Biomedical subjects

W R Stanton

Publications and source records attributed to W R Stanton.

At least 19 recordsLinked to original sources

PubMed2005

Predictors of responsiveness to physiotherapy management of cervicogenic headache.

A recent randomized controlled trial tested the effectiveness of therapeutic exercise and manipulative therapy on 200 subjects with cervicogenic headache. Although treatments were efficacious, 25% of patients did not achieve a clinically acceptable outcome--50% reduction in headache frequency. This study aimed to identify predictors from variables in subjects' demographics and headache history which might identify those who did or did not achieve a 50-79% or 80-100% reduction in headache immediately after the active treatments and 12 months postintervention. The results revealed no consistent pattern of predictors, although the absence of light-headedness indicated higher odds of achieving either a 50-79% [odds ratio (OR) = 5.45) or 80-100% (OR = 5.7) reduction in headache frequency in the long term. Headaches of at least moderate intensity, the patient's age and chronicity of headache did not mitigate against a successful outcome from physiotherapy intervention.

Adult↗

PubMed2003

Cervicogenic headache: locus of control and success of treatment.

BACKGROUND: A number of extraneous factors have been implicated in the effectiveness of treatment of headache, including patient beliefs about aspects of the treatment or persons delivering the treatment. OBJECTIVE: The concept of external locus of control for headaches refers to patients with a high level of belief that headache and relief are influenced primarily by health care professionals. The aim of this study was to examine whether external locus of control is associated with a reduction in frequency of cervicogenic headaches among patients treated by a physiotherapist. DESIGN: A recent randomized controlled trial of the effectiveness of physiotherapy among 200 patients with headache enabled a test of this relationship. Treatment consisted of manipulative therapy, therapeutic exercise, or a combination of the 2. Analysis of relative change in headache frequency was conducted after 6 weeks of treatment and at 3- and 12-month follow-up appointments. RESULTS: Results of the analysis indicated that participants with relatively high external Headache-Specific Locus of Control scores were more likely to achieve a reduction in headache frequency if they received the combined manipulative therapy and exercise therapy, compared with those who received no treatment. This was not determined for the group who received manipulative therapy, which is a treatment received passively by the patient. CONCLUSIONS: The interpretation of these findings is considered in the context of nongeneralization to the other physiotherapy treatment groups and sustained reduction in headache frequency following withdrawal of treatment. The pattern of findings suggests that characteristics of the therapy were more pertinent than characteristics of the therapist.

Adolescent↗

PubMed2002

Behavior of caregivers to protect their infants from exposure to the sun in Queensland, Australia.

Exposure to the sun by infants has been demonstrated to increase the risk of the development of melanoma and other skin cancers later in life. A cohort of 508 women who delivered healthy Caucasian babies were followed up at 1 year to determine their knowledge, attitudes and practices regarding sun protection towards themselves and their child. In addition, the 1-year-old infants were assessed by a trained nurse for the number of nevi they had on their skin. Results indicate caregivers reported a high level of sun-protection practices towards their child, with 93% of the caregivers reporting usually or always placing the child in the shade when going outside. Further, 81% of the caregivers reported usually or always placing a hat on the child, while 64% reported usually or always applying sunscreen to the child's exposed skin. Interestingly, only 61% of the caregivers reported that they stayed in the shade to reduce sun exposure and only 42% wore a hat when out in the sun. Mother's own personal sun-protection methods predicted the method of sun protection that she would most likely use for the child. While children appear to be reasonably protected from the sun, they are influenced by their mother's own behaviors.

Female↗

PubMed2001

Identifying trajectories of adolescent smoking: an application of latent growth mixture modeling.

The goal of the current study was to identify discrete longitudinal patterns of change in adolescent smoking using latent growth mixture modeling. Five distinct longitudinal patterns were identified. A group of early rapid escalators was characterized by early escalation (at age 13) that rapidly increased to heavy smoking. A pattern characterized by occasional puffing up until age 15, at which time smoking escalated to moderate levels was also identified (late moderate escalators). Another group included adolescents who, after age 15, began to escalate slowly in their smoking to light (0.5 cigarettes per month) levels (late slow escalators). Finally, a group of stable light smokers (those who smoked 1-2 cigarettes per month) and a group of stable puffers (those who smoked only a few puffs per month) were also identified. The stable puffer group was the largest group and represented 25% of smokers.

Adolescent↗

PubMed2000

Measurement of community beliefs about colorectal cancer.

Few educational campaigns have focused on bowel cancer, though studies have indicated that members of the community need and want current information about relevant issues. In order to facilitate research in this area, reliable and valid measures of community attitudes are needed. Content validity of a survey instrument was obtained through use of a Delphi process with Directors of Education from the Australia Cancer Council and focus group discussions with informed members of the public. The subsequent survey of community perceptions about colorectal cancer included a broad range of content areas related to the risk of bowel cancer, preventing and coping with bowel cancer and beliefs about susceptibility and severity. The construct validity of these content areas was investigated by use of a factor analysis and confirmation of an association with related predictor variables. Two measures related to personal influence and anticipated coping responses showed favourable psychometric properties, including moderate to high levels of internal consistency and test-retest reliability. A test of the concurrent validity of these measures requires further development of instruments related to colorectal cancer or adaptation of measures from other areas of health research.

Adult↗

PubMed2000

Development of an instrument for monitoring adolescent health issues.

The aim of the project was to develop a survey instrument to monitor relevant health status and health-related behaviors among secondary school students. The development of the instrument occurred in three main phases: collection of existing surveys, workshops with relevant health professionals and focus groups with adolescents. The topics for inclusion were refined using Health Goals and Targets for Australian Children and Youth and consultations with health professionals, and included alcohol/illicit drug use, smoking, nutrition, exercise, injury, mental health, violence and sexual health. Content validity was demonstrated through a comprehensive literature review, review and application of existing instrumentation, dialog and exchange with health professionals, and focus groups with adolescents. The process of peer review through correspondence with health professionals, and the coordination of workshops and focus groups established face validity. Responses from students also indicated that they interpreted the questions as intended. The instrument was piloted in five secondary schools during class periods. Process evaluation was also conducted to determine the appropriateness of the survey and the procedures used in administering the survey. Feedback from school staff was supportive and favorable with respect to the choice of issues. Reliability was assessed by a test-re-test procedure 2 weeks apart. In general, most of the questions showed moderate to high reliability (kappa > 0.5) indicating agreement of 50% or greater. This instrument was developed as a monitoring instrument and places emphasis on determining prevalence levels of a range of health issues and health behaviors to assist with identifying clustering patterns of negative health outcomes. Although the instrument is primarily for use with students in school hours, the nature of the instrument allows modification for use in older groups of adolescents and out-of-school youth. The final version of the questionnaires for senior and junior students can be accessed via the Internet (http://;+www.spmed.uq.edu.au/CHPCPR /qu estionnaire).

Adolescent↗

PubMed2000

Sun-safe behaviour among secondary school students in Australia.

This paper reports data on the first national survey of sun-protection measures of Australian secondary school students. A cross-sectional survey of a representative sample of 23,915 Australian school children in Years 7-12 was conducted in 1993. Students were questioned about usual sun-protection practices, beliefs about skin cancer and suntans, and sunburn history. The results showed differences in sun-protection behaviours as a function of 'year level', 'gender', 'skin type' and 'concern about getting cancer' among others. Adolescents who believe there is a lot they can do to avoid skin cancer are more likely to engage in sun-protective behaviours. Males were more likely to wear a cap, yet females tended to use sunscreen. The use of clothing to protect themselves from the sun was higher in males, yet females were more likely to stay mainly in the shade. All behaviours decreased with age. Poorer protective practices were also associated with increased sunburn, except for sunscreen use where the converse was the case. Suntan was still a desire for adolescents. While there is considerable room for improvement in the sun-protection behaviour of adolescents (particularly those in higher grades), most students usually take some precautions. However, by Year 12 (17 and 18 year olds) less than half report usually wearing a hat and just two-thirds reported usual sunscreen usage.

Adolescent↗

PubMed2000

Sun exposure and primary prevention of skin cancer for infants and young children during autumn/winter.

OBJECTIVE AND METHOD: Excessive sun exposure in childhood has been associated with the development of skin cancer, and appropriate levels of sun protection during the early years of a child's life can significantly reduce the risks. A survey of 133 mothers was undertaken in south-east Queensland to examine the levels of sun exposure and skin protection of infants and young children. RESULTS: Among this sample of 133 mothers, use of appropriate skin protection was relatively high for themselves and their children. However, even by six months of age, a third had been sunburnt and 15% had experienced painful sunburn. By three years of age, 82% had been sunburnt and one-third had experienced painful sunburn, though mothers' knowledge levels of sun safety issues were very high. The predictors associated with primary prevention varied across the type of prevention behaviour, but indicated that interventions should focus on susceptibility to sunburn and history of sunburn. Similar programs could be applicable across a broad range of socio-demographic groups, but require attention to mother's country of birth as a factor that significantly influences their use of protection for their young children. CONCLUSIONS: Ongoing public education that targets specific groups and settings may contribute to adoption of appropriate sun protective behaviours for young children. IMPLICATIONS: Results of the study provide some of the needed baseline data to assist future skin cancer prevention campaigns for young children and infants. A similar study of levels of sun exposure and skin protection for children during summer is under way.

Adult↗

PubMed2000

Correlations between reported and measured ultraviolet radiation exposure of mothers and young children.

Cumulative and intermittent sun exposure are risk factors for skin cancer, highlighting the need to monitor exposure during childhood. There is currently very little available information concerning the accuracy of self-reported levels of sun exposure, particularly for very young children. In this study, UV radiation (UVR) exposure measured by polysulfone dosimeters worn on the wrist was compared with a measure of estimated exposure using a diary based on recall at the end of the 4 day study period and ambient dosimetric measures. Results of the study indicate that the relative UVR exposures expressed as a fraction of daily total ambient received during the 4 day period by young children and mothers are similar. A high level of association was obtained for the estimated levels of exposure between young children and their mothers. Moderate correlations were evident for dosimeter readings of mother and child on weekends with no significant association on weekdays. The association between estimated exposure and dosimeter readings was poor and needs improvement. This may be achieved by greater consideration of structural and environmental factors that influence the levels of UVR exposure received by individuals and by increasing the level of specificity in the measurement instruments. Methodological issues such as recall of exposure after several days, quantity of sun exposure and more precise measurement of grades of exposure when outside may have more impact than previously expected, and further information is being sought with a larger sample for exposure during the summer months.

Adult↗

PubMed2000

A measure of skin familiarity and its role in the early detection of skin cancer.

Skin self-examination (SSE) is promoted widely so that individuals will become familiar with their skin and be better able to identify suspicious changes earlier. However, individuals can also become familiar with their skin other than through purposeful SSE. In this article, we develop a measure of skin familiarity based on the density of spots on 14 different areas of the body. A factor analysis of the 14 body-area scores revealed that they could be grouped into four broad body regions (shoulders and back, front of legs, back of legs, and feet). Each total body score and body-region score has high internal consistency (Cronbach's alpha coefficients ranging from 0.79 to 0.93). Moreover, the scores correlate as expected with skin self-examination behaviors and other personal characteristics, indicating high construct validity. We consider the advantages that skin familiarity measures offer over the exclusive use of SSE measures in the assessment of early detection activities and discuss the direction of future research in this area.

Factor Analysis, Statistical↗

PubMed1999

Beliefs about smoking cessation among out-of-school youth.

Although the majority of adolescents in the 13-18 age range are at school, there is a need to target specific groups of young smokers such as unemployed youth. For those young people who are not at school, few directed programs are available in either prevention or cessation and information is needed about the design and delivery of appropriate programs for this population. This report presents the results from a survey of unemployed youth and students at vocational colleges about various aspects of smoking cessation. The majority of out-of-school youth smokers had not tried to quit, but 52% were contemplating action to quit. Only a quarter of the smokers had quit for more than a week. Few young smokers would use a recognised program though more females would change to a lower nicotine brand, quit with the help of a friend or participate in a group quit program. The method of quitting most would recommend to peers is 'use of will power'. Incentives to quit were attractive to only a third of the smokers, and many enhancing and inhibiting factors for participation in programs were identified. In particular, efforts to quit increased their confidence in quitting, supporting the need to assist those who are contemplating action to quit. Programs need to incorporate input from youth and be tailored for them but not necessarily for different groups such as non-secondary school students and unemployed youth.

Adolescent↗

PubMed1999

Healthy behaviors, lifestyle, and reasons for quitting smoking among out-of-school youth.

STUDY OBJECTIVE: To investigate the relationships among healthy behavior, healthy values, social influences, and quitting smoking in adolescents not attending school. DESIGN: Following screening procedures, young smokers independently completed a self-report questionnaire administered by trained staff. SETTING: Vocational (TAFE) colleges and Commonwealth Employment Offices (CES) from varying socioeconomic localities were selected as sites to intercept smoking adolescents on their attitudes about quitting smoking. SUBJECTS: Youth attending vocational colleges or CES. RESULTS AND CONCLUSIONS: There were no differences between the two groups of smokers (vocational students and unemployed youth). The decision to quit smoking among these youth is based on a number of factors including social and personal reasons. Health-oriented values were found to be more highly associated with quitting behavior than social influences. Programs for smoking cessation need to be focused on an overall health and improvement approach rather than only a quit-smoking approach.

Adolescent↗

PubMed1999

Predictors of sun protective behaviors among school students.

A random sample of students (N = 3,655) in Grades 7, 9, and 11 from 55 schools in Queensland (Australia) were surveyed about their sun protection knowledge, attitudes, and behaviors. An aggregate sun protection behavior index (SPBI) was developed from self-reported behaviors on a school day and a weekend day. Repeated measures regression analyses revealed that negative views of sun protection measures were associated with low scores on the SPBI, an association that was strongest among older students and in larger schools. Low perceived parental sun protective behaviors were associated with low SPBI ratings, and this association was greatest in small schools and on Saturdays. Older students had lower SPBI ratings, but their scores increased on Saturdays. Gender did not appear to be independently related to the SPBI after adjustment for the other variables. These findings reinforce the need for adolescent sun protection programs to address the complex interactions among psychological, social, and environmental factors that influence different subgroups of the student population.

Adolescent↗

PubMed1999

Evaluation of a three-year school-based intervention to increase adolescent sun protection.

The efficacy of a school-based intervention was evaluated using a randomized controlled trial in Australia. In consecutive grades (8, 9, and 10), students in the intervention group received components of a program that addressed issues related to the need to protect yourself from the sun, behavioral strategies related to using sun-protective measures, personal and social images of having a tan, the use of sun-safe clothing, and how to change their schools through forms of structural change. Pre- and postintervention measures among junior high school students showed greatest improvement in the intervention group's knowledge scores and minimal changes in sun protection behavior from Grade 8 to Grade 9, which were not maintained through Grade 10. Results of the study highlight some limitations of school-based interventions for changing sun protection behaviors.

Adolescent↗

PubMed1998

Adult physical health outcomes of adolescent girls with conduct disorder, depression, and anxiety.

OBJECTIVE: To examine the young adult physical health outcomes of adolescent girls with behavior problems. METHOD: Girls with conduct disorder, girls with depression, girls with anxiety, and healthy girls (N = 459) who had been evaluated at age 15 years were followed up at age 21, when general physical health, substance dependence, and reproductive health were assessed. RESULTS: After control for potentially confounding variables including prior health, adolescent conduct disorder predicted more medical problems, poorer self-reported overall health, lower body mass index, alcohol and/or marijuana dependence, tobacco dependence, daily smoking, more lifetime sexual partners, sexually transmitted disease, and early pregnancy. Adolescent depression predicted only adult tobacco dependence and more medical problems; adolescent anxiety predicted more medical problems. CONCLUSIONS: The robust link between female adolescent conduct disorder and poor physical health in adulthood suggests that intervention with girls who have conduct disorder may be a strategy for preventing subsequent health problems.

Adolescent↗

PubMed1997

Prevalence and correlates of cannabis use and dependence in young New Zealanders.

AIMS: To determine change in patterns of cannabis use in New Zealand in an unselected birth cohort and investigate the relationship between level of cannabis use, violent behaviour and employment history. METHOD: Prospective longitudinal design using members of the Dunedin Multidisciplinary Health and Development Study at ages 15, 18 and 21 years. RESULTS: Rates of cannabis use increased from 15% (n = 144) at age 15 years to more than half of the sample seen at age 21 years (n = 497; 52.4%). DSM-III-R defined cannabis dependence assessed at age 18 and 21 years increased from 6.6% (n = 61) to 9.6% (n = 91). Males were more likely to use and be dependent on cannabis than females. Early use substantially increased the risk for the development of cannabis dependence in young adulthood. Cross-sectional analysis at age 21 found levels of cannabis use and dependence to be higher among the unemployed and those with a history of violent behaviour. CONCLUSIONS: Prevalence rates of cannabis use in young New Zealanders were found to be higher than previously reported. A history of unemployment or of violent behaviour was associated with more frequent cannabis use at age 21. Males were more likely than females to use cannabis frequently and to meet DSM-III-R criteria for dependence at age 21. It is suggested that drug education campaigns should specifically target young males.

Adolescent↗

PubMed1997

Community perceptions about the important signs of early melanoma.

BACKGROUND: Detecting melanoma early often relies on patient concern about a particular pigmented lesion. However, it is not clear what specific features the public views as being important. OBJECTIVE: Our purpose was to explore the importance persons place on various features of skin lesions when looking for early signs of melanoma. METHODS: This study comprised 1148 respondents (participation rate, 78%) from 60 rural communities in Queensland, Australia, who participated in a telephone interview. RESULTS: The following features were considered important and are listed in order of importance: change in the lesion (clearly identified as the most important), more than one color, uneven edges, elevation, large size (the last three of equal importance), and hairiness of the lesion. Age, sex, education, self-efficacy, perceived knowledge, and recent self-examination influenced importance levels, but having a recent skin examination by a family physician did not. CONCLUSION: To increase the skin self-examination skills of the community, guidelines may have to become more specific and all opportunities fully utilized to educate the public.

Adolescent↗

PubMed1997

Harm reduction: roads less travelled to the holy grail.

In recent years, a number of countries have embraced harm reduction as their principal philosophical stance and policy platform on alcohol and other drug-related problems. Harm reduction, while argued by some as not being a new concept, has dramatically changed the overall orientation of many health and human service approaches. We argue that as a result many important considerations have been overlooked. This paper explores the merits of harm reduction and examines the limitations and potential pitfalls that may exist in its application in the real world. For instance, where do we position non-drug-use? Such questions are raised in light of the impression perpetuated by some leading practitioners in this field that harm reduction is a global panacea for alcohol and drug problems. Without exploring all possible paths, progress toward our holy grail of minimising the harms and maximising the potential benefits of drug use will be hampered. An integrated model is discussed, which we believe provides an opportunity for wider acceptance and ownership by alcohol and drug stakeholders, politicians and the community.

Alcoholism↗