Professional development. Use the media.
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Because of low rates of colorectal cancer screening among African Americans, it may be beneficial to begin educating persons about this disease before age 50. Using the Patient/Provider/System Theoretical Model for cancer screening, this study compared knowledge of colorectal cancer, sources of information, and awareness of programs among participants of age 20-29, 30-49, and 50-75 years. The majority (n = 354) were women and African American (mean age = 37 years, mean education = 12th grade). Younger participants tended to know less about the disease, but there were few differences in knowledge between the two older groups. Persons in the 40-49-year age group were more likely to be familiar with the role diet plays in the risk of colorectal cancer. Participants associated the need for screening with the presence of symptoms. Television and radio were listed as the most frequent source of information about cancer. The Internet was the least used. The majority were not familiar with selected national programs and services focused on increasing awareness of cancer. Findings suggest that colorectal cancer-related information should be targeted toward this population before age 50, using multiple sources such as TV/radio, providers, magazines, and cancer-related organizations. An estimated 104,950 colon and 40,340 rectal cancer cases will be diagnosed in 2005 with an estimated 56,290 deaths from the disease (American Cancer Society [ACS], 2005). Despite a stabilization of colorectal cancer (CRC) incidence rates since the 1980s, African American males and females have higher incidence and mortality rates associated with this disease compared to Whites. The 5-year survival rate for CRC among African Americans improved to 54% during the years 1995-2000, but lagged well behind the 64% survival rate for Whites during the same time period. Screening and early detection of CRC followed by effective treatment is crucial to reducing these mortality rates.
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This article examines the determinants of physician advertising using a nationally representative sample of 2,573 self-employed physicians. In contrast to a previous study by Folland, this article identifies a number of physician characteristics that are strongly related to the advertising decision. In particular, female physicians and foreign medical graduates (FMGs) are significantly less likely to advertise than are males and non-FMGs, respectively. Board certified physicians are less likely to advertise than are uncertified physicians. Also in contrast to previous results, primary care physicians are not necessarily more likely to advertise than nonprimary care physicians. For example, advertising propensity is strongest among plastic surgeons, whereas the propensity to advertise in such primary care specialties as internal medicine and pediatrics are quite close to advertising propensities for general surgeons. Furthermore, the relationship between practice size and advertising propensity is shown to be much stronger than previous research in this area has indicated. Finally, the results suggest that a number of physician characteristics associated with advertising through written media (newspapers or magazines) are also associated with advertising through audiovisual media (television or radio).
From October 1, 1990, until April 28, 1991, 13,578 cases of measles were reported in the urban community of Niamey, Niger. Vaccine coverages (one dose of Schwarz vaccine given after 9 months) in urban community of Niamey were, respectively, 63% at the age of 12 months and 73% at 24 months before the epidemic. Incidence rates were the highest among children ages 6 to 8 months and 9 to 11 months and 22% of the cases were less than 1 year old. Vaccine efficacy estimates ranged from 86 to 94% according to age groups and the method used (screening method, case control study, retrospective cohort study). The risk of transmission of illness increased with the intensity of contact with a case. Contact with a health facility 7 to 22 days before onset of rash was not a risk factor. Seasonal migrants in Niamey were more likely to develop measles. Recommendations included implementation of an early two dose schedule of measles immunization during the outbreak, vaccination offered at each contact with a health facility, radio and television advertising for measles immunization and distribution of vitamin A to all measles cases.
BACKGROUND AND OBJECTIVES: Project Horizonte, an open cohort of homosexual and bisexual HIV-1-negative men, is a component of the Minas Gerais AIDS Vaccine Program of the Federal University of Minas Gerais, Belo Horizonte, Brazil. Its objectives included the evaluation of seroincidence of HIV, to ascertain the role of counseling on behavior modification and to assess their willingness to participate in future HIV vaccine trials. METHODS: Various means of recruitment were used, including pamphlets, notices in community newspapers, radio, and television, at anonymous testing centers, and by word of mouth. RESULTS: From October 1994 to May 1999, 470 volunteers were enrolled. Their mean age was 26 years and over 70% of them had high school or college education. During the follow-up, they were seen every 6 months, when they received counseling and condoms, and when HIV testing was done. Eighteen seroconversions were observed, and the incidence rates estimates were 1.75 per 100 and 1.99 per 100 person-years, for 36 and 48 months of follow-up, respectively. During the entire period, 139 volunteers were lost to follow-up. Among them, 59 (42.4%) never returned after the initial visit and 51 (36.7) came only once after their initial visit. No losses were observed for those observed during follow-up for more than 3 years. At enrollment, 50% of participants said they would participate in a vaccine trial, and 30% said they might participate. CONCLUSIONS: The results obtained up to this moment confirm the feasibility of following this type of cohort for an extended period, estimating HIV incidence rate, and evaluating counseling for safe sexual practices in preparation for clinical trials with candidate HIV vaccines in Brazil.
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After many years of declining rates, it became apparent in 1999 that syphilis cases were on the rise in Florida. Data analysis identified that the outbreak was predominately contained in Miami and Ft. Lauderdale and among men who have sex with men. An in-depth investigation was undertaken to identify the risk factors, the best way to attack the outbreak, and how to build sustainability into implemented strategies. After thorough review of the data and extensive dialogue with local public health and community participants, the Bureau of STD Prevention & Control developed initiatives that focused public awareness through print, radio, and television media resources; expanded access to men's health services; and enhanced education/training for public and private health care providers, STD program field staff, and community representatives. This initiative has resulted in unprecedented community involvement in syphilis control efforts.
The socialization of blind multihandicapped children depends on their acquisition of a system of communication that will permit their participation in a social world. Bereft of clear visual information and a diminished input from other senses, these children are prone to a range of language acquisition problems. Some children lack the capacity for speech while others speak in well-structured sentences that are simply repetitions of the speech of others or of the commercials heard on radio and television.
OBJECTIVES: To examine the effect of religion and spirituality on social support, psychological functioning, and physical health in medically ill hospitalized older adults. DESIGN: Cross-sectional survey. SETTING: Duke University Medical Center. PARTICIPANTS: A research nurse interviewed 838 consecutively admitted patients aged 50 and older to a general medical service. MEASUREMENTS: Measures of religion included organizational religious activity (ORA), nonorganizational religious activity, intrinsic religiosity (IR), self-rated religiousness, and observer-rated religiousness (ORR). Measures of spirituality were self-rated spirituality, observer-rated spirituality (ORS), and daily spiritual experiences. Social support, depressive symptoms, cognitive status, cooperativeness, and physical health (self-rated and observer-rated) were the dependent variables. Regression models controlled for age, sex, race, and education. RESULTS: Religiousness and spirituality consistently predicted greater social support, fewer depressive symptoms, better cognitive function, and greater cooperativeness (P<.01 to P<.0001). Relationships with physical health were weaker, although similar in direction. ORA predicted better physical functioning and observer-rated health and less-severe illness. IR tended to be associated with better physical functioning, and ORR and ORS with less-severe illness and less medical comorbidity (all P<.05). Patients categorizing themselves as neither spiritual nor religious tended to have worse self-rated and observer-rated health and greater medical comorbidity. In contrast, religious television or radio was associated with worse physical functioning and greater medical comorbidity. CONCLUSION: Religious activities, attitudes, and spiritual experiences are prevalent in older hospitalized patients and are associated with greater social support, better psychological health, and to some extent, better physical health. Awareness of these relationships may improve health care.
OBJECTIVE: To assess public views on emergency exception to informed consent in resuscitation research, public awareness of such studies, and effective methods of community consultation and public notification. METHODS: A face-to-face survey was conducted in two academic Level I trauma center emergency departments (EDs) in Oregon and Minnesota from June through August 2001. RESULTS: Five hundred thirty people completed the survey, with an 82% response rate. The mean age of the respondents was 41 years (range 18-95) with a standard deviation of 14.5; 46% were female and 64% white. Most (88%) believed that research subjects should be informed prior to being enrolled, while 49% believed enrolling patients without prior consent in an emergency situation would be acceptable and 70% (369) would not object to be entered into such a study without providing prospective informed consent. Informing and consulting the community as a substitute for patient consent in emergency research was thought to be reasonable by 45% of the respondents. Most respondents would prefer to be informed about a study using emergency exception from informed consent by radio and television media (42%). Two hundred fifty-eight respondents (49%) stated they would attend a community meeting; the less educated were more likely to attend than those with college degrees (OR = 0.53; 95% CI = 0.33 to 0.85, p = 0.008). However, only 5% knew of ongoing studies in their community using emergency exception from informed consent. CONCLUSIONS: Most respondents disagreed with foregoing prospective informed consent for research participation even in emergency situations; however, many would be willing to participate in studies using emergency exception from informed consent. Most respondents would not attend community meetings, and would prefer to rely upon the media for information. Very few were aware of emergency exception from informed consent studies in their community. This suggests that current methods of community notification may not be effective.
More should be done for Turner's girls/women and their parents. There is a need for early diagnosis, provision of information to Turner's parents, girls and women, provision of a support system in the form of Turner's contact groups, relevant treatment of all Turner's related disorders and problems at the appropriate age. More information is needed, including information given by physicians and Turner's women in journals, radio and television. This has been happening in Denmark during recent years. Turner's contact groups should be available in all countries, and all Turner's girls and women and their parents should be encouraged to join such groups. More research should be undertaken concerning growth, growth stimulating treatment, oestrogen treatment and in vitro fertilization in Turner's syndrome; more social-psychological studies are also needed.
The diet-health message for the 1990s has become complex, changing from the simple directives of previous decades as scientific evidence has evolved. If today's consumers are more knowledgeable, they are also more confused. The confusion stems not only from the complexity of the message, but also from the fact that the various groups and organizations developing it respond to the challenge from their own perspectives. Added to this are the constraints of the various media (print, radio, and television) that deliver the message. For consumers, the result has been not only confusion but, at times, outright rejection of resonable recommendations. The more that health professionals in academia, government, and voluntary organizations, food producers, and health reporters can agree on a set of clear, consistent, focused, and positive messages based on current scientific knowledge, the sooner recommendations for a healthful diet will be accepted and followed.
Community programs of preventive mental health are especially likely to face difficulties during times of fiscal constraint. Mental health professionals should be aware that prevention activities can be developed with limited resources and existing staff, by making use of local news media--newspapers, radio, and television--to educate, support, and inform the public about mental health issues.
Ocular injuries of sufficient severity to necessitate admission to the Eye and Ear Clinic, Royal Victoria Hospital, Belfast, were sustained by 1707 male patients and 325 female patients. Blunt injury occurred in 1063 eyes (49.2%), perforating injury in 1037 (48%), and intraocular or intraorbital foreign bodies in 181 eyes (8.4%). More than three-quarters of the patients (77.4%) were less than 36 years of age and 84% of all injuries occurred in males. Normal visual acuity (6/6 or better) was regained by 41.2% of the patients in whom the final visual outcome was known. The benefit of wearing seat belts in road vehicles and protective goggles in industry and sport should receive more publicity on radio and television and via poster campaigns. Compulsory fitting of laminated windscreens in all road vehicles is recommended. The vulnerability of children to ocular injury should be highlighted through the mass media, schools, and health centres.