Older women's willingness to discontinue Papanicolaou test screening.

We surveyed our patients to assess their willingness to discontinue Papanicolaou testing. Our findings differ from those of previous studies, with 72% of our eligible respondents voicing willingness to discontinue screening. There may be many reasons for this, including linking the recommendation with the name of the patient's own physician.

Nonpharmacological management of agitation in hospitalized patients: a pilot study.

This article reports on the use of Simple Pleasures interventions to minimize agitation in hospitalized patients with late-stage dementia. The pilot project was not able to demonstrate statistical significance; however, the positive response to the education and provision of interventions has led to a hospital-wide dissemination of the interventions in the form of an activity box. No adverse effects of the interventions were found, and some patients experienced a significant decrease in agitation and use of sedative medications after exposure to the interventions. Hospital lengths of stay were shorter than expected and may also have been influenced by the intervention.

Barriers to outdoor physical activity in wintertime among Somali youth.

To identify barriers to outdoor physical activity in winter among Somali youth in Maine. Despite the many proven health benefits of physical activity among children, such as cardiovascular fitness and health status as an adult, there has been a decrease in physical activity among children in recent years. Specifically, children who are of low socio-economic status or are from communities where many immigrants are at increased risk for developing obesity. Immigrants are also less likely to be physically active. There are many potential barriers to wintertime physical activity among Somali youth in Maine, such as lack of financial resources, transportation, proper winter clothing, and appropriate knowledge of winter safety, and language and cultural barriers. For females, different attire required for outdoor activity may be a barrier. Somali parents and children were recruited from Portland, Maine to participate in focus groups led by a trained facilitator with a Somali translator and cultural broker. Transcripts were coded using NVIVO software to identify barriers to physical activity among Somali youth outside in winter. Eight focus groups were conducted. Sixty-one Somali community members were recruited. Participants felt outdoor physical activity is important, but note that it is decreased in winter. Barriers to outdoor activity in winter cited by focus group participants were lack of resources, health concerns, gender barriers for females, and knowledge barriers. Concern over lack of supervision while children play outside was also cited. This study revealed many of the underlying beliefs, barriers and cultural issues that impact Somali families' intention to be active and ability to be active outdoors in winter. These findings can be used to generate research hypotheses and public health interventions regarding outdoor physical activity among Somali youth.

Awareness of altitude sickness among visitors to a North American ski resort.

OBJECTIVE: To quantify awareness of acute mountain sickness (AMS) in a sample of visitors to a North American ski resort and to identify strategies and interest for increasing knowledge of AMS in that population. METHODS: One hundred and thirty visitors to Big Sky Ski Resort, Montana, were surveyed. Demographic data were obtained. Respondents were asked about their current knowledge of AMS and then answered questions designed to quantify their depth of knowledge of the subject. Correct answers were correlated with demographic data. Respondents also answered questions indicating their interest in further education about altitude illness and their preferred modality for obtaining this information. RESULTS: In general, most respondents were young, 18 to 30 years (62.3%), and male (62.5%). Seventy-six percent had at least some college education and more than 5 years of skiing/snowboarding experience. Only 55% of respondents had some knowledge of AMS, but only 30% had knowledge of AMS symptoms using the Lake Louise Scoring System. About 30% knew the lowest altitude this illness can occur. There was a correlation between educational background and improved knowledge of altitude illness. Half of the respondents desired further information about AMS, and the Internet was the preferred source of information. CONCLUSIONS: This study suggests that a large population of skiers in North America may be relatively naive to the dangers of AMS. The majority of the respondents were interested in learning more about altitude illness, and the Internet was the most attractive source of information.

Assessing the appropriate use of metformin in an inpatient setting and the effectiveness of two pharmacy-based measures to improve guideline adherence.

OBJECTIVE: To demonstrate the level of compliance to metformin-prescribing guidelines and to evaluate the effectiveness of 2 pharmacy-based interventions. METHODS: Retrospective chart review of all inpatients who had received at least 2 doses of metformin while hospitalized. Two cohorts of patients had chart audits-one group (group A) hospitalized between March and August of 2003 (487 patients) and one group (group B) hospitalized between August of 2005 and January of 2006 (370 patients). In December of 2003, the pharmacy inserted a safety alert in the electronic ordering system and mailed a printed safety alert to all clinical staff outlining the contraindications and precautions concerning metformin use. RESULTS: More than two-thirds (69.3%) of the charts reviewed demonstrated that metformin was used in accordance with the prescribing guidelines. Surgical procedures, intravenous contrast use, and elevated serum creatinine levels accounted for the greatest percentage of guideline violations. The prescribing guidelines were violated 27.4% (47/137 charts) of the times in group A and 34.3% (40/146 charts) of the times in group B. CONCLUSIONS: The significance of this study is that metformin is often given in spite of the presence of contraindications to its use. Two pharmacy interventions were ineffective in decreasing the guideline violation frequency in a group of patients who were prescribed the drug.

Misrepresentation of research citations by applicants to a primary care sports medicine fellowship program in the United States.

OBJECTIVE: To determine the prevalence of misrepresentation of publications and national presentations claimed in applications to the Maine Medical Center (MMC) Primary Care Sports Medicine Fellowship Program from 2001 through 2004. DESIGN: A retrospective chart review study. SETTING: The Maine Medical Center Primary Care Sports Medicine Fellowship Program. METHODS: Presentations were confirmed in the program of the cited meeting or by contacting the sponsoring organization. Publications were verified by performing a MEDLINE search or by cross-referencing in Ulrich's International Periodicals Directory. If the title was listed, the citation was verified by contacting the publisher. RESULTS: Fifty applicants reported research publications. Of those, 14 applications had publications that could not be verified. The overall misrepresentation rate was 11.3%; among applicants claiming publications it was 28%. There was no difference in misrepresentation rate between specialties. Eighteen applicants reported giving national presentations, and nine presentations could not be verified, corresponding to an overall misrepresentation rate of 5.6%. Of applicants claiming presentations, 38.9% had at least one misrepresentation. CONCLUSION: Applicants to the Maine Medical Center Sports Medicine Fellowship Program were found to have high rates of misrepresentation in their citations of both publications and presentations.