The impact of a screening mammography program on Sydney general practitioners

Abstract: The aim of this study was to determine changes in Sydney general practitioners' (GPs) knowledge about, attitude towards and intention to recommend screening mammography over the two years since a screening mammography program was first implemented in the Central Sydney Health Service (CSHS) area. 123 GPs from the CSHS area were selected from a list maintained by the Breast X-ray Programme, while 127 GPs from the rest of Sydney were selected from the Yellow Pages telephone directory. The overall response rate was 84 per cent. Outcomes were assessed by a self-administered questionnaire covering knowledge, attitudes and beliefs, self-report of recent referral practice, intention to recommend, and sources of information about mammography screening. Demographic data were also collected. Results showed that overall knowledge has increased both inside and outside the CSHS area, but important deficiencies in knowledge remain in both areas. Attitudes to screening mammography have improved in the CSHS area, especially regarding the efficacy of screening mammography and patient compliance. Importantly, positive views of screening mammography have declined outside the CSHS area, especially about whether screening mammography can save women's lives. GPs in both areas remain concerned about costs. The presence and strategies of the Breast X-ray Programme have had some positive effect on the attitudes of GPs towards, but not knowledge of, screening mammography.     

Laparoscopic-assisted bowel surgery

The use of laparoscopic surgical techniques is now being applied to a variety of operations traditionally performed in an open fashion. Twenty patients underwent laparoscopic-guided large and small bowel surgery at our institution from March 1991 to April 1992. The indications for surgery included polyps, obstruction, bleeding, and perforation, and pathologic diagnoses included benign polyps, lipomas, inflammatory bowel disease, perforation of a jejunal diverticulum, colonic arteriovenous malformations, and adenocarcinoma. Mobilization of the colon, ligation of the mesentery, and closure of the mesenteric defect were performed using the laparoscopic equipment. One trocar site was enlarged to 3 cm to deliver the bowel through the abdominal wall. All anastomoses were hand-sewn. Postoperative hospitalization ranged from 2 to 31 days (median, five days). No mortality was noted, and morbidity was 20 percent. We conclude that laparoscopic-guided bowel surgery is technically feasible and should translate into shorter hospitalization and less patient discomfort.     

Self-administration of GBR 12909 on a fixed ratio and progressive ratio schedule in rats

Intravenous self-administration of GBR 12909, an indirect dopamine agonist, was examined on a Fixed Ratio (FR 1) and a Progressive Ratio (PR) schedule of reinforcement in rats. Subjects were first trained to self-administer cocaine (1.5 mg/kg/inj) during daily 5 h sessions, after which GBR 12909 (0.187–1.5 mg/kg/inj) was substituted. On the FR 1 schedule, the inter-infusion interval for GBR 12909 self-administration was directly related to dose and was approximately three times longer than that established for equivalent doses of cocaine. Breaking points on the PR schedule were comparable for GBR 12909 and cocaine self-administration. The data indicate that, compared to cocaine, GBR 12909 has a longer duration of action and a similar reinforcing efficacy.     

Booze on the box: The portrayal of alcohol on British television: a content analysis

The portrayal of alcohol was examined in a systematic sampleof 50 programmes broadcast on British television. Four out offive programmes contained visual or verbal references to alcohol.On average, there was a reference to alcohol in every 6 minutesof programming. The programmes showed more alcohol being consumedthan soft drinks or beverages, but there were few referencesto the hazards of alcohol consumption. The main recommendationis that television companies should accept a responsibilityfor presenting a more realistic and healthier approach to theuse of alcohol in Britain     

Can a Single Muscle Fiber Model the Features of Myocardial Stunning?

The exact mechanisms that cause myocardial stunning are still unclear. We previously utilized a computer model of the ventricle that was effective in modeling the dominant observable features of stunning, but it was not simple to implement. This led to the design of a single muscle fiber model. The mathematical model of a muscle fiber consisted of three elements: a contractile element, a series elastic element, and a parallel elastic element. The model created length waveforms based on time-dependent force and contractile stiffness functions. This model was initially evaluated by entering the same regional parameter values used in the global dual region ventricular model. First a reduction of the contractile stiffness function was applied by reducing the peak stiffness by 30%, and then the rates of activation and deactivation were reduced by 20% while maintaining the peak values constant. The three-element model produced results very similar to the canine and ventricular model. Thus, it is concluded that the simpler three-element model provides an accurate model of the myocardial tissue and its deficiencies during stunning.     

Manifestation of depressive symptoms among adolescents. A comparison of Mexican Americans with the majority and other minority populations.

The purpose of this research was to investigate differential manifestation of depressive symptomatology among adolescents from diverse ethnocultural groups. Data from a national survey of persons 12 to 17 years of age (N = 2200) were analyzed, comparing responses of Anglo, African, Mexican, and other Hispanic Americans with a 12-item version of the Center for Epidemiologic Studies Depression Scale. The results indicated minimal differences in terms of item response and internal consistency-reliability among the four adolescent groups. However, there were differences in patterns of item endorsement, as indicated by principal component factor analysis. Anglo- and African Americans exhibited similar factor structure, represented by negative affect, positive affect, and psychosomatic symptoms. The two Hispanic groups also exhibited a three-dimensional pattern, but there was a tendency among Hispanic adolescents for somatic symptoms and negative affect symptoms to cluster together. This pattern may indicate a more prominent role of somatic complaints in the presentation of depression among Mexican Americans and other Hispanics.     

Reduction of scrotalized skin improves the cosmetic appearance of feminising genitoplasty

A modified labioplasty to improve the cosmetic appearance after feminizing genitoplasty is described. Good results were obtained in all five patients in whom the technique was utilized.     

Results of speech perception and speech production training for three prelingually deaf patients using a multiple-electrode cochlear implant.

Five studies were conducted to measure changes in the perception and production of selected speech targets, with training, in three prelingually deaf patients. The two adults and one adolescent were implanted with the Cochlear (Nucleus) multiple-electrode prosthesis. The studies were perception and production of nasal consonants; perception of syllable-final consonants; perception and production of alveolar consonants; auditory-visual perception of alveolar consonants; and perception and production of vowels. Perceptual data were collected in the audition (implant)-alone condition, except for the auditory-visual perception of alveolar consonants where the audition-alone, vision-alone, and auditory-visual conditions were used. Speech perception data in the audition-alone condition were also collected from four postlingually deaf adult implant patients, without training, to indicate differences between the two classes of patients. The three prelingually deaf patients generally showed some improvements in speech production. In perception, improvements were recorded only for individual patients in some studies. The performance of the adolescent was better than that of the two adults in all cases. The perceptual performance of the postlingually deaf patients was superior to that of the prelingually deaf patients in all cases.