Clinical validation of a pressure-standardized compression mammography system.

OBJECTIVES: Validation of a pressure-standardized compression mammography (PSCM) system, which aims to reduce discomfort and pain by applying the same pressure to every breast, independent of breast size. METHODS: We retrospectively studied mammograms of 39 patients acquired with a conventional force-standardized compression mammography (FSCM) technique and intra-individually compared them to mammograms acquired on a checkup visit with PSCM technique. Patients received one craniocaudal (CC) and one mediolateral oblique (MLO) compression for both breasts. All images were processed to obtain the contact area between the breast and the compression paddle. The pressure was calculated by dividing the compression force by the contact area. RESULTS: A total of 150 FSCM and 150 PSCM images were analyzed. The mean pressure decreased significantly from 17.1 to 12.8 kPa (p < 0.001), when using PSCM instead of FSCM. The applied pressure hardly depended on the breast contact area with the paddle (-0.014 kPa/cm2), while a clear dependency was observed using FSCM. Furthermore, the relative number of over-compressions reduced from 26% to 2%, benefitting patients with smaller breasts. CONCLUSIONS: Our study suggests that using PSCM can reduce patient discomfort and pain during mammographic compression compared to conventional FSCM as a result of lower average pressure. Moreover, standardized pressure may provide a more constant image quality, which could improve diagnostic performance.

Porphyrin molecules boost the sensitivity of epitaxial graphene for NH3 detection.

The sensitivity of quasi-free standing epitaxial graphene for NH3 detection is strongly enhanced by chemical functionalization with cobalt porphyrins resulting in a detection limit well below 100 ppb. Hybridization between NH3 and cobalt porphyrins induces a charge transfer to graphene and results in a shift of the graphene Fermi-level as detected by Hall measurements and theoretically explained by electronic structure calculations.

Developing an EndoCaseTrac.

Many smaller hospitals are merging with large facilities to form healthcare groups. Standardization is the key to cost effectiveness and consistency within such groups. Not only should standardization be applied to equipment, but also to various aspects of documentation. A multi-facility Endoscopy Nurses Task Force was formed to develop an all-encompassing, easy flowing conscious sedation nursing record. The end product was an EndoCaseTrac that is thorough, complete, and multi purposed, to be used in any situations where intravenous conscious sedation is administered, but with the option of being department-specific. Staff education prior to implementation of the EndoCaseTrac played a very important part in the overall acceptance of this newly developed, very thorough and complete nursing documentation. Frequent staff meetings and discussions after implementation decreased the resistance and insecurity in using the EndoCaseTrac. A performance improvement program was also developed to evaluate the accurate completion by the endoscopy nurse and to identify problems.

Public reactions towards people with AIDS: an attributional analysis.

This article addresses the issue of stigmatization and discrimination towards people with AIDS (PWAs) using Weiner's attributional theory of motivation and emotion. In a field experiment, subjects responded to vignettes describing patients with AIDS, syphilis, lung cancer or tuberculosis. In these vignettes, the onset of the diseases was either described as personally controllable or as uncontrollable. Results show that although attributional variables do account for a significant amount of variance in helping behavior and emotions towards PWAs, other variables such as the incurability of the disease, the risk of infection and associations with (homo)sexuality, may be more useful in explaining reactions to PWAs. Implications for education tailored at the prevention of the stigmatization of PWAs are discussed.

The effects of computer-tailored smoking cessation messages in family practice settings.

BACKGROUND: Many conventional health education materials, such as pamphlets and booklets, are designed to reach as wide an audience as possible; they are therefore often lengthy and contain information irrelevant to many consumers. Computer technologies allow sophisticated tailoring of messages targeted to individual patients and free of irrelevant information. METHODS: In two studies in North Carolina (study 1, N = 51; study 2, N = 197), adult cigarette smokers were identified from a cohort of family practice patients. Cigarette consumption, interest in quitting smoking, perceived benefits and barriers to quitting, and other characteristics relevant to smoking cessation were collected. Based on this information, smoking cessation letters were tailored by computer to individuals. Smokers were randomly assigned to experimental (tailored health letters) or comparison groups (generic health letter in study 1, no health letter in study 2). Smoking status was assessed again at 4 months (study 1) or 6 months (study 2). RESULTS: Both studies found statistically significant positive effects of tailored health letters among moderate to light smokers. In study 1, 30.7% reported quitting after 6 months vs 7.1% in the control group (P < .05); in study 2, 19.1% vs 7.3% (P < .05). CONCLUSIONS: Results from both studies indicate positive effects of computer-tailored smoking messages among moderate to light smokers. These findings are consistent with the focus of our computer-tailored program on psychological and behavioral factors related to smoking cessation. Smoking cessation outcomes may be enhanced by combining tailored messages with nicotine replacement therapies to treat physical dependency. Methods of tailoring health messages and incorporating the results into family practice are described.

Prevention of duodenal ulcer relapse with ranitidine.

Forty-three patients with a recently healed duodenal ulcer were entered into a 1-year double-blind trial to evaluate the efficacy and tolerance of ranitidine (Zantac; Glaxo). There were no drop-outs. After 1 year 18 of the 22 patients receiving 150 mg ranitidine at night (82%) and 3 of the 21 receiving placebo (14%) were ulcer- and symptom-free. No drug-related side-effects were noticed. A maintenance dose of ranitidine seems to be a safe and effective means of preventing duodenal ulcer recurrence.