Community medicinePub Date : 1989-11-01DOI: 10.1093/OXFORDJOURNALS.PUBMED.A042482
M. Schwartz, W. Savage, J. George, L. Emohare
{"title":"Women's knowledge and experience of cervical screening: a failure of health education and medical organization.","authors":"M. Schwartz, W. Savage, J. George, L. Emohare","doi":"10.1093/OXFORDJOURNALS.PUBMED.A042482","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.PUBMED.A042482","url":null,"abstract":"A survey of the knowledge of and attitudes towards cervical cytology screening in various locations in Tower Hamlets showed that 77 per cent of women in the sample reported that they had a smear test, and 86 per cent knew about them, although a small group of active elderly were unlikely to know much about the test or to have had one. Only 11 per cent of the 600 women under 65 understood that cervical cytology was to prevent cancer, whereas 71 per cent thought that it was to detect cancer. Of the 205 women who recalled their experience of the test, all had some difficulty. Two-thirds were embarrassed, and 54 per cent had pain or discomfort, which included all those women who did not feel embarrassed. Forty-three per cent had been informed of the result of their tests and about one-quarter of those took steps to get the result. Seventy-one per cent of the women had had their first test done before the age of 35, but only 9 per cent after the age of 45. A quarter of those screened had only had one test done. The women considered that more publicity about the test, the knowledge that a woman doctor would do the test, and more encouragement by health professionals would be improvements most likely to increase the uptake of screening. The possibility of a service offering immediate results should be explored by means of a pilot study.","PeriodicalId":75726,"journal":{"name":"Community medicine","volume":"35 1","pages":"279-89"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.PUBMED.A042482","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61160369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Women's knowledge and experience of cervical screening: a failure of health education and medical organization.","authors":"M Schwartz, W Savage, J George, L Emohare","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A survey of the knowledge of and attitudes towards cervical cytology screening in various locations in Tower Hamlets showed that 77 per cent of women in the sample reported that they had a smear test, and 86 per cent knew about them, although a small group of active elderly were unlikely to know much about the test or to have had one. Only 11 per cent of the 600 women under 65 understood that cervical cytology was to prevent cancer, whereas 71 per cent thought that it was to detect cancer. Of the 205 women who recalled their experience of the test, all had some difficulty. Two-thirds were embarrassed, and 54 per cent had pain or discomfort, which included all those women who did not feel embarrassed. Forty-three per cent had been informed of the result of their tests and about one-quarter of those took steps to get the result. Seventy-one per cent of the women had had their first test done before the age of 35, but only 9 per cent after the age of 45. A quarter of those screened had only had one test done. The women considered that more publicity about the test, the knowledge that a woman doctor would do the test, and more encouragement by health professionals would be improvements most likely to increase the uptake of screening. The possibility of a service offering immediate results should be explored by means of a pilot study.</p>","PeriodicalId":75726,"journal":{"name":"Community medicine","volume":"11 4","pages":"279-89"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13775613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cervical screening in the workplace.","authors":"J Thornton, J Chamberlain","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In an attempt to improve cervical cytology screening uptake in women aged over 40, a mobile screening unit was used to make screening easily available to women at work. This service was organized jointly between the District Health Authority, the Women's National Cancer Control Campaign and the South West Thames Regional Cancer Organization, and was offered to all companies employing at least 25 women. Thirty-nine out of 82 companies accepted the offer. Among those companies which were able to supply a register of their employees aged over 40, 91 per cent of eligible women attended the mobile clinic. The clinic doctors followed District guidelines in not taking smears from women who had been screened and found negative within the previous three years, or who had had a hysterectomy for an unrelated reason. Of the 1038 women who attended the clinic, cervical smears were taken from 568 (55 per cent). Fifteen women were found to have cervical neoplasia, of whom nine had either never been screened before or had last been screened more than five years previously; a further two women (one of whom was found to have early invasive cancer) had previously had an abnormal smear for which the recommended follow-up had not been done. It was not possible to quantify the benefits of other tests (clinical breast examination, blood pressure, urinalysis and gynaecological examination) included in the screening clinic, but they were popular with the women attending. Provided that the health authority is involved in the planning and organization of workplace screening, it can be a valuable adjunct to improving screening coverage, particularly for women aged over 40.</p>","PeriodicalId":75726,"journal":{"name":"Community medicine","volume":"11 4","pages":"290-8"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13775614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T Stroffolini, E Franco, G Romano, P Uccheddu, L Zaratti, P Pasquini, A Panà, A Maida, B Scarpa
{"title":"Hepatitis A virus infection in children in Sardinia, Italy.","authors":"T Stroffolini, E Franco, G Romano, P Uccheddu, L Zaratti, P Pasquini, A Panà, A Maida, B Scarpa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The prevalence of antibody to hepatitis A virus (anti-HAV) in a sample of 1662 Sardinian children aged 3 to 11 years was estimated by ELISA. The overall anti-HAV prevalence was 3.8 per cent; it increased from zero among children of 3 to 7.2 per cent in children of 11 years. A slight male predominance was observed (4 versus 3.6 per cent). Anti-HAV prevalence was inversely related to the number of years of education received by the father and positively related to the number of households in the sample. Children whose fathers had received less than six years of schooling, had a 6.2-fold risk (Cl 95 per cent = 2.6-15.3) and children with five or more households under one roof had a 2.6-fold risk (Cl 95 per cent = 1.4-5.0) of previous exposure to hepatitis A virus (HAV) infection. These findings suggest that exposure of Sardinian children to hepatitis A virus is relatively low, probably because of improvements in socioeconomic conditions in recent years in the island. However, overcrowding and poor education in the father of schooling appear to be important determinants of infection.</p>","PeriodicalId":75726,"journal":{"name":"Community medicine","volume":"11 4","pages":"336-41"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13775617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Community medicinePub Date : 1989-11-01DOI: 10.1093/OXFORDJOURNALS.PUBMED.A042490
A. Johnson, R. King
{"title":"A regional register of early childhood impairments: a discussion paper. The Steering Committee of the Oxford Region Child Development Project.","authors":"A. Johnson, R. King","doi":"10.1093/OXFORDJOURNALS.PUBMED.A042490","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.PUBMED.A042490","url":null,"abstract":"A regional register of preschool children with cerebral palsy, severe vision loss and sensorineural deafness has been complied. Case definition, the threshold for including or excluding a case and a standard method for describing a case have been predefined. In order to achieve complete ascertainment, multiple sources of information were used and account was taken of population movement, and loss of cases through death. The optimal age of case ascertainment poses a particular problem and counting of definite cases was delayed until age three years with a further review at age five years. The register can be used to estimate prevalence of impairment, as a basis for aetiological and interventive studies and for service planning. It fills an important gap in the information currently available on childhood morbidity.","PeriodicalId":75726,"journal":{"name":"Community medicine","volume":"11 4 1","pages":"352-63"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.PUBMED.A042490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61160723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Community medicinePub Date : 1989-11-01DOI: 10.1093/OXFORDJOURNALS.PUBMED.A042481
Hugh Sanderson, Alison Storey, David Morris, R. Mcnay, Michael P. Robson, Jeremy Loeb
{"title":"Evaluation of diagnosis-related groups in the National Health Service.","authors":"Hugh Sanderson, Alison Storey, David Morris, R. Mcnay, Michael P. Robson, Jeremy Loeb","doi":"10.1093/OXFORDJOURNALS.PUBMED.A042481","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.PUBMED.A042481","url":null,"abstract":"Evaluation of the use of diagnosis-related groups (DRGs) has revealed a number of technical problems in coding of diagnoses and operative procedures, as well as unresolved issues in the clinical acceptability of existing groupings. An investigation of the statistical homogeneity of DRGs, in terms of duration of patient stay, is described. Consideration of data relating to some 990,000 episodes of in-patient care in three English Regions discloses wide variations in statistical homogeneity, both between DRGs and in relation to individual clinical specialties. The greatest homogeneity is found in ENT surgery and gynaecology; and the least in general medicine and orthopaedic surgery. The need for improved data collection and coding procedures is discussed, together with the advisability of sensitivity in the interpretation of DRGs, as well as the need for a co-ordinated approach to their refinement for application in any wider introduction in the NHS.","PeriodicalId":75726,"journal":{"name":"Community medicine","volume":"13 1","pages":"269-78"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.PUBMED.A042481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61160160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anonymous testing for HIV. What does the public think?","authors":"C Smith, D Nutbeam","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75726,"journal":{"name":"Community medicine","volume":"11 4","pages":"384-5"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13777196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cerebrovascular disease in Scotland during 1959 to 1983: its geographical distribution and associations.","authors":"F L Williams, O L Lloyd","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A study of the geographical distribution of cerebrovascular disease in Scottish communities during three quinquennia between 1959 and 1983 showed a marked tendency for high SMRs to be present in the west of Scotland and low SMRs in the east. Cerebrovascular disease was significantly correlated with coronary heart disease, with bronchitis, emphysema and asthma, and to a lesser extent with other heart disease, with other circulatory disease and with indices of overcrowding. It was not associated with either urbanization or industrialization.</p>","PeriodicalId":75726,"journal":{"name":"Community medicine","volume":"11 4","pages":"306-15"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13775615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Community medicinePub Date : 1989-11-01DOI: 10.1093/OXFORDJOURNALS.PUBMED.A042484
A. Cribb, A. Haycox
{"title":"Economic analysis in the evaluation of health promotion.","authors":"A. Cribb, A. Haycox","doi":"10.1093/OXFORDJOURNALS.PUBMED.A042484","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.PUBMED.A042484","url":null,"abstract":"The problems of using cost-effectiveness analysis in health promotion are set out in order to argue against the simplistic application of QALY-type analysis between the preventive and curative sectors. The difficulties of conceptualizing and measuring 'effectiveness', and the obstacle of achieving predictive validity in cost-effectiveness analysis are discussed.","PeriodicalId":75726,"journal":{"name":"Community medicine","volume":"53 1","pages":"299-305"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.PUBMED.A042484","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61160031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Communicable disease report. April to June 1989. The PHLS Communicable Disease Surveillance Centre.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75726,"journal":{"name":"Community medicine","volume":"11 4","pages":"376-83"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13705380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}