systematically related to memory ability. These results add to the evidence that bilateral fornix damage produces amnesia, and that sparing of the left fornix alone is sufficient to ensure a more favourable outcome.

Adult↗
PubMed1995

Task interruption in prospective memory: a frontal lobe function?

Prospective memory involves remembering an intention to do something as well as remembering the content of the task. It also shares common features with executive skills that are argued to be mediated by the frontal lobes. This paper describes performance on tests of prospective memory by a subject with bilateral frontal lobe infarcts and good retrospective memory but who displayed impairments of planning, initiation and inhibition of ongoing behaviour. The results lend some support to the suggestion that separate neuroanatomical pathways underly retrospective and prospective memory. They also indicate dissociable features within prospective memory that may reflect differences in utilisation of attentional resources and inhibitory control mechanisms.

Attention↗
PubMed1995

Performance on the Tower of London test after severe head injury.

Efficient solution of the Tower of London (T of L) test (Shallice, 1982) has been hypothesized to depend on frontal lobe mediation. Performance on the test by 20 patients with severe, diffuse, traumatic head injury was compared with that of control subjects, matched on age and years of education, and, within the patient group, according to broad location of damage (frontal or nonfrontal). Scores were also compared with those obtained on two commonly used tests of frontal lobe function, Verbal Fluency, and the Wisconsin Card Sorting test (WCST). Results indicated that whereas the Verbal Fluency test and WCST discriminated well between patients and control subjects, the T of L test did not, nor did it discriminate well between patients with and without documented frontal lobe damage. However, there were large individual differences in planning and solution times across all subjects. Interpretation of results was complicated by interaction of other variables such as premorbid IQ and duration of posttraumatic amnesia. It is suggested that closer attention to the relation between planning and total times separately for correct and incorrect solutions might be informative. A need for systematic study of the relationship between test performance and everyday behavior is also identified.

Adolescent↗
PubMed1995

Acceptance of screening for colorectal cancer by flexible sigmoidoscopy.

OBJECTIVE: To determine the acceptance rate of screening by flexible sigmoidoscopy in a sample of general practice patients aged 50 to 60, and the acceptability of the procedure among those undergoing the test. SETTING: Recruitment took place in selected general practices in Melbourne, Australia. Flexible sigmoidoscopies were performed at the local public hospital. PATIENTS AND METHODS: 187 patients aged between 50 and 60, and without bowel symptoms, were seen by one of 12 non-randomly selected general practitioners during the study period. At the conclusion of routine consultation general practitioners discussed colorectal screening with eligible patients and recommended that they attend a free screening clinic at the local hospital. The patients who attended the clinic underwent flexible sigmoidoscopy performed by experienced endoscopists. Clinic attenders completed a questionnaire which measured perceptions of the screening visit. RESULTS: The attendance rate was 49%. All clinic attenders were satisfied with the care received at clinic. Sixty five per cent of people experienced either no discomfort or mild discomfort, while 15% of people experienced moderate or severe pain. A bloated feeling was common (80%), with around 36% of people experiencing moderate or extreme bloating. Most people said that they were not at all embarrassed (64%), though 9% reported moderate or extreme embarrassment. Seventeen people (19%) were found to have polyps. CONCLUSIONS: Although the procedure was acceptable to those who underwent the screening test, further research on effective recruitment strategies is required if a full scale flexible sigmoidoscopy screening programme is to be considered feasible.

Age Factors↗
PubMed1995

Public understanding of medical screening.

AIM: To estimate the extent of public understanding of mass screening for disease and of the benefits and limitations of screening. METHODS: Telephone interviews were conducted with a national sample of 835 Australians. RESULTS: Of total respondents, 68% claimed to have heard of screening tests, but only 21% correctly understood that screening tests are for asymptomatic people. This understanding was related to education. The most frequently named tests were mammography (51%) and Pap tests (33%), and for all age groups these were mentioned by more women than men. Around 27% of respondents thought that the Pap test would detect 95% or more of case, 45% thought the test would detect 90% or more, while 60% of respondents thought the test would detect 80% or more of cases. Around 29% of respondents thought that mammography would detect 95% or more of cases, 49% thought the test would detect 90% or more, while 65% of respondents thought the test would detect 80% or more of cases. Of all respondents, 33% favoured compensation when cases were "missed" by screening provided people were warned beforehand, 58% were not in favour, and 9% were unsure. CONCLUSIONS: There are misconceptions among the public concerning the purpose of screening and the accuracy of screening tests. However, most people accept that some cases of disease will be missed by screening and that if people are adequately informed beforehand compensation should not automatically follow for those whose disease is missed.

Adolescent↗
PubMed1994

Early detection of skin cancer. Knowledge, perceptions and practices of general practitioners in Victoria.

OBJECTIVE: To determine the current knowledge, perceptions and practices of general practitioners (GPs) in Victoria in the diagnosis and management of skin cancer. METHOD: A stratified random sample of 666 Victorian GPs was surveyed by postal questionnaire (a colour photographic quiz on 12 examples of benign and malignant skin tumours). RESULTS: GPs were better at recognising the 12 skin tumours as suspicious or benign than they were at providing the correct diagnosis. They were better at providing the correct diagnosis for benign lesions (75%) than for skin cancers (61%) or dysplastic lesions (61%). They had more difficulty in recognising early melanoma than late melanoma and were more likely to manage benign lesions (85%) and dysplastic lesions (34%) than skin cancers (4%). Knowledge of appropriate management was high for GPs who correctly identified tumours. Most perceived skin cancer as an important public and individual health concern. CONCLUSIONS: Overall, GPs had a good knowledge of diagnosis and management of skin cancer and related benign tumours. Several gaps in knowledge and practice were apparent and need specific targeting for educational programs.

Adolescent↗
PubMed1994

A comparative study of the fetal electrocardiogram recorded by the STAN an Nottingham systems.

OBJECTIVE: To compare the T:QRS ratio recorded by the STAN and Nottingham fetal electrocardiogram (FECG) monitors. DESIGN: Prospective observational study. SETTING: London teaching hospital delivery suite and research unit. METHODS AND SUBJECTS: The T:QRS ratios generated by the STAN and Nottingham FECG monitors were simultaneously recorded and compared using signals generated from a computer-produced ECG signal and signals from 11 term fetuses recorded during labour. RESULTS: There was an acceptable level of agreement between the two systems with the computer-generated signals, but it was not clinically acceptable with the signals from the fetuses recorded during labour. Disagreements in the T:QRS values were probably due to differences in the reference points for the measurement of the S-T segment and T-wave height. CONCLUSION: The different points of reference for measurement of S-T segment and T-wave height can explain poor agreement between the two methods of FECG waveform analysis. The suggested adopted points of reference are those corresponding to adult electrocardiographic methodology.

Delivery, Obstetric↗
PubMed1994

Undiagnosed breech.

Explore the source record for details and available documents.

Breech Presentation↗
PubMed1994

Anxiety and errors of prospective memory among elderly people.

Understanding the relationship between age and prospective memory may be increased by studying the distribution and constituents of incorrect responses. Failure to perform the right activity at the right time may manifest itself as an 'error of omission', in which no response is made at the critical moment, or an 'error of commission', in which the intended action is replaced by a related one. These may, in turn, result from breakdown of encoding/storage or from retrieval failure. Which error is made may depend on the nature of the task, the context or the available processing resources of the performer. Responses of a group of elderly people to the appointment item of the Rivermead Behavioural Memory Test were examined for frequency of occurrence of different types of error and their relationship to other variables. Logistic regression analysis was used to explore the contribution made by variables of anxiety, age and current intelligence to performance on the task. The results suggest that the relationship is a complex one, in which there is an inverse relationship between anxiety and intelligence, and error type is differentially related to low and high anxiety and to age.

Age Factors↗
PubMed1994

Psychological consequences of screening mammography.

OBJECTIVE: To examine the psychological consequences at a number of stages in the screening process for women attending a screening mammography programme. SETTING: A pilot mammographic screening programme in Melbourne, Australia. METHOD: The psychological consequences questionnaire (PCQ; a reliable and valid measure of the psychological consequences of screening mammography) was used to measure the emotional, social, and physical functioning of women in a mammographic screening programme and a control community sample. A screening group (in whom no abnormality was detected at initial screen; n = 142) had four measurements: at screening clinic; before results were received; one week after all-clear results were received; and eight months after initial visit. The recall group (who were recalled for further investigation which showed the detected abnormality to be benign; n = 58) had measurements at the same points as the screening group and an additional measurement while waiting at the recall assessment clinic. A randomly selected community control group (n = 52) had measurements one week, two weeks, three weeks, and eight months after consenting to participate. RESULTS: Emotional, social, and physical functioning of women in the screening group did not change over time and at no point differed significantly from that of community controls. The profiles of emotional and physical dysfunction of women in the recall group differed significantly from those of the screening and control groups. The level of emotional and physical dysfunction in the recall group was highest while waiting at recall assessment clinic, and scores were still significantly higher than scores obtained at comparable times from screening and control groups one week after obtaining notification that there was no sign of cancer (emotional P < 0.001; physical P < 0.05). This difference had disappeared eight months after the screening visit, when the level of emotional and physical functioning was similar to that of the screening and control groups. Social dysfunction scores did not change significantly over time and were similar for all three groups. CONCLUSIONS: Given that up to 10% of women are recalled for further investigations on first round screening, significant numbers of women may have psychological consequences. This speaks for the necessity for accurate reading of mammograms to minimise the false positive recall rate, and for counselling services to be available at recall assessment centres.

Attitude to Health↗