Search

Harold G Koenig,1–4 Kathleen Perno,5 Ted Hamilton5 1Department of Psychiatry, 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 4School of Public Health, Ningxia Medical University, Yinchuan, People’s Republic of China; 5Medical Mission Integration, Adventist Health System, Orlando, FL, USA Objective: We report here the impact of an educational training program on attitudes and practices of physicians (MDs) and mid-level practitioners (MLPs) toward controversial spiritual practices, such as practitioner-led prayer, sharing personal religious beliefs, and encouraging patients’ religious beliefs.Methods: In this single-group experimental study, 427 physicians and 93 MLPs affiliated with the Adventist Health System agreed to complete a questionnaire assessing demographics, practice characteristics, religiosity, and attitudes and behaviors at baseline, 1 month, and 12 months. Changes in attitudes and practices over time were examined and baseline predictors were identified using mixed-effects regression models.Results: For the most part, attitudes regarding praying with patients, sharing faith with patients, and encouraging patients’ own religious faith did not change much during the 12-month ­educational training program. However, significant increases were found in frequency of praying with patients (MDs and MLPs), willingness to pray with patients (MDs), sharing their faith with patients (MDs), and encouraging patient’s own religious faith (MDs and MLPs). Among physicians, predictors of praying with patients across time were older age, Christian affiliation, and importance of religion, and among MLPs, they were older age, non-White race, and importance of religion. No interaction between time and religiosity was found.Conclusion: Although attitudes toward these mostly controversial practices were largely unaffecte

A conventional stock assessment model is applied to determine the impact of entrainment and impingement at the Monroe Power Plant on the yellow perch stock of the Western basin of Lake Erie. Parameters of the model are estimated using power plant data, biological data available in the literature, and commercial catch data. The model is applied to estimate the age structure and biomass of the perch stock and to estimate the impact of the power plant on abundance of the impingeable stock and abundance and biomass of the exploited stock. The level of impact was examined under a range of mortality conditions. Under the most extreme conditions examined of full pumping, high fishing mortality, and low natural mortality, the fishable biomass is reduced by 1.7%. This impact is not large, but there are several other power plants and many additional water intakes around the Western basin of Lake Erie.

BACKGROUND Public awareness and education may lead to the detection of thinner melanomas, which may result in a decrease in morbidity and mortality rates. Which detection patterns, lesion, and patient characteristics are associated with early detection? METHODS Using the University of Michigan prospective melanoma database, the detection patterns, lesion characteristics, and patient characteristics of 1515 consecutive patients with in situ or invasive cutaneous melanomas were reviewed. Tumor thickness (measured in millimeters) was evaluated in relationship to detection patterns (patient, physician, spouse), lesion characteristics (change in color, size, shape/elevation, ulceration, bleeding, tenderness, itching), and patient characteristics (gender, skin type, number of atypical and clinically benign nevi, history of sunburn, personal and family history of melanoma). RESULTS Patient characteristics associated with early detection included female gender, at least one atypical nevus, greater than 20 clinically benign nevi, and/or a personal history of melanoma. Skin types I, II, and III, a history of sunburn, and/or a family history of melanoma were also associated with thinner lesions, but these associations were not statistically significant. Lesion characteristics associated with earlier detection included a change in color, size, shape/elevation, and/or itching. Physician-detected melanomas were significantly thinner than patient or spouse-detected lesions. CONCLUSIONS Educational campaigns should include increasing melanoma awareness in males and educating the public on the early signs and symptoms. Education should be directed at both high and low-risk groups. Physicians should consider performing total skin examinations routinely on patients. Although they detect a relatively small percentage of all melanomas, physicians detect significantly thinner lesions. Cancer 2002;95:1562-8. © 2002 American Cancer Society. DOI 10.1002/cncr. 10880

"D'Or: Goin' Solo is a compendium of essays and images exploring the exhibitions at the Or Gallery in the year 2004" -- p. [4].