Modern Pesticides and Bobwhite Populations

(Invited Paper) Bobwhite (Colinus virginianus) are frequently used as test animals for wildlife tests of pesticides. The organophosphate and carbamate pesticides that have replaced the organochlorines have many desirable properties, but they span a wide range of acute toxicities and some of them affect survival, reproduction, food consumption, behavior, and nervous system enzymes in laboratory tests. Applying these laboratory findings to the field requires assumptions about the severity of exposure in the field. Direct field measurements show that birds may be exposed to significant amounts of these pesticides or even more toxic degradation products under some conditions. Adverse population effects may also result from depression of insect populations during the seasons when bobwhites rely on insects for food

Southeast Asian refugee children: Self-esteem as a predictor of depression and scholastic achievement in the U.S.

The eruption of conflicts and war in this century has led to new masses of refugees and displaced persons. Globally, host countries will continue to confront issues of how to ensure the successful adaptation of refugees who typically are women and children. The United States received three major waves of Southeast Asian (SEA) refugees during the past twenty-five years. One million SEA refugees arrived in the past decade; the majority were children and adolescents. Today, there is still a lack of understanding surrounding mental health issues and their relationship to children\u27s violence experience. We know that SEA refugee children suffered violence during the war in Southeast Asia, their escape from homelands, in camps of asylum and in the U.S. Although researchers have examined the relationship of violence with depression and post-traumatic stress disorder in refugee children, the findings have been unclear and sometimes conflictual in their relationship to scholastic achievement. In the U.S., healthy self-esteem is recognized as an important component of mental health and academic success, while low self-esteem is associated with depression and academic failure. In general, self-esteem and measures of self-esteem have not been studied cross-culturally. The authors report the findings of a measure of self-esteem, depression and academic achievement in a convenience sample of 237 Southeast Asian refugee children aged 6 to 17 years of age in the U.S. Internationally, nurses who assess the mental health of refugee children and design interventions to assist in their adaptation, will want to have an understanding of mental health issues cross-culturally

Exploring cancer survivors’ views of health behavior change: "Where do you start, where do you stop with everything?"

International audienceObjective: Physical activity (PA) and a healthy diet can improve the well‐being of cancer survivors. However, cancer survivors often do not engage in these behaviours. This study aimed to explore barriers and facilitators to engaging in these behaviours following cancer treatment.Methods: During the development of a web‐based intervention to enhance health‐related quality of life in cancer survivors, 32 people who had completed treatment for breast, colon or prostate cancer were presented with an intervention for PA and healthy eating. In‐depth think‐aloud and semi‐structured interviewing techniques were used to elicit perceptions of both behaviours. Data were analysed using thematic analysis.Results: Some individuals reported implementing positive health behaviour changes to maintain health and prevent recurrence, or to help them to move forward after cancer. However, others reported feeling abandoned, and many did not report an intention to engage in lifestyle changes. Individuals discussed contextual and health‐related barriers that were specifically linked to their situation as post‐treatment cancer survivors: individuals described uncertainty about how to implement adaptive changes and perceived a lack of support from healthcare providers. Others viewed behaviour change as unnecessary or undesirable, with some arguing that non‐modifiable factors contributed more to their cancer diagnosis than lifestyle‐related factors.Conclusions: For many participants in this study, the period that follows treatment for cancer did not represent a ‘teachable moment’. A variety of complex and heterogeneous factors appeared to impact motivation, and may limit cancer survivors from engaging with diet and PA changes

Malodorous consequences: What comprises negligence in anosmia litigation?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106718/1/alr21257.pd

Oral cancer awareness amongst hospital nursing staff: a pilot study

<p>Abstract</p> <p>Background</p> <p>Oral cancer is as prevalent as cervical and testicular cancer in the United Kingdom. Nursing staff provide the oral health care for the patient population in hospital. Admission to hospital provides a 'window of opportunity' for oral cancer 'screening' via an oral health check during nursing clerking. This study aimed to investigate whether nursing staff are aware of risk factors for oral cancer, its clinical signs, and could therefore provide a 'screening' service for oral cancer.</p> <p>Method</p> <p>Through the use of a questionnaire we assessed 121 nursing staff on oral health check behaviour and attitudes; their knowledge of risk factors for oral cancer; their understanding of common clinical signs of oral cancer; and their undergraduate and postgraduate training in oral health and oral cancer.</p> <p>Results</p> <p>Over 80% thought oral health checks were important although only 49% performed this task regularly; approximately 70% identified smoking as a risk factor but less than 30% identified alcohol. Awareness of the clinical signs of oral cancer was low with 21% identifying white patches, 15% identifying ulceration and only 2% identifying red patches despite their malignant potential. Nurses within 3 years of qualification were significantly better at recognising risk factors for oral cancer than their colleagues, identifying a need for continuing postgraduate education on oral health and oral cancer. Sixty-one percent of nursing staff received oral healthcare as an undergraduate with 34 percent receiving postgraduate training.</p> <p>Conclusion</p> <p>An oral health check upon admission to hospital provides an opportunity for nurses to 'screen' for oral diseases including oral cancer and allows nurses a greater role in total patient care. Nurses' awareness of oral cancer risk factors and clinical signs was, however, poor. This study highlights a need for improved education of nurses on oral cancer to make the oral health check on admission viable for oral cancer screening.</p

Health-related quality of life and distress in cancer patients: results from a large randomised study

To compare the effectiveness of individual support, group rehabilitation and a combination of the two in improving health-related quality of life (HRQOL) and psychological well-being in cancer patients during 24 months after diagnosis, as compared with standard care (SC). Furthermore, to compare the study sample and a random sample of the Swedish population with regard to HRQOL. A total of 481 consecutive patients, newly diagnosed with cancer, were randomly assigned to one of the four alternatives. Data on HRQOL and psychological well-being were collected at baseline and after 3, 6, 12 and 24 months. The interventions did not improve HRQOL or psychological well-being, as compared with SC. At 3 months, the study sample reported an HRQOL comparable with the normal population. Many cancer patients are able to manage their cancer-related concerns with the support available from SC. However, it is reasonable to assume that the findings suffer from a lack of data from especially vulnerable patients and a possible Hawthorne effect. It cannot be concluded that cancer patients have no need for additional psychosocial interventions. Future projects should include screening and target interventions for those at risk for significant and prolonged psychological distress

Patient- and system-related barriers for the earlier diagnosis of colorectal cancer

<p>Abstract</p> <p>Background</p> <p>A cohort of colorectal cancer (CRC) patients represents an opportunity to study missed opportunities for earlier diagnosis. Primary objective: To study the epidemiology of diagnostic delays and failures to offer/complete CRC screening. Secondary objective: To identify system- and patient-related factors that may contribute to diagnostic delays or failures to offer/complete CRC screening.</p> <p>Methods</p> <p>Setting: Rural Veterans Administration (VA) Healthcare system. Participants: CRC cases diagnosed within the VA between 1/1/2000 and 3/1/2007. Data sources: progress notes, orders, and pathology, laboratory, and imaging results obtained between 1/1/1995 and 12/31/2007. Completed CRC screening was defined as a fecal occult blood test or flexible sigmoidoscopy (both within five years), or colonoscopy (within 10 years); delayed diagnosis was defined as a gap of more than six months between an abnormal test result and evidence of clinician response. A summary abstract of the antecedent clinical care for each patient was created by a certified gastroenterologist (GI), who jointly reviewed and coded the abstracts with a general internist (TW).</p> <p>Results</p> <p>The study population consisted of 150 CRC cases that met the inclusion criteria. The mean age was 69.04 (range 35-91); 99 (66%) were diagnosed due to symptoms; 61 cases (46%) had delays associated with system factors; of them, 57 (38% of the total) had delayed responses to abnormal findings. Fifteen of the cases (10%) had prompt symptom evaluations but received no CRC screening; no patient factors were identified as potentially contributing to the failure to screen/offer to screen. In total, 97 (65%) of the cases had missed opportunities for early diagnosis and 57 (38%) had patient factors that likely contributed to the diagnostic delay or apparent failure to screen/offer to screen.</p> <p>Conclusion</p> <p>Missed opportunities for earlier CRC diagnosis were frequent. Additional studies of clinical data management, focusing on following up abnormal findings, and offering/completing CRC screening, are needed.</p