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  • 1
    Electronic Resource
    Electronic Resource
    How Do Practicing Clinicians Manage Helicobacter pylori-Related Gastrointestinal Diseases in Germany? A Survey of Gastroenterologists and Family Practitioners (1998)
    Cambridge, MA, USA : Blackwell Science Ltd
    Helicobacter 3 (1998), S. 0 
    Details
    ISSN: 1523-5378
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Since the bacterium H. pylori was identified in 1982, overwhelming evidence has implicated it as the causal factor in the occurrence and relapse of peptic ulcer disease. The major objective of this study was to examine the extent to which physicians recognize H. pylori as a causal agent in peptic ulcer disease or as potential cofactor in other gastrointestinal diseases, and the extent to which this knowledge has influenced diagnostic and therapeutic practices.〈section xml:id="abs1-2"〉〈title type="main"〉Materials and Methods.Using a national mail survey in Germany in September 1995, 1197 family practitioners and 1197 gastroenterologists were selected for the study.〈section xml:id="abs1-3"〉〈title type="main"〉Results.Of the surveyed physicians, 756 (32%) responded. Family practitioners treated almost 50% of their patients with initial presentation of suspected ulcer disease without ordering further diagnostic tests. More than 25% of the family practitioners and 14% of the gastroenterologists reported that they do not treat diagnosed H. pylori infection in the first presentation of duodenal ulcer. At the time we conducted the study, 22% of responding family practitioners and 5% of responding gastroenterologists treated the first presentation of H. pylori-positive ulcer disease with regimens determined to be ineffective according to the available literature.〈section xml:id="abs1-4"〉〈title type="main"〉Conclusions.Gastroenterologists preferred to treat H. pylori infection when the associated disease was one for which a causal relationship had been more clearly established, while family practitioners showed less discrimination. In order to provide optimal therapy aimed at minimizing the course and consequences of H. pylori-related diseases, researchers in the field must ensure continuous dissemination of current knowledge.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1523-5378.1998.08027.x
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Proportional melanoma incidence and occupation among White males in Los Angeles County (California, United States) (1995)
    Springer
    Cancer causes & control 6 (1995), S. 451-459 
    Details
    ISSN: 1573-7225
    Keywords: Education ; males ; melanoma ; occupation ; solar radiation ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: A case-control analysis of cancer registry data was used to examine the hypothesis that occupational exposure to sunlight influences the risk of melanoma. Occupation at diagnosis was available for 3,527 cutaneous melanomas and 53,129 other cancers identified by the Los Angeles County (California, United States) Cancer Surveillance Program among non-Spanish-surnamed White males aged 20 to 65 years between 1972 and 1990. Occupational exposure to sunlight was assessed by blinded expert coding of job titles as indoor, outdoor, and mixed indoor/outdoor. Relative to indoor occupations, proportionate odds ratios (OR) adjusted for age, level of education, and birthplace were 1.16 (95 percent confidence interval [CI]=1.07–1.27) for indoor/outdoor occupations and 1.15 (CI=0.94–1.40) for outdoor occupations. However, increasing levels of the education or training required for the occupation was associated more strongly with increased melanoma occurrence (ORs adjusted for age, occupational sun exposure, and birthplace, were 1.0, 1.63, 2.09, 2.23, and 2.99 for low-skill occupation, high school, college, postgraduate, and doctoral levels, respectively). Analysis of melanoma occurrence by job titles confirmed a clear variation by the required education or training level but not by the category of occupational sunlight exposure. The findings suggest that lifestyle factors associated with higher levels of education may be more important determinants of melanoma risk than characteristics of the work environment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00052186
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  • 3
    Electronic Resource
    Electronic Resource
    Compliance with Childhood Immunizations in Kern County, California (2000)
    Springer
    Journal of immigrant health 2 (2000), S. 213-222 
    Details
    ISSN: 1573-3629
    Keywords: child ; Hispanic ; immunization ; compliance ; rapid survey
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A rapid survey was conducted to describe the immunization status of the 0- to 2-year-old population in selected communities of Kern County, California, and identify reasons for noncompliance with immunization recommendations. Households were selected by two-stage cluster sampling. Among 860 children, 38% had received immunizations on schedule, while 44% had not received the recommended doses for their age. Compliance with the immunization schedule worsened dramatically after the first year of life. Among 2 year olds, the proportion that had the recommended number of vaccine doses was 81% for MMR, 82% for polio, 65% for DTP, and 47% for Hib. Parents' main reasons for noncompliance included child's illness, procrastination, and limited access to information and services. The low levels of compliance reflect lack of active follow-up in preventive health care across socioeconomic levels. The results show the importance of aiming immunization messages at parents and physicians of 12- to 18-month-old children. The rapid survey approach offers public health agencies an efficient means of assessing community health problems and targeting programs according to need.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1009592329980
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    Paper (German National Licenses)
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