Australian women's awareness of ovarian cancer symptoms, risk and protective factors, and estimates of own risk.

OBJECTIVE: To examine Australian women's perceived risk of ovarian cancer, reasons for perceived risk levels, and knowledge of ovarian cancer symptoms at two timepoints (2003 and 2007). METHODS: A computer-assisted telephone (CATI) survey of 2,954 Australian women with no history of ovarian cancer was conducted. RESULTS: Approximately 60% of women perceived their risk of ovarian cancer was similar to other women of their age; 10% indicated an increased risk, and 30% indicated a lower risk. These figures were similar in 2003 and 2007. Logistic regression found that lower income, increased age, being born overseas, and being retired were significantly associated with lower perceived risk (accounted for only 7.5% of the variance). Common reasons for higher perceived risk included family history of ovarian/other cancers, increasing age, and having had other types of cancer or health problems. Reasons for lower than average risk included absence of family history, having a hysterectomy, and having regular Pap smears (indicating confusion between ovarian and cervical cancer). There appeared to be substantial confusion in women's understanding of ovarian cancer symptoms; this was similar in 2003 and 2007. CONCLUSION: The observed misperceptions and confusion regarding ovarian cancer symptoms and risk factors suggest ongoing public education campaigns are needed to improve knowledge and awareness.

Examining the pathways linking chronic sleep restriction to obesity.

A growing number of studies have identified chronic sleep restriction as a potential risk factor for obesity. This could have important implications for how obesity is prevented and managed, but current understanding of the processes linking chronic sleep restriction to obesity is incomplete. In this paper, we examined some of the pathways that could underlie the relationship between chronic sleep restriction and obesity. This involved exploring some of the potential environmental, health, behavioral, and sociodemographic determinants of chronic sleep restriction, which require further investigation in this context. Three pathways that could potentially link chronic sleep restriction to obesity were then examined: (1) altered neuroendocrine and metabolic function, (2) impaired glucose regulation, and (3) waking behavior. The selected pathways linking chronic sleep restriction to obesity reviewed in this paper are presented in a schematic representation; this may be used to guide future research in this area. This area of research is important because it may lead to more effective interventions and strategies to combat the present obesity epidemic.

Content analysis of disease awareness advertisements in popular Australian women's magazines.

OBJECTIVE: To examine the nature of disease awareness advertising (DAA). DESIGN: Therapeutic advertisements in six popular Australian women's magazines were monitored between April 2006 and March 2007. A subset of advertisements was included in the study based on criteria derived from a definition of DAA. Unique advertisements were analysed by four independent coders. MAIN OUTCOME MEASURES: Types of advertisements and their sponsors, the types of disease information present, and the persuasive techniques utilised. RESULTS: Of 711 advertisements identified, 60 met the inclusion criteria for DAA, and 30 of these were unique. Over one-third of the advertisements were classified as "unbranded product advertisements", which promote a product without referring directly to a brand. DAA sponsored by pharmaceutical companies most often provided treatment and prevalence information. Most (22/30) advertisements used emotional appeals; 15 of these used "happiness/healthiness/wellbeing". CONCLUSIONS: The educational value of industry-sponsored DAA could be improved if regulations and guidelines stipulated disease information requirements, such as inclusion of risk-factor and symptom information. Regulators should provide guidelines for "unbranded product advertisements" and the acceptability of other persuasive techniques. Further research into DAA is required and should consider advertisements in a range of media, and behavioural responses.

Factors associated with short and long sleep.

OBJECTIVE: Short (<7 h) and long sleep durations (> or = 9 h) have recently been linked with increased mortality in the US, Europe and Asia, but little is known about the sleep patterns of Australian adults. The present study examined the sleep habits of Australian adults and identified socio-demographic and health-related factors associated with short and long sleep. METHODS: This study analyzed cross-sectional and self-reported data from 49,405 Australian adults aged 45 to 65 years collected between 2006 and 2008. Socio-demographic and health-related factors were entered into multinomial logistic regression models predicting self-reported sleep duration. RESULTS: Short and long sleep were reported by 16.6% and 13.9% of participants respectively. Short sleep was associated with long working hours (odds ratio [OR]=1.17, 95% confidence interval (CI): 1.08, 1.28) and obesity (OR=1.29, 95% CI: 1.19, 1.41); long sleep was associated with recent treatment for cancer (OR=1.64, 95% CI: 1.34, 2.02) and heart attack/angina (OR=1.58, 95% CI: 1.19, 2.09). CONCLUSIONS: Short and long sleep were common in this sample of middle aged Australian adults. The determinants of short sleep have potential public health implications and could be targeted to prevent morbidity and mortality associated with short sleep.

Depression and quality of life in cancer survivors: is there a relationship with physical activity?

BACKGROUND: Evidence is growing on the benefit of physical activity to improve well-being following a cancer diagnosis. This study examined changes in physical activity from pre to post diagnosis and explored this relationship with quality of life and depression. METHODS: Participants were recruited by posters and by letter of invitation. The questionnaire was completed by 59 prostate and 32 breast cancer survivors. RESULTS: Physical activity decreased by 72 minutes per week from pre to post diagnosis, although 20.9% reported having increased activity post diagnosis. Over 30% were considered depressed. Breast cancer participants who increased physical activity post diagnosis reported higher scores for Physical Wellbeing subscale (26 versus 21; F[1,29] = 5.19, p < .03), Emotional Wellbeing subscale (22 versus 19; F[1,30] = 4.57, p < .04) and Functional Wellbeing subscale (26 versus 19; F[1,30] = 9.03, p < .001). A greater proportion of participants taking part in no physical activity were depressed (55.6%; chi2 = 6.83, p < .04). CONCLUSION: Over 25% of participants identified with emotional and/or well being problems, and more than half reported insufficient physical activity to yield benefits. Future research needs to gain a better understanding of why cancer survivors decrease their physical activity following a cancer diagnosis and what is necessary for them in order to retain or increase their physical activity.

Review and critique of the quality of exercise recommendations for cancer patients and survivors.

The benefit of exercise for cancer patients is starting to become recognized. The purposes of this paper were to review the literature to examine whether research findings are being converted into guidelines for patients and survivors and to examine the quality of evidence on which they were based. A computer search of major health databases was conducted for peer-reviewed literature and books on exercise and cancer, and an Internet search was conducted for cancer websites reporting any exercise guidelines/recommendations for cancer patients. Seven peer-reviewed articles, eight books and eight cancer websites were identified that suggested exercise guidelines for cancer patients and survivors. None of the published guidelines identified appeared to have been developed via a process that would allow them to be cited as evidence-based guidelines. Based on the studies to date, no direct cancer-specific evidence about the best type, frequency, duration or intensity of exercise is currently available in the peer-reviewed literature. It is currently not known what would be most beneficial for which cancers, at which stage of disease or treatment. Given the current interest in cancer and exercise, there is an urgent need for an evidence-based set of exercise guidelines to be developed.

Physician Communication Skills: Results of a Survey of General/Family Practitioners in Newfoundland.

PURPOSE: To describe the attitudes related to communication skills, confidence in using communication skills, and use of communication skills during the physician-patient encounter among a population-based sample of family physicians. PROCEDURES: A mailed survey, distributed to all family physicians and general practitioners currently practicing in Newfoundland. The questionnaire was designed to collect data in five general areas-participant demographics, physician confidence in using specific communication strategies, perceived adequacy of time spent by physicians with their patients, physician use of specific communication strategies with the adult patients they saw in the prior week, and physician use of specific communication strategies during the closing minutes of the encounters they had with adult patients in the prior week. MAIN FINDINGS: A total of 160 completed surveys was received from practicing family physicians/ general practitioners in Newfoundland, yielding an adjusted response rate of 43.1%. Most of the respondents (83.8%) indicated their communication skills are as important as technical skills in terms of achieving positive patient outcomes. Between one-third and one-half of the respondents, depending on the educational level queried, rated their communications skills training as being inadequate. Fewer than 20% of the respondents rated the communications skills training they received as being excellent. Physicians indicated a need to improve their use of 8 of 13 specific communication strategies during patient encounters, and reported using few communication strategies during the closing minutes of the encounter. Interactions that occurred during a typical encounter tended to focus on biomedical versus psychosocial issues. CONCLUSIONS: Family physicians/general practitioners recognize a need to improve their communications skills. Well-designed communications skills training programs should be implemented at multi-levels of physician training in order to improve patient satisfaction with their encounters with family/general practitioners, and to increase the likelihood of positive patient outcomes.