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Biomedical subjects

M F McCann

Publications and source records attributed to M F McCann.

At least 19 recordsLinked to original sources
PubMed2003

The role of primary healthcare professionals in oral cancer prevention and detection.

AIM: To investigate current knowledge, examination habits and preventive practices of primary healthcare professionals in Scotland, with respect to oral cancer, and to determine any relevant training needs. SETTING: Primary care. METHOD: Questionnaires were sent to a random sample of 357 general medical practitioners (GMPs) and 331 dental practitioners throughout Scotland. Additionally, focus group research and interviews were conducted amongst primary healthcare team members. RESULTS: Whilst 58% of dental respondents reported examining regularly for signs of oral cancer, GMPs examined patients' mouths usually in response to a complaint of soreness. The majority of GMPs (85%) and dentists (63%) indicated that they felt less than confident in detecting oral cancer, with over 70% of GMPs identifying lack of training as an important barrier. Many practitioners were unclear concerning the relative importance of the presence of potentially malignant lesions in the oral cavity. A high proportion of the GMPs indicated that they should have a major role to play in oral cancer detection (66%) but many felt strongly that this should be primarily the remit of the dental team. CONCLUSION: The study revealed a need for continuing education programmes for primary care practitioners in oral cancer-related activities. This should aim to improve diagnostic skills and seek to increase practitioners' participation in preventive activities.

Clinical Competence↗
PubMed2000

The influence of maternal intergenerational education on health behaviors of women in peri-urban Bolivia.

The influence of maternal education on infant mortality has been demonstrated repeatedly in health and social science literature. Less explored is the influence of the education level of the mother's mother. In the present paper the authors examine the possible effect of grandmother's education on maternal behaviors. The relationship between intergenerational education and selected health behaviors, including utilization of health services for prenatal care, breast-feeding and family planning, are reported. The data were collected in peri-urban Santa Cruz, Bolivia among mothers of infants between 0 and 18 months of age. It appears that grandmother's education does exert an effect on health behaviors above and beyond the effect of maternal education. This effect is more pronounced for health services which fall clearly in the domain of the formal health care system. While the results are exploratory, the results suggest the worth of further study and consideration of the influence of mothers' mothers in the design of culturally sensitive quality health services.

Adult↗
PubMed2000

The role of the general dental practitioner in detection and prevention of oral cancer: a review of the literature.

Over the last two decades little progress appears to have been made in reducing the incidence and number of deaths associated with oral cancer. The most recently available Scottish data indicate a steady rise in both incidence of, and mortality rates from, tongue and 'mouth' cancer, supporting previous observations of a steady rise in the incidence of oral cancer since the mid 1970s. Very little improvement in 5-year survival rates for oral cancer has been observed in England and Wales and, over the last 30 years, survival rates in Scotland have actually declined. Although many dentists are committed to examining the mouth for oral cancer, the majority still feel uncomfortable with involvement in patient education. Clearly scope exists for dental practitioners to improve patient awareness of both oral cancer itself and the risk factors associated with the disease. Dental teams should be aware of the opportunities within dental practice to contribute to preventive initiatives--such as smoking cessation.

Adult↗
PubMed2000

A survey of Scottish primary care dental practitioners' oral cancer-related practices and training requirements.

OBJECTIVE: The study sought to investigate current examination habits and preventive practices of Scottish dental primary care professionals, with respect to oral cancer, and to determine any training needs of these practitioners in relation to the disease. BASIC RESEARCH DESIGN: A questionnaire was sent to a random sample of 331 general dental practitioners and community dental officers throughout Scotland, achieving an overall response rate of 68%. MAIN OUTCOME MEASURES: The study investigated examination and health promotion practices in relation to oral cancer. Confidence in, and barriers to, participating in these activities were studied, and information sought both on past training and future education needs regarding oral cancer. RESULTS: Although 58% of respondents reported examining regularly for signs of oral cancer in those aged >16 years, 63% indicated they felt less than confident in detecting oral cancer, with only 43% expressing confidence about discussing suspicious findings with patients. Practitioners were well aware of the importance of smoking and alcohol as risk factors, but had mixed views on the health-promoting role of the dentist regarding these issues. Furthermore, while only 3% reported training on these topics, over half expressed a desire to develop appropriate counselling skills. Overall, 87% and 79% of respondents wanted further training in oral cancer detection and prevention, respectively. CONCLUSION: The study indicated a need for continuing education programmes for dental primary care practitioners in oral cancer-related activities. Postgraduate education, utilising a variety of media formats, should aim to improve diagnostic skills and seek to increase practitioners' participation in both smoking and alcohol counselling.

Alcohol Drinking↗
PubMed1998

From efficacy to effectiveness: selecting indicators for a community-based lactational amenorrhoea method promotion programme.

This paper reviews the results of clinical trials and community studies of lactational amenorrhoea and its role as a contraceptive method (LAM). Indicators which are used in efficacy trials and effectiveness interventions are compared and sets of indicators of effectiveness appropriate to community-based LAM programmes are recommended. A five-tiered ecological framework is used to facilitate selection of indicators which range from individual to policy level outcomes. The indicator framework is intended as a tool for health practitioners in family planning and maternal and child health service delivery settings who are interested in designing programmatic interventions for the promotion of LAM, particularly among less well-educated women of lower socioeconomic communities.

Amenorrhea↗
PubMed1994

Infant feeding in Bolivia: a critique of the World Health Organization indicators applied to demographic and health survey data.

Infant feeding is a multidimensional activity that can be described and analysed in many different ways. The World Health Organization (WHO) has recently issued recommended indicators for assessing infant feeding practices. This paper presents these indicators and demonstrates their applications using the 1989 Demographic and Health Survey (DHS) data for Bolivia. The results indicate that, although most Bolivian infants are breastfed and two-thirds are breastfed for > 1 year, supplementary feeding practices deviate considerably from international recommendations. Only 58% of infants < 4 months old are receiving breastmilk alone (the 'exclusive breastfeeding rate') and a similarly low percentage (54.7%) of 6-9 month olds are receiving the recommended combination of breast milk plus solid or semi-solid foods (the 'timely complementary feeding rate'). Furthermore, almost half of breastfed infants < 12 months old are also receiving bottle feeds. The infant feeding practices of city residents are least likely to conform to the infant feeding recommendations, while practices of mothers who have always lived in the country are most likely to be similar to the WHO guidelines. Mothers who have moved to the city since the age of 12 are most likely to be giving their infants other milks in addition to breast milk and to be bottle feeding their infants. The WHO infant feeding indicators provide a useful framework for quantifying infant feeding practices, and most of the indicators can readily be applied to DHS data. Nonetheless, improvements can be made in both the indicators themselves and the DHS questionnaire to improve reporting of internationally comparable infant feeding information.

Age Factors↗
PubMed1993

Validation of self-report of literacy among periurban women in Bolivia.

Many surveys ask women to rate their literacy level, but the validity of these self-reports is not usually evaluated. In this study of infant health, conducted in Cochabamba, Bolivia, maternal literacy was assessed by the mother herself and by the interviewer, based on the mother's reading a short text aloud. The two ratings were highly correlated (P < 0.001). This finding suggests that maternal self-reports of literacy are very reliable.

Adolescent↗
PubMed1992

Barrier methods of contraception and cervical intraepithelial neoplasia.

This North Carolina-based case-control study examined risk factors for cervical intraepithelial neoplasia (CIN). Cases were 103 women with biopsy-confirmed CIN II or III who were recruited from a referral dysplasia clinic. Controls were 258 family practice patients with normal cervical cytology. All subjects were interviewed regarding their sexual and reproductive history, Pap smear screening, active and passive cigarette exposures, and contraceptive use patterns. When compared with controls, cases were half as likely to have ever used barrier methods of contraception; the adjusted odds ratio was 0.5 (95% CI 0.2-0.9). The risk of CIN II/III decreased further with increasing years of barrier method use. Recency, latency, and age at first barrier method use were all associated with a reduced risk of CIN. Men and women should carefully consider the range of benefits of barrier method use as a means to reduce their risk of unwanted pregnancies, sexually transmitted diseases, and cervical neoplasia.

Adult↗
PubMed1992

Oral contraceptive use and cervical intraepithelial neoplasia.

To explore the somewhat controversial relationship between oral contraceptives and pre-invasive cervical cancer, 103 cases of biopsy-confirmed cervical intraepithelial neoplasia (CIN) II or CIN III were compared with 258 controls who had normal cervical cytology. Cases were slightly less likely than controls to have ever used oral contraceptives; the odds ratio, controlling for age, socioeconomic status, barrier method use, smoking history, age at first sexual intercourse, number of sex partners, current marital status, and number of Pap smears, was 0.7 (95% CI 0.3-1.6). Recency, latency, duration, and age at first oral contraceptive use were evaluated and in no instance was oral contraceptive use positively associated with CIN. This study adds to the body of knowledge that oral contraceptives are not associated with pre-invasive cervical cancer. Further, if oral contraceptive users continue to be regularly screened, their risk of developing the more invasive lesions should be very low.

Adolescent↗
PubMed1992

Occupational and environmental hazards in art.

Artists and craftspeople, art teachers, hobbyists, and children often use art materials containing toxic chemicals without suitable precautions and often without the knowledge that their art materials are hazardous. The Center for Safety in the Arts, a national clearinghouse for research and education on hazards in the visual and performing arts, answers telephoned and written inquiries on art hazards, distributes publications, publishes a newsletter, and offers educational programs and consultative services to arts organizations.

Environmental Exposure↗
PubMed1992

Maternal and infant feeding practices in rural Bolivia.

Seventy-four members of mothers' clubs in a rural area outside of La Paz, Bolivia, were interviewed in order to learn more about maternal and infant nutritional practices and use of child health services. Most of the women used a combination of western and traditional child health services, though a substantial percentage used only traditional services. Almost all of their deliveries were attended solely by family members, most notably the pregnant woman's husband. All the interviewed mothers breast-fed their infants, although most gave them other prelacteal liquids in the immediate postpartum period. Breast milk supplementation generally began when the infants were between four and eight months old, occasionally later. Most of those interviewed said they stopped breast-feeding when they knew they were pregnant again; some continued breast-feeding through all or part of the pregnancy; only a small number stopped breast-feeding before they knew that they were pregnant. Almost all the women increased their food intake when they were breast-feeding, primarily by consuming additional liquids. These findings suggest that some current maternal and infant nutritional practices in the study area (such as universal breast-feeding and increased consumption of liquids by lactating mothers) should be encouraged, while others (particularly prelacteal feeding of liquids other than breast milk and late supplementation) should be discouraged. Both traditional and western health providers should be mobilized to perform this task.

Adult↗
PubMed1989

An epidemiologic study of contraception and preeclampsia.

The primary hypothesis of this study was that contraceptive methods that prevent exposure to sperm and seminal fluid (condoms, diaphragms, spermicides, withdrawal) are associated with an increased risk of developing preeclampsia during the subsequent pregnancy. A case-control study was conducted comparing the contraceptive and reproductive histories of 110 primiparous women with preeclampsia with 115 pregnant women without preeclampsia, aged 15 to 35 years, who gave birth at North Carolina Memorial Hospital, Chapel Hill, between 1984 and 1987. Controls were frequency matched to cases by age, race, and distance from the hospital. Unconditional logistic regression analysis indicated a 2.37-fold (95% confidence interval, 1.01 to 5.58) increased risk of preeclampsia for users of contraceptives that prevent exposure to sperm. A dose-response gradient was observed, with increasing risk of preeclampsia for those with fewer episodes of sperm exposure. These results were supportive of the hypothesis that birth control methods that prevent sperm exposure may play a role in the etiology of preeclampsia.

Adolescent↗
PubMed1989

The effects of a progestin-only oral contraceptive (levonorgestrel 0.03 mg) on breast-feeding.

This study was a non-randomized clinical trial which compared the breast-feeding experience of 250 Argentine women taking levonorgestrel 0.03 mg daily (begun one week after delivery) with that of 250 women using non-hormonal contraceptives. Weight gain of unsupplemented infants, the most important of the several criteria used to assess breast-feeding performance, was similar for the two contraceptive groups. Levonorgestrel users began supplementary feeding of their infants significantly later than did non-hormonal users; levonorgestrel users were also somewhat less likely to discontinue breast-feeding during the study period. The two contraceptive groups were similar with regard to several other measures of breast-feeding performance: growth of all infants (regardless of supplementation), patterns of contraceptive discontinuation, mothers' subjective impressions of breast-milk sufficiency, and comparison of supplementation initiation with previous experience.

Adult↗
PubMed1983

Effects of breastfeeding on IUD performance.

The effect that lactation might have on intrauterine device (IUD) performance was investigated by using data from a series of multicenter clinical trials. Life-table methods were applied to compare breastfeeding and non-breastfeeding women with respect to IUD expulsion, accidental pregnancy, IUD removal for various reasons, and overall continuation of IUD use. Results indicate that breastfeeding does not increase the risk of expulsion or other events, whether the device is inserted immediately (within ten minutes) or more than 42 days after delivery. (Am J Public Health 1983; 73:384-388.)

Age Factors↗
PubMed1980

A clinical trial of Neo Sampoon vaginal contraceptive tablets.

Results are reported of a clinical trial of Neo Sampoon vaginal contraceptive tablets, conducted by the International Fertility Research Program (IFRP) in collaboration with the Dacca Medical College Hospital, Bangladesh. Of the 150 women enrolled, 115 remained in the study at the end of 12 months. The 12-month cumulative gross life-table rates per 100 women were 6.5 for pregnancy and 24.8 for discontinuation due to other reasons. Discomfort associated with the heart generated by the tablets' effervescence was the primary side effect of Neo Sampoon use, and was one of the major causes of discontinuation. Regularity of use and acceptability of this foaming tablet appeared to be high compared to other barrier methods. Further research is needed on Neo Sampoon and other vaginal contraceptives to develop and promote methods that can help meet the worldwide demand for fertility control.

Actuarial Analysis↗