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Biomedical subjects

R M Chamberlain

Publications and source records attributed to R M Chamberlain.

At least 37 records · Page 2Linked to original sources
PubMed1996

Participants' perceptions of a phase I colon cancer chemoprevention trial.

To assess participants' perceptions of a phase I colon cancer chemoprevention trial using a calcium intervention, questionnaires were mailed to trial participants at the conclusion of the study. Responses to questionnaire items reported here include (1) perceived benefits and barriers of participation, (2) interest in participating in future trials, (3) willingness to pay trial expenses out of pocket, and (4) posttrial continuation of the calcium regimen. The study found that the most highly rated trial benefit was the perception of potential colon cancer prevention; the trial barrier reported to be the most troublesome was inappropriate or mistaken billing for study visits. Three fourths of the subjects expressed an interest in future trials of the same duration. For trials of longer duration, this percentage decreased to 66%. Approximately half did not object to participation in future trials involving placebos, and just over one third indicated that they would either definitely (8%) or probably (27%) have joined the calcium trial even if they had to pay some study expenses out of pocket. Over 90% indicated they would continue taking the calcium pills if calcium is shown to be effective. The level of perceived benefits was positively associated with reported interest in participating in future trials of the same and longer durations, and the level of reported difficulty with trial pills and procedures was inversely related to interest in future placebo-controlled trials. The results of this study, in conjunction with results of prospective studies of trial participation, may be applied in future chemoprevention trials to facilitate recruitment, reduce attrition, and promote positive trial experiences for participants by emphasizing frequently reported benefits and minimizing frequently reported barriers.

Adenocarcinoma↗
PubMed1995

Screening at a health fair to identify subjects for an oral leukoplakia chemoprevention trial.

Screening examinations were conducted at a Chinese community health fair in Houston, Texas, to identify individuals with oral leukoplakia for a chemoprevention trial of oral-cavity squamous cell carcinoma. All 161 volunteer participants were interviewed regarding age, smoking habits, and betel-nut and alcohol use. The screening included an examination of the oral cavity, oropharynx, and neck. One participant had a 1-mm area of oral leukoplakia on the right lateral surface of the oral tongue. Eighteen participants had other head and neck abnormalities. Only 12 participants (7.5%) were active smokers, and eight (5%) reported a prior history of smoking. One participant reported prior betel-nut use. The mean age was 55 years. The authors conclude that a venue such as this has a low yield for screening and recruitment of high-risk individuals for chemoprevention of oral-cavity squamous cell carcinoma, that generally health-conscious individuals attend health fairs, and that only a small percentage volunteer for oral screening.

Adult↗
PubMed1995

Improving residents' knowledge of cancer prevention: are physicians prepared for prevention?

BACKGROUND: Primary care physicians recognize the goal of integrating cancer-prevention strategies into clinical practice. However, there is little formal training in cancer prevention and early detection. This study describes the effectiveness of a cancer-prevention curriculum called "Recommendations for Cancer Prevention (ReCaP) for Residents" for primary care residency programs. METHODS: The ReCaP for Residents curriculum was organized into eight instructional modules by organ site-specific areas for which there are established primary and secondary cancer-prevention recommendations. The modules include content outlines, learning objectives, slides, and case studies. In-house faculty and 21 residents of two family practice programs participated in an intervention comprising seven one-hour modular presentations during their regular summer teaching program. An established cancer-prevention knowledge test with 100 test items was used to test the residents' knowledge before and after the intervention; the data were analyzed by factor analysis with principal-component extraction and varimax rotation. RESULTS: The residents knew significantly more about cancer prevention after the ReCaP for Residents program. The mean overall prevention knowledge increased significantly (p < .05), and the scores of six of eight specific organ-site areas also increased. CONCLUSION: This study provided evidence that ReCaP for Residents was an effective curriculum for increasing residents' knowledge of cancer prevention. The authors recommend that more extensive programs of this type be implemented.

Curriculum↗
PubMed1994

Pediatric oncologists' assessment of oncology education in U.S. medical schools: Cancer Education Survey II.

The status of cancer education in U.S. medical schools was reassessed in the Cancer Education Survey II, which was initiated in 1989. One thousand and thirty-five cancer educators from 126 of the country's 128 medical schools participated, including 65 pediatric oncologists and 36 family physicians. All agreed that the most important aspects of cancer to teach medical students are early detection and cancer prevention; they considered less important electives in basic science, radiation therapy, and surgical oncology. The 101 pediatric oncologists and family physicians believed that more curriculum time should be devoted to cancer epidemiology, psychosocial aspects, and palliative care. Approximately one third of these 101 physicians also expressed the desire to have more teaching materials available in five general areas: patient education about pediatric cancer, nutrition, epidemiology, palliative care, and continuing care. Lay-language information about pediatric cancer, participation in clinical trials, and current cancer research is still needed.

Curriculum↗
PubMed1992

Cancer prevention practices among Texas primary care physicians.

Primary care physicians are uniquely positioned to practice primary and secondary cancer prevention. However, despite a positive commitment, many physicians are pessimistic about the success of their interventions. This study describes the self-reported cancer prevention practices and perceived obstacles of 1600 Texas primary care physicians. These practices differed by primary care specialty and by length of time in practice. Time constraints were uniformly perceived as the leading obstacle to the provision of smoking cessation counseling. High cost, lack of third-party reimbursement, and poor patient compliance were cited as the leading barriers to patient referral for screening mammography. Professional education should stress to physicians that interventions need not be elaborate, expensive, or time consuming, the main purpose being to motivate and reinforce patient behavior. The special challenges of introducing health promotion activities into the clinical setting must be addressed with practical aids such as prompting systems, flowsheets, and computer-based aids for monitoring compliance rates.

Female↗
PubMed1992

Survey design and observations relating to cancer education funding. Cancer Education Survey II: cancer education in United States medical schools (conducted by The American Association for Cancer Education with the support of the American Cancer Society).

A survey has been conducted of cancer education programs for medical students in United States medical schools by the American Association for Cancer Education with grant support from the Department of Detection and Treatment of the American Cancer Society (formerly the Professional Education Department). Two questionnaires were used, an Educational Resources Questionnaire (ERQ), which 126 of the 128 medical schools completed and returned, and a Faculty and Curriculum Questionnaire (FCQ), which was completed and returned by 1,035 faculty members who had been named as active in undergraduate medical student cancer education by respondents in each school who had been designated by the Dean's Office to complete the ERQ. Overall conclusions included: (1) increased coordination of cancer education activities is a major need in many schools; (2) there is widespread interest in the further development of cancer education objectives; (3) development of a national cancer education curriculum is needed; (4) there is interest in the development of improved instructional materials and methods; (5) development of evaluation methods is needed for cancer education programs; and (6) an ongoing funding process is needed to provide support for interdepartmental coordination of cancer education activities. Cancer prevention and detection topics were ranked above cancer treatment in plans for future curriculum emphasis. More detailed conclusions and recommendations are provided in this publication and three subsequent articles in this issue of the Journal of Cancer Education.

American Cancer Society↗
PubMed1992

Instructional methods and the use of teaching resources in cancer education curricula. Cancer Education Survey II: cancer education in United States medical schools.

The findings on cancer teaching methodology presented in this abstract come from an American Association for Cancer Education (AACE)/American Cancer Society-sponsored survey of American allopathic medical schools in 1989 and 1990 to determine how and how well cancer is presented in the medical school curriculum. Responses were received from 126 institutional and approximately 1,000 faculty respondents. Approximately one-third (368) of faculty respondents indicated the use of specific learning objectives; utilization does vary across disciplines. The lecture remains the dominant form of instructional method. Computers were reported as an instructional modality by only 16% of the faculty respondents. Prepared audiovisual instructional materials appeared to be widely utilized. Use varied from 86% for 35mm slides to 11% for video discs. Faculty favored the development of new teaching materials for ten topic areas ranging from approximately 40% for early detection and prevention to a low of approximately 25% for rehabilitation and continuing care. The survey identified an underutilization of existing outpatient facilities and tumor registries for cancer teaching purposes. The findings give rise to questions concerning the appropriateness of the match between specific instructional goals and the teaching methods employed. Eight recommendations designed to strengthen cancer training are made.

Computer-Assisted Instruction↗
PubMed1992

Cancer prevention education in United States medical schools. Cancer Education Survey II: cancer education in United States medical schools.

The Cancer Education Survey collected data from 126 of 128 US Medical Schools on the current status of cancer-related educational activities for undergraduate medical students. The study was conducted by a Supervisory Committee of the American Association for Cancer Education, with funding from the American Cancer Society. The survey obtained data concerning institutional characteristics in support of undergraduate medical student cancer education, ie, administrative structures, current cancer-related curricula, sources of financial support, and anticipated changes in these characteristics. Institutions were also queried on specific topics of cancer prevention, detection, and diagnosis that might be taught as identifiable areas of instruction for medical students. Three-fourths of the institutions had a lecture on the principles of cancer screening, and, among those, nearly three-fourths classified it as a part of a required course or rotation. Detection of common cancers is taught in virtually all institutions. The least likely cancer prevention lecture topics are related to prevention and cessation of smoking, a well-verified cancer risk. Also, no consistent pattern emerges that might indicate that association with a cancer center imparts to a medical school a greater emphasis on delivery of cancer prevention topics.

American Cancer Society↗
PubMed1992

Changing the cancer curriculum: a curriculum committee's response to the results of the AACE Cancer Education Survey II. Cancer Education Survey II: cancer education in United States medical schools.

The AACE Cancer Education Survey-II offers an unusual opportunity based on data from 125 medical schools and 1,035 experienced cancer educators to effect constructive change with regard to cancer education. The changes suggested include more coordination; integration; and a shift of emphasis to include more on topics of prevention, early diagnosis, tumor biology, rehabilitation, palliative care, and psychosocial issues. Ample opportunities, especially in the ambulatory care arena, exist at most medical schools, and there is a great deal of interest in improving the situation. This article reviews the factors contributing to resistance to change, the data on adult learning, and the major movements and dilemmas facing medical education today. It also discusses some of the external forces like the Liaison Committee on Medical Education (LCME) and foundation support, which are being harnessed to effect change. Given these barriers, forces, and opportunities, the article ends with a possible action plan for an individual, an institution, and national bodies interested in cancer education. The knowledge, skills, values, and attitudes must be defined, taught effectively, and evaluated. It is an opportune time, armed with this useful data, to bring about change in how cancer subjects are taught. The ultimate goal is more knowledgeable and effective practitioners and scientists who can decrease the morbidity and mortality from cancer.

Curriculum↗
PubMed1992

Prevention of familial cardiovascular disease by screening for family history and lipids in youths.

We analyzed medical family history information from 51,053 families of high school students in Utah and Texas and cholesterol measurements from 853 youths and 1618 adults in Utah families with cardiovascular disease (CVD) to assess the utility of different approaches to risk-factor evaluation for youths. The major question addressed was in which youths should blood cholesterol be tested? Applying National Cholesterol Education Program recommendations suggested that 36% in Utah and 38% in Texas be tested. Heterozygous familial hypercholesterolemia (hFH) is the best documented and most serious cholesterol disorder readily diagnosed in youths. In Utah families ascertained for CVD in adults, blood cholesterol levels among youths were significantly bimodal with hFH present in 84% of youths in the upper cholesterol mode. Blood cholesterol levels in adults from the same families were less bimodal with hFH present in 38% of adults in the upper mode. More overlap existed between high and normal modes in adults than in youths. Data from this study suggest that family histories and cholesterol concentrations obtained from high school students may meet the needs of cholesterol screening, education, and follow-up in a controlled and cost-effective setting.

Adolescent↗
PubMed1990

Cigarette smoking patterns in patients after treatment of upper aerodigestive tract cancers.

There is a paucity of data on variables predictive of successful smoking cessation in cancer patients. In this questionnaire-based study, we report the smoking status of 75 patients (46 men, 29 women) with head and neck cancer followed for a minimum of 30 months after definitive therapy. Seventy-one percent of the men and 61% of the women who were current smokers at diagnosis stopped smoking subsequent to diagnosis and treatment. Only 29% and 39%, respectively, continued to smoke, most at decreased intensity. Patients with laryngeal cancer were most likely to have stopped (83%). Conversely, patients with oral cavity cancer were most likely to be continuing smokers (66%). In addition, older age, college education, and lighter smoking habits were somewhat predictive of successful cessation. Fear of recurrent disease and physician advice were the questionnaire-listed incentives most often chosen as contributing to success in cessation. The role health professionals can play in counseling cancer patients to stop smoking is stressed.

Age Factors↗
PubMed1988

A pilot study on cholesterol screening in the school environment.

A newly-developed analyzer measures total cholesterol from a single drop of blood and gives results within minutes. This procedure has made mass cholesterol screening inexpensive and less invasive than methods requiring a venipuncture blood sample, and it offers the opportunity for on-the-spot counseling and referral. In a pilot study, 610 high school students in the Victoria (Tex.) School District were screened for elevated cholesterol. Eighteen percent were found to have cholesterol levels above 180 mg/dl. Mean cholesterol values were higher for females than males, and higher for blacks and Hispanics than whites. Follow-up questionnaires indicated students and their parents understood the basic relationship between cholesterol and cardiovascular disease and how to modify their diet to reduce cholesterol intake. Telephone contact with parents of students with elevated cholesterol showed only about 27% of students with elevated cholesterol had visited a physician subsequent to the cholesterol testing.

Adolescent↗
PubMed1988

Health family trees: a tool for finding and helping young family members of coronary and cancer prone pedigrees in Texas and Utah.

We report on the feasibility and utility of a new approach for identifying the small percentage of families in the general population with strong familial predisposition to early coronary heart disease, strokes, and common familial cancers (breast, colon, lung), using the "Health Family Tree," a medical family history. A total of 24,332 "trees" were completed by parents and students in 37 high schools in 14 urban and rural communities in Texas and Utah during the years 1980-86. Completed "trees" were obtained from 68 per cent of all enrolled students. High-risk families, included 1,796 families with early coronary disease (7.5 per cent of all student families or 3.7 per cent of their parents' families), 870 stroke families (3.6 per cent), and 415 cancer prone families (1.7 per cent). Among these 3,081 high-risk families there were 8,245 family members already reported to have been diagnosed by a physician to have the familial disease of interest and 43,269 high risk unaffected siblings and offspring of these persons. The average cost per identified high-risk unaffected person was under $10. We conclude that the "Health Family Tree" is a feasible and cost-effective way to find high-risk families.

Adolescent↗
PubMed1987

Application of cancer prevention knowledge: a longitudinal follow-up study of medical students.

Measuring the clinical application of knowledge and skills acquired in specific medical school courses is a critical part of curriculum evaluation. Second-year Cancer Prevention Course (CPC) students and a comparison group were surveyed by questionnaires, cognitively tested, and a subsample participated in in-depth interviews. The 6-month and 18-month follow-up interviews indicated that more CPC students practiced prevention in their clinical rotations than did the comparison group. Direct, one-on-one access to patients during clinical training was an important mediating factor in the practice of prevention skills. In addition, a behavioral intent inventory showed that CPC students, in their future careers, intend to perform certain specific cancer prevention activities more than others. Long-term retained knowledge (75% correct) stabilized at levels significantly higher (p less than .001) than baseline test scores prior to the Cancer Prevention Course. At the time of the two follow-up exams of cognitive knowledge, the comparison group of students was able to do no better than had the CPC students at baseline before the course. Positive beliefs about cancer prevention improved over the study period. More than twice as many cancer course students attended subsequent optional lectures and reported optional reading on cancer prevention topics than did the comparison group. Overall, the study showed a lasting effect of the elective course in cancer prevention, in terms of tested knowledge, and self-reported measures of attitudes, beliefs, practice of prevention in clinical rotations, and intent to apply prevention in future practice.

Curriculum↗
PubMed1984

Integrating cardiovascular health education with an English curriculum in a secondary school.

The purpose of this study was to assess the impact on cognitive and attitude retention of a cardiovascular (CV) health education unit that was integrated within high school English classes. The integrated program was an extension of previous research on the Cardiovascular School Health Curriculum that was developed by the National Heart and Blood Vessel Research and Demonstration Center, Baylor College of Medicine. The results of this study supported the hypotheses that CV health education can be successfully integrated within the English curriculum of secondary schools. This joint effort between health education and a liberal art assisted students in retaining important facts related to CV disease and in maintaining more positive attitudes toward their abilities to control their CV risks.

Adolescent↗
PubMed1980

Social isolation in lung cancer patients.

Lung cancer patients were found to score significantly higher on a social isolation scale when compared to a group of patients with other chronic lung diseases as well as to a control group of apparently healthy adults. Social isolation in lung cancer patients did not correlate with their apparent isolation, depression or with their physicians' estimations of their attitudes. Social workers involved in the care of lung cancer patients should be aware that these patients may be actually, if not obviously, socially isolated.

Depression↗