Colorectal cancer (CRC) screening in the United States is suboptimal. We conducted a national survey to learn about CRC screening perceptions and practices among trainees who perform CRC screening ...tests including those enrolled in Gastroenterology and Hepatology (GIH), General and Colorectal Surgery, and Diagnostic and Abdominal Radiology training programs.
Program directors/administrators (PDs/PAs) from 642 programs were contacted by e-mail with an invitation to forward our survey to trainees in their programs. Participating trainees then completed an anonymous, Web-based questionnaire.
A total of 130/642 (20%) PDs/PAs forwarded our survey to their trainees, with responses received from 476 trainees (80 GIH, 261 surgery, 135 radiology). Colonoscopy was felt to be the best CRC screening test at reducing CRC mortality, with patient-related factors perceived as greater barriers than system-related factors. No single guideline was deemed very influential on CRC screening practices by most trainees. A total of 2 of 5 above-average risk patient profiles were not recognized by most trainees. Colonoscopy was selected as the preferred follow-up test for a positive CRC screening test by most trainees. However, 34% of respondents chose an option other than colonoscopy alone for follow-up of a positive fecal occult blood test.
Based on data from this national survey of gastroenterology, surgery, and radiology trainees, opportunities exist for curricular changes that may help enhance current perceptions and practices of trainees who perform CRC screening tests.
In the past decade, acid deposition and its effect on the environment has come increasingly to the forefront of public attention and concern. Computer modelling allows us to study the interaction of ...the various processes which are involved in such pollution, and to examine the consequences of the various strategies which are proposed to alleviate the problem. In this review we examine these processes, and consider the various ways in which they have been and could be represented in a computer model. The different approaches which can be adopted in such a model are also considered, together with their advantages, disadvantages, and some of the problems which can arise. Finally we present conclusions as to the most beneficial methods of developing our understanding of how to represent the various processes in a model.
In recent years, the recognition of non-protein coding RNAs as a functional effector of genetic expression has been highlighted by the discovery of RNA interference (RNAi). RNAi is an intracellular ...phenomenon that enables the eukaryotic cell to utilize double-stranded RNA molecules to silence gene expression in a sequence-specific manner. The short interfering RNA (siRNA) pathway has been intensively investigated and continues to serve as the basis for the development of potent molecular genetic tools. The power of this technology is most clearly evidenced by the fact that siRNA effector molecules can be chemically synthesized and exogenously delivered to specifically target and silence any gene of choice. This capability enables not only basic research, but also opens the door to a new therapeutic modality. Furthermore, the introduction of certain chemical modifications to siRNA effectors can produce a more robust knockdown of gene expression, hence, optimizing serum stability and increasing target specificity yet limiting the induction of cellular stress response, which are key features for in vivo delivery and successful therapeutics. This article outlines the progress in the development of differentially modified siRNA duplexes and their potential role as human therapeutics.
Rats fed maize-based diets approximating to that eaten by blacks at risk of Mseleni joint disease developed fibrous osteodystrophy and nutritional secondary hyperparathyroidism, thought to be due to ...dietary calcium deficiency. This suggests that a dietary cause for this disease needs to be investigated further.
During the summer of 2007, Utah experienced a statewide outbreak of gastrointestinal illness caused by Cryptosporidium, a parasite transmitted via the fecal-oral route. Approximately 5,700 ...outbreak-related cases were identified across the state. Of 1,506 interviewed patients with laboratory-confirmed cryptosporidiosis, 1,209 (80%) reported swimming in at least one of approximately 450 recreational water venues during their potential 14-day incubation period. Cryptosporidium is extremely chlorine-tolerant, and secondary or supplemental disinfection with ultraviolet light or ozone can control but not prevent outbreaks. Because swimmers are the primary source of Cryptosporidium contamination, healthy swimming campaigns are needed to increase awareness and practice of healthy swimming behaviors, especially not swimming while ill with diarrhea (i.e., swimming while ill with diarrhea can lead to gross contamination of recreational water). Before the 2008 summer swimming season, Utah public health agencies launched a multimedia healthy swimming campaign. To assess knowledge of healthy swimming, a survey of Utah residents was conducted during July-September 2008. The results of that survey found that 96.1% of respondents correctly indicated that "it is not OK to swim if you have diarrhea." In a separate national survey in 2009, 100% of Utah residents but only 78.4% of residents of other states correctly indicated that "not swimming while ill with diarrhea protects others from recreational water illnesses (RWIs)." No recreational water-associated outbreaks were detected in Utah during 2008-2011. The healthy swimming campaign, as part of a multipronged prevention effort, might have helped prevent recreational water-associated outbreaks of cryptosporidiosis in Utah.
The study compared the demographic and diagnostic characteristics of clients and the outcomes of treatment in five short-term acute residential treatment programs and two acute hospital-based ...psychiatric programs.
A total of 368 clients in the short-term acute residential treatment programs and 186 clients in the psychiatric hospital programs participated in an observational study. The study used a repeated-measures design and assessed participants on multiple standardized measures of symptoms and functioning at admission, discharge, and four-month follow-up. Comparisons between the two groups were conducted separately by diagnostic category. Measures included the Brief Symptom Inventory, the Behavior and Symptom Identification Scale-32, the Medical Outcomes Short-Form-36, and the Client Satisfaction Questionnaire-8.
The two types of programs admit persons with similar levels of acute distress who have comparable levels of improvement at discharge and an equivalent degree of short-term stability of treatment gains. Costs of treatment episodes were considerably lower for the short-term residential programs, and client satisfaction with the two types of programs was comparable.
Short-term acute residential treatment is a less costly yet similarly effective alternative to psychiatric hospitalization for many voluntary adult patients.
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