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Presents news items on cancer practice and related issues in the United States, for the months of November and December 2001. Findings of a U.S. Centers for Disease Control and Prevention report on AIDS in the United States; American Cancer Society's publication of a nutrition guide for cancer survivors; Pacific Biologic Co.'s recall of capsules containing the herbs Akebia trifoliata caulis and Asarum sieboldii herba cum radix.

Presents updates relevant to cancer research in the United States compiled as of September 2001. Concerns over the growing health threat caused by increased tobacco use among women in the country; Genetic chips developed in Sweden to diagnose childhood cancer; Web sites of the U.S. Centers for Disease Control & Prevention that address health-related quality of life issues.

The authors examined physicians' reasons for ordering an exercise tolerance test and the influence of the test results on management decisions. Subjects of this study included 265 family physicians in Pennsylvania who completed a questionnaire on the management of a patient with typical chronic stable angina. Eighty-one percent of the respondents reported they would order a noninvasive stress test as a first step in the management of the patient. Of these physicians, 40% would refer the patient to a cardiologist only if the exercise tolerance test were strongly positive, 8% would refer only if it were negative, and 53% would not change their referral decisions on the basis of test results. No more than 57% of the physicians rated as very important any given reason for ordering a noninvasive diagnostic test. The results suggest that a test may be ordered routinely but without a consensus as to why it is ordered and without an effect on clinical management decisions. [ABSTRACT FROM PUBLISHER]

The article presents a study, which discusses the development of the Ward Initiative Scale, the clinical and research implications of measuring patient initiatives, and directions for future research. A Ward Initiative Scale was constructed consisting of seven subscales indicative of patient initiative. The scores were not greatly influenced by social desirability response set, and were sensitive to differences among a heterogeneous sample of psychiatric wards. Reliabilities were in the expected range for this type of questionnaire, and correlations among the subscales were sufficiently low to justify their separate utilization.

The purpose of the present article was to assess the differential effects of the social atmospheres of psychiatric wards. The present study was concerned with investigating whether wards which were different in social atmosphere as measured by the Ward Atmosphere Scale were also demonstrably different on two sets of dependent variables: general patient satisfaction and reaction to the ward, and initiatives which patients perceived themselves as taking in order to cope with the ward milieu. The Ward Initiative Scale consists of seven subscales: affiliation with patients, revealing self to others, involvement with the ward, aggression, seeking variety, submission to staff and autonomy toward staff. For this sample of eight wards, the average ward score on support correlated .82 with the average ward score on practicality, which is as high as the reliability of either scale. Results indicated that wards with a higher emphasis on aggression have patients who perceive themselves as taking fewer affiliative initiatives, more aggressive initiatives, and fewer initiatives related to seeking variety or change, and that wards with a higher emphasis on spontaneity and/or support have patients who perceive themselves as taking fewer initiatives to be submissive to the staff.

Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles or TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended lo be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small. [ABSTRACT FROM AUTHOR]