Biomedical subjects

M J Schofield

Publications and source records attributed to M J Schofield.

31 records · Page 2Linked to original sources

PubMed1996

How to prepare cancer patients for potentially threatening medical procedures: consensus guidelines. NSW Cancer Council Cancer Education Research Program.

BACKGROUND: Cancer patients face a frightening array of potentially threatening medical interventions. While the need to prepare patients for such procedures is widely acknowledged, there have been few attempts to clearly specify in detail what adequate preparation entails. METHODS: This study sought to develop a set of guidelines on how to prepare cancer patients for potentially threatening medical procedures. These guidelines were extensively reviewed and modified by a consensus panel of experts. The guidelines were then rated by 101 cancer patients. RESULTS AND CONCLUSIONS: These ratings led to further modification of the guidelines, the final version of which was developed into a training module for junior medical officers in New South Wales.

Adaptation, Psychological↗

PubMed1996

Smoking on hospital grounds and the impact of outdoor smoke-free zones.

OBJECTIVES: To describe the type and location of smokers on the grounds of smoke-free public hospitals and to observe the impact of introducing smoke-free signs in outdoor areas of the hospital grounds. DESIGN: Observation study of outdoor smoking behaviour before and after the introduction of outdoor smoke-free signs at one hospital (H1) and at the same two time periods at a nearby control hospital (H2), which already had some outdoor smoke-free signs at Time 1. SETTING: The John Hunter Hospital (H1) in Newcastle, Australia and a nearby control hospital, Maitland Hospital (H2) in 1991. SUBJECTS: All people in defined outdoor sites of the two hospitals on seven randomly selected days over two weeks before and after the policy change were coded as either "smoker" or "non-smoker" and as either "staff", "patient", or "visitor". The number of smokers observed in each site was measured as a proportion of all smokers observed on the grounds of that hospital. INTERVENTION: Introduction of outdoor smoke-free zones and signs at H1. RESULTS: Less than 10% of observed outdoor smokers in both hospitals were patients, 40% were visitors, and more than 50% were staff. Of outdoor smokers, 82% were observed less than 10 m from entrances to the hospital building at time 1. After the introduction of signs in H1, a 4-percentage point decrease (P < 0.05) occurred in the percentage of smokers observed in smoke-free zones at time 2 (from 32% to 28%), compared with a 2-percentage point decrease (P > 0.05 at time 2 in H2 (from 48% to 46%). DISCUSSION: This observation study of smoking behaviour in hospital grounds highlights the need to reduce smoking among staff and visitors near hospital entrances. Specific strategies are discussed, which are likely to enhance compliance and hence enable the effective introduction of smoke-free policies on hospital grounds.

Hospitals↗

PubMed1995

Community attitudes to bans on smoking in licensed premises.

Information about public attitudes to the restriction of smoking in licensed premises could provide an impetus for a campaign to address the failure of the industry to improve the health of its employees and the public. A probability sample of 816 people was surveyed to determine community attitudes to the introduction of bans on smoking in licensed premises. A total ban on smoking was supported by 20 per cent and provision of special smoking areas by 65 per cent, and 15 per cent wanted no bans. More-educated people, white-collar workers, nonsmokers and those who went to licensed premises less than weekly were more likely to support bans than were the less educated, blue-collar workers, smokers, and those who went to licensed premises at least weekly. The less educated, smokers and those who went to licensed premises at least weekly were most likely to perceive that the introduction of smoking bands would reduce their patronage of licensed premises. Nonsmokers and those with more than 12 years of education were more likely to report that their patronage would increase if bands were introduced than were smokers and the less educated. The introduction of bans on smoking in licensed premises would result in only a small loss of patronage after accounting for potential increases from supporters of bans. The effect of the bans is likely to be felt most strongly among the less educated, smokers and regular patrons.

Adolescent↗

PubMed1995

What are women told about Pap smears that lack endocervical cells?

BACKGROUND: Debate exists about the definition of what constitutes an adequate Pap smear and about the recommended rescreening interval for Pap smears lacking an endocervical component. This study aimed at determining whether women are currently informed about the endocervical status of their Pap smears and what rescreening recommendations are made to women whose smears lack endocervical cells. METHOD: Consecutive Pap smears lacking an endocervical component were identified from pathology records. After obtaining consent from the referring doctor, 165 women were interviewed by telephone. RESULTS: Only 110 (67%) of 165 women received active notification of their Pap test result and only six (4%) were aware that their smear lacked endocervical cells. Thirteen (8%) had been advised to have a repeat smear within three months. Nearly half the women reported that they would like more information about their result. CONCLUSIONS: It seems that current Pap smear notification patterns for women in New South Wales could be improved. One third are not actively informed at all about their results, and few are given detailed information about their Pap test results. Methods of enhancing the level of information women are given about their medical and screening tests need to be improved.

Adult↗

PubMed1995

Responsiveness of the corpus luteum of the rhesus monkey (Macaca mulatta) to gonadotrophin in vitro during spontaneous and prostaglandin F2 alpha-induced luteolysis.

The ability of luteal tissue from rhesus monkeys, collected from spontaneous and prostaglandin F2 alpha (PGF2 alpha) induced luteolytic cycles, to secrete progesterone in response to hCG or dibutyryl cAMP in vitro was assessed. It was expected that the corpus luteum exposed to PGF2 alpha would behave in a similar manner to the corpus luteum of normal cycles undergoing luteal regression. PGF2 alpha (10 ng microliters-1 h-1) or vehicle (1 microliter h-1) was infused into the corpus luteum from 7 days after the preovulatory oestradiol surge. Lutectomy was performed at 2, 3 and 4 days after the start of the intraluteal infusion and at menses. Luteal progesterone content was determined and the secretion of progesterone in response to hCG (10 miu ml-1) or dibutyryl cAMP (5 mmol l-) was evaluated in vitro. A third group of monkeys underwent lutectomy sequentially during the luteal phase and were grouped by luteal age from days after the preovulatory oestradiol surge: early luteal (days 4-6), mid-luteal (days 7-9), late luteal (days 10-14) and menses. Immediately before luteal excision, an ovarian venous blood sample was taken for progesterone determination. Approximately 2-5 mg of minced luteal tissue was incubated at 37 degrees C in 2 ml of Krebs-Ringer bicarbonate buffer for 2 h in the presence or absence of hCG or dibutyryl cAMP.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

Notification and follow-up of Pap test results: current practice and women's preferences.

BACKGROUND: This study aimed to determine women's knowledge of their Pap test results and predictors of accurate knowledge, adherence to follow-up recommendations for abnormal results, current methods of notifying women about their Pap test results, women's preferences for notification method, and women's satisfaction with the current notification system. METHOD: A telephone survey was undertaken of 315 women with a recent normal or abnormal Pap test result, drawn from pathology records in Sydney, Australia. RESULTS: Findings revealed that 61% of women with a normal result and 93% of women with an abnormal result self reported having been notified about their result. According to women's reports, 7% of those with abnormal results had not been notified and a further 11% of women with abnormal results were unaware that their result was abnormal, giving a total of 18% of abnormal results not communicated adequately to women. Self-reported adherence with follow-up recommendations among women with an abnormal result was less than optimal. The most common methods of notifying women of their results were initiated by the women such as the woman phoning the doctor or receptionist. However, women strongly preferred doctor-initiated methods, such as a written record from the doctor, the doctor phoning the woman, or consultation with the doctor. CONCLUSION: Results suggest that better methods of notifying and educating women about their Pap test results are necessary to improve women's knowledge and satisfaction and, even more importantly, to improve their level of adherence with follow-up recommendations for abnormal results.

Adult↗

PubMed1994

Alcohol sales to minors: a surrogate study.

BACKGROUND: Legislation is a potentially important health promotion strategy to control the consumption of tobacco and alcohol by minors. Effectiveness of such laws may depend on the extent of which laws are adequately drafted, implemented, and enforced. However, studies of adherence with laws banning the sale of cigarettes to minors indicate low levels of enforcement. As a comparison, this study investigated adherence of alcohol retailers to legislation banning the sale of alcohol to minors in New South Wales, Australia. The aim was to determine the proportion and characteristics of alcohol retail outlets which sell alcohol to apparently underage youth. METHOD: Eight 18-year-olds who were judged by independent raters to look younger than the legal age attempted to purchase alcohol from 168 alcohol retail outlets (hotels, registered clubs, and bottle shops), in a nonmetropolitan region of New South Wales. RESULTS: No challenge about age was made for 68% of purchases. Youth were asked their age on 8% of occasions and proof of age was required on only 24% of occasions. Display of a warning sign was not associated with being required to show proof of age, nor was gender or dress of the buyer (casual clothes vs school uniform). Bottle shops were more likely to require proof of age than hotels or clubs. CONCLUSIONS: The results suggest that the implementation of legislation banning the sale of alcohol to minors is currently inadequate and that new efforts are needed to discourage the sale of alcohol to minors.

Adolescent↗

PubMed1994

Response of serum cytokines in patients undergoing laparoscopic cholecystectomy.

The clinical observation that a laparoscopic cholecystectomy is a minimally invasive operation has not been demonstrated on a biochemical basis. Interleukin-6, a known endogenous pyrogen and hepatocyte-stimulating protein, correlates with the significance of surgical trauma. Utilizing the IL-6 immunoassay, we studied this biochemical parameter of trauma to compare its response in laparoscopic vs open cholecystectomy. Sixteen patients who underwent only laparoscopic cholecystectomy showed peak IL-6 concentrations of 51 pg/ml (22-86) vs a peak IL-6 concentration of 124 pg/ml (56-225) for open cholecystectomy. Six additional patients who underwent an ERCP followed by laparoscopic cholecystectomy showed a dramatic rise in peak IL-6 concentration to 315 pg/ml (15-634). These results biochemically confirm the true minimal invasiveness of laparoscopic cholecystectomy. The findings in the ERCP-followed-by-laparoscopic-cholecystectomy group support the theory that two invasive procedures in close proximity may prime the cytokine system in its response to surgical trauma.

Blood Loss, Surgical↗

PubMed1993

Smoking control in restaurants: the effectiveness of self-regulation in Australia.

OBJECTIVES: The provision of smoke-free areas in restaurants has been a controversial issue; the restaurant industry largely opts for a self-regulation approach. This study aimed to examine the effectiveness of self-regulation as a strategy in meeting the industry's and customers' perceived needs. METHODS: Restaurateur and customer perspectives on the provision of smoke-free areas in restaurants were examined by survey among 365 restaurateurs and 1327 customers in New South Wales, Australia. RESULTS: Less than 2% of restaurants were totally smoke-free; 22% provided some smoke-free areas. Customers were much more likely than owners to think that smoke-free areas should be provided. Owners appeared to be unaware of customers' views about smoke-free areas in restaurants. CONCLUSIONS: Little evidence was found to support the effectiveness of the self-regulation policy adopted by the restaurant industry. Characteristics of restaurants and owners associated with the provision of smoke-free areas are presented and implications of the findings are discussed.

Attitude↗

PubMed1992

Availability of cigarettes to minors.

Legislation banning the sale of cigarettes to minors is potentially a cost-effective means of reducing smoking rates among adolescents. Such legislation has been in existence in Australia for over 80 years. Two studies examined the retail industry's adherence to the sales ban in two regions of New South Wales in 1990. The first study was a survey of 1,849 12- to 15-year-old adolescents from 12 high schools in New South Wales, providing data on self-reported purchasing of cigarettes from retail outlets by minors. In all, 38 per cent reported having purchased cigarettes illegally. A second study was undertaken to determine the proportion of retail shops which sell cigarettes to apparently underage youth. Two 16-year-olds who looked young for their age attempted to purchase cigarettes from 101 different retail outlets in one region of New South Wales. No challenge about age was made for 70 per cent of purchases, and proof of age was requested on only 15 per cent of occasions. The results suggest that legislation banning sales of cigarettes to minors requires strong enforcement procedures to be effective.

Adolescent↗

PubMed1991

Self-reported long-term outcomes of hysterectomy.

OBJECTIVES: To investigate women's perceptions of and satisfaction with the long-term outcomes from a hysterectomy performed between 2 and 10 years ago and to determine whether satisfaction is related to demographic factors, factors associated with the hysterectomy, and the number or type of perceived benefits and problems associated with the hysterectomy. DESIGN: Retrospective survey by telephone interview and postal questionnaire of 236 women who had a hysterectomy between 2 and 10 years ago. SETTING: Women who had had a hysterectomy were identified from a community survey in the Hunter Region of NSW, Australia. SUBJECTS: Two hundred and thirty-six women who self-reported having had a hysterectomy between 2 and 10 years ago. MAIN OUTCOME MEASURES: Perceived benefits resulting from the hysterectomy; perceived physical and psychological problems caused by the hysterectomy; satisfaction with care. RESULTS: Relief from heavy bleeding was the most frequent benefit (57%) and the most important benefit (32%). Most of the women reported improvements in symptoms experienced before hysterectomy but more than half the women had symptoms which they believed had been worsened or caused by the hysterectomy. Despite this, high levels of satisfaction with the operation were reported. CONCLUSION: The results highlight the need to examine more closely decision-making about treatment for menstrual symptoms such as heavy bleeding.

Adult↗

PubMed1991

Prevalence and characteristics of women who have had a hysterectomy in a community survey.

A community survey of 8,896 households was undertaken in the Hunter region of New South Wales to assess women's health status. Consent was gained from 5,781 of the 6,361 eligible women between 18 and 69 years of age. The prevalence of hysterectomy in this sample was 16.9%, with 34.2% of women in their fifties having had a hysterectomy. Most hysterectomies (75%) were performed on women between the ages of 30 and 49 years. The demographic variables of parent's country of birth, educational level and employment status predicted recent hysterectomies after controlling for the effect of age.

Adolescent↗

PubMed1991

Solar protection issues for schools: policy, practice and recommendations.

This study presents findings on solar protection policies and practices in primary and secondary schools in New South Wales, Australia. The findings suggest that policies have been more fully articulated in primary schools than in secondary schools and that there is wide scope for further public health initiatives to protect children from the risk of skin cancer. Little attention has been given to the potential benefits of timetable changes and provision of shade in school environments, although school principals considered the latter would be a successful means of increasing protection. The level of solar education provided in the schools surveyed in our study was minimal, suggesting that urgent attention should be given to incorporating these issues in the school curriculum. Observations of school children's solar protection behaviours suggest that the majority of children used some form of protection in the middle of the day, but the form of protection changed with age. Consideration of more structural and environmental changes is needed to maximise the opportunities for solar protection in schools.

Australia↗