Increasing screening mammography in asymptomatic women: Evaluation of a second-generation, theory-based program.

Two theory-based programs to increase mammography screening rates among asymptomatic women were implemented and evaluated in the community. One program (E) was based on the Health Belief Model (HBM); the second program (EP) added exercises adapted from the social psychology of compliance. Program impact on screening among 295 primarily Caucasian, middle-class women was evaluated against untreated controls (C) over a 6-month period. Both programs led to increases in HBM components (Perceived Susceptibility, and Perceived Benefits) and Intentions to obtain a mammogram. Screening rates 2 to 3 times higher were observed in the EP and E over C conditions; EP and E did not differ. A mediational model of compliance illustrated the interplay of HBM components in the compliance process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Breast cancer in women who undergo screening mammography: relationship of hormone replacement therapy to stage and detection method

PURPOSE: To compare the breast cancer stages and detection methods in screened women who receive hormone replacement therapy (HRT) with those in screened women who do not receive HRT to determine whether HRT affects the stage or mammographic detection of malignancy. MATERIALS AND METHODS: One hundred fifteen cases of breast cancer in women (age range, 55-65 years) in whom at least one screening mammogram had been obtained at least 24 months before diagnosis and in whom the history regarding HRT could be determined were reviewed retrospectively. Statistical analysis was performed with CHI-2 analysis and the Fischer exact test. RESULTS: The cancer stages in the 58 women who received HRT were stage 0 in 15 (26%), stage I in 28 (48%), stage II in 13 (22%), and stage III in two (3%) women. The stages in the 57 women who did not receive HRT were stage 0 in 19 (33%), stage I in 24 (42%), stage II in 11 (19%), stage III in two (4%), and stage IV in one (2%) woman. Cancers in 38 (67%) of the women who did not receive HRT and in 38 (66%) of those who did receive HRT were detected with mammography alone; false-negative mammograms were obtained in five (9%) women in the non-HRT group and in four (7%) women in the HRT group (P = .89). CONCLUSION: Among screened women who developed breast cancer, there were no significant differences in cancer stages or in the number of mammographically detected cancers or false-negative mammograms between the HRT group and the non-HRT group.     

An evaluation of educational outreach to general practitioners as part of a statewide cervical screening program

OBJECTIVES: The purpose of this study was to determine the acceptability, effectiveness, and cost of a face-to-face educational outreach intervention in the context of a program aimed at increasing cervical screening in Victoria, Australia. METHODS: All identified general practitioners in a specified intervention area were offered a visit by a general practitioner educator. Practitioners completed a questionnaire evaluating the acceptability of the visit. Odds ratios for a woman being screened in the 3 months following the visits were determined. RESULTS: Fifty-nine general practitioners (69.4%) accepted the offer of a visit. Most found both the process and the content of the intervention to be acceptable. The intervention and nonintervention regions did not differ either before or after the intervention. In both regions, there was a statistically significant increase in number of Pap tests performed. There was no difference in the change in screening between the two regions. Costs were estimated at Au$34 per general practitioner visited. CONCLUSIONS: This strategy cannot be recommended for widespread use in a cervical screening program.     

Characteristics of women working as child aides in a school-based preventive mental health program.

Investigated whether a group of 50 adult women hired to work as nonprofessional mental health workers (child aides) were higher than 40 demographically comparable controls on attributes which, on an a priori basis, could be expected to be related positively to effective functioning in their role. Ss were compared on the Personality Research Form, the SVIB, the Marlowe-Crowne Social Desirability scale, a semantic differential, the Situational Response Test, and R. Hogan's Empathy Scale. The groups were significantly differentiated from one another on a wide range of scales. The inference is drawn that the aide group possessed more desirable attributes than the control group for the role of nonprofessional mental health worker. (25 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic role of mammography and clinical examination in the framework of a screening program for breast carcinoma in Brescia

Screening by mammography is at present the only way to obtain good results in terms of diagnosis of breast cancer at an early stage. In this paper we present the results of first and second rounds of a mammographic and clinical screening programme carried out in the health district of Brescia. At the first round out of 129 cancers detected, mammography was diagnostic in 124 cases; in 82 cases, the examination also allowed the identification of a suspicious nodule, while in 42 cases non palpable neoplasm was diagnosed with mammography alone. In the remaining 5 cases mammography was negative and only clinical examination led to the discovery of breast neoplasms. In the second round, in the 125 cancers detected, mammography was diagnostic in 124 cases; clinical examination allowed the identification of 59 of these tumours, while in 65 cases non palpable tumours were found with mammography alone. Only in one case mammography was negative and clinical examination led to the identification of the tumour.     

Patterns of use of a free nicotine patch program for Medicaid and uninsured patients

As a part of the Bacillus subtilis genome sequencing project, we have determined a 25-kb sequence covering the 17 degrees-19 degrees region. This region contains 26 complete open reading frames (ORFs) including the alkA and adaA/B operon, which encode genes for adaptive response to DNA alkylation. A homology search for the newly identified 21 ORFs revealed that 4 of them exhibit a significant similarity to known proteins, e.g., methicillin-resistant Staphylococcus aureus (MRSA) protein homolog, proteins involved in chloramphenicol resistance, glucosamine synthase and an ABC transporter protein. The remaining 17 ORFs did not show any significant sequence similarities to known gene products in the database.     

Posttraumatic stress disorder among incarcerated battered women: a comparison of battered women who killed their abusers and those incarcerated for other offenses

During development, telencephalic neural progenitors acquire positional specification and give rise to distinct structures such as the striatum and cortex. Here, we examine, in vivo, the influence of developmental stage, cell-surface molecules and regional differences along the dorso-ventral and antero-posterior axes on the selective incorporation of neural progenitors derived from different regions of the developing brain, utilizing a cross-species in utero transplantation paradigm. Striatal progenitors derived from the embryonic day (E) 12-14 mouse lateral ganglionic eminence (LGE) were observed consistently to incorporate into the developing striatum as early as 24-48 h following intraventricular injection into the E15-17 rat host. By removing cell-surface molecules from the LGE progenitors, the pattern of incorporation was remarkably different with no preferential striatal incorporation. Cortical progenitors with intact cell-surface molecules, by contrast, displayed little telencephalic (including striatal) incorporation as compared with precursors from the LGE. However, both progenitors from cortex and LGE incorporated widely into diencephalic and mesencephalic structures. The capacity for integration of precursors derived from the LGE and cortex gradually decreased during development of the host and was minimal in the postnatal day (P) 1 host. Unlike the telencephalic precursors, the vast majority of progenitors derived from the midbrain and cerebellar primordium (with cell-surface molecules intact) incorporated into diencephalic and midbrain nuclei with only a few cells observed in the telencephalon. These results demonstrate that incorporation of neural progenitors across the ventricular wall in the embryonic host is strictly developmentally regulated, dependent on their position along the antero-posterior axes and in the case of progenitors from the LGE is mediated by cell-surface molecules expressed on the transplanted cells.     

Analytical evaluation of the new Prostatus PSA Free/Total assay for prostate-specific antigen as part of a screening study for prostate cancer

A second Philadelphia (Ph) chromosome is one of the most common nonrandom secondary chromosome changes in leukemias with 9;22 translocations. It has been suggested, and observed in two studies of masked t(9;22), that the second Ph chromosome is an exact duplication of the entire derivative chromosome 22. In a cytogenetic study of bone marrow cells from an acute myelogenous leukemia patient, a cell line carrying two different Ph chromosomes evidenced by a chromosome 22 centromeric heteromorphism was found. From this observation arose the question whether the second der(22) was a true Ph chromosome or whether it was a deleted chromosome derived from the normal chromosome 22 that did not contain the bcr-abl rearrangement. A fluorescent in situ hybridization (FISH) study with the t(9;22) probe revealed two bcr-abl positive signals on 60 of 100 interphase nuclei. The second Ph could have resulted from a mitotic crossing over; or, analogously to late-appearing Philadelphia chromosomes, it may be derived from a new chromatid translocation between the chromosomes 9 and 22 not involved in the initial t(9;22).     

Effect of a bicycle safety program and free bicycle helmet distribution on the use of bicycle helmets by elementary school children

A retrospective follow-up study was performed on 40 patients, in which tuberculous spondylitis was treated conservatively between 1969 and 1985 with orthotic supports for an average of 16 months (range, 10-30 months) and with anti-tuberculous agents. All had persistent back pain, but none had neurological deficits. The mean follow-up period was 17 years (range, 10-26 years). Diagnosis was confirmed histopathologically. The spinal segments involved ranged from T5 to L5. The kyphotic angle was calculated according to Cobb. At final follow-up, 22 patients were pain free, 11 had occasional pain, 6 complained of pain in the morning, and 1 had chronic pain and needed frequent analgesics. Solid bony union was found in 75% of patients. The kyphotic deformity occurred in the thoracic spine with a mean angle of 20 degrees (range, 13-28 degrees) and in the lumbar spine with a mean angle 12 degrees (range, 5-26 degrees). The long-term follow-up of conservative treatment showed only slightly increased kyphosis. Conservative treatment is an alternative to surgical intervention in cases with kyphosis < 35 degrees.     

Anger as a vehicle in the treatment of women who are sexual abuse survivors: Reattributing responsibility and accessing personal power.

Some clinicians view client anger as a problematic symptom to be reduced, whereas others view it as an opportunity for therapeutic development. The present authors describe how client anger, a fitting emotional response to abuse, can work as a vehicle to help sexual abuse survivors reattribute responsibility and develop personal efficacy. The role of anger in the healing process of the sexual abuse survivor is explored through 2 case studies. It is suggested that by reframing anger as a vehicle for recovery rather than a symptom, therapists can learn to effectively incorporate anger work (which involves successfully negotiating any dynamics that cause therapist discomfort) into the treatment of survivors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The theory of reasoned action as a model of marijuana use: Tests of implicit assumptions and applicability to high-risk young women.

The theory of reasoned action (TRA) is used to model decisions about substance use among young mothers who became premaritally pregnant at age 17 or younger. The results of structural equation modeling to test the TRA indicated that most relationships specified by the model were significant and in the predicted direction, Attitude was a stronger predictor of intention than norm, but both were significantly related to intention, and intention was related to actual marijuana use 6 months later. Outcome beliefs were bidimensional, and positive outcome beliefs, but not negative beliefs, were significantly related to attitude. Prior marijuana use was only partially mediated by the TRA variables; it also was directly related to intentions to use marijuana and to subsequent use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress disorder after treatment for breast cancer: prevalence of diagnosis and use of the PTSD Checklist-Civilian Version (PCL-C) as a screening instrument

The presence of a posttraumatic stress disorder (PTSD) diagnosis in women (n = 82) diagnosed with Stage 0-IIIA breast cancer was assessed 6 to 72 months after cancer therapy. The PTSD Checklist-Civilian Version (PCL-C) and the PTSD module for the Structured Clinical Interview for DSM-IV, Nonpatient Version, PTSD module (SCID-NP-PTSD) were administered in a telephone interview. SCID-NP-PTSD results indicated prevalence rates of 6% and 4% for current and lifetime PTSD, respectively. Use of the recommended cutoff score of 50 on the PCL-C to determine diagnosis of current cancer-related PTSD resulted in a sensitivity of .60 and a specificity of .99 with 2 false-negative diagnoses. In conclusion, PTSD can be precipitated by diagnosis and treatment of breast cancer, and the PCL-C can be a cost-effective screening tool for this disorder.     

Reinforcement value of unsafe sex as a predictor of condom use and continued HIV/AIDS risk behavior among gay and bisexual men.

The pleasure or reinforcement value of high-risk sex may be an important influence on success in risk reduction efforts. Seronegative gay and bisexual men (N?=?297) completed measures assessing their unprotected and safer sex practices, as well as measures of cognitive and skill factors and a measure assessing the subjective reinforcement value of unprotected anal intercourse. Regression analyses showed that the reinforcement value of unprotected anal intercourse accounted for variance in predicting levels of condom use above that that could be accounted for by factors such as knowledge, behavior change intentions, perceived vulnerability, condom attitudes, and sexual communication skills. Only reinforcement value of unprotected sex and substance use significantly predicted how frequently participants engaged in high-risk sex. Increased attention to the valence of sexual reinforcers will improve HIV risk reduction models and enhance AIDS prevention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)