Two analyses of patient delay in seeking a medical diagnosis are considered. In the first, a model of delay is presented. Specifically, delay is comprised of four stages (appraisal, illness, behavioural and scheduling delay intervals), each governed by a conceptually distinct set of decisional and appraisal processes beginning with the initial day that an unexplained symptom is detected to the day the individual appears before a physician. The second analysis is a social psychological one of the attributions individuals draw when relating their symptoms to their expectations and knowledge about physiological bodily processes. The eight principles of Psychophysiological Comparison Theory (PCT) provide the basis for clarifying the psychological processes of symptom interpretation and appraisal. Two studies were conducted with women seeking diagnostic evaluations for prevalent cancers: breast or gynaecological tumours. Regarding the delay model, results indicated that the delay intervals were independent (i.e. uncorrelated). Also, appraisal delay constituted the majority (at least 60 per cent) of the total delay. In the test of PCT, support was found across measures of symptoms, the context in which the symptoms arose, and the inferences people made about the symptoms.
Although amphetamine is the most widely illicitly used drug in the United Kingdom after cannabis, relatively few problematic users present to treatment agencies. Injecting amphetamine users are a high risk group as far as HIV transmission is concerned. This paper reviews the first 3 years' operation of an oral amphetamine prescribing programme for injecting users. Over half the subjects ceased injecting, and there was a considerable reduction in injecting by the remainder. 85% had not used or shared injecting equipment during the programme. However, subjects reported still using street amphetamine and offending, although at a lower rate than previously. There was little change in sexual practices. There was an increase in primary amphetamine users presenting for treatment. There is a case to be made that closely controlled and monitored programmes such as this can be justified on harm reduction grounds. A number of issues concerned with amphetamine prescribing are discussed.
Exposure to ultraviolet (UV) light is the leading behavioral cause of skin cancer. This study evaluated the efficacy of 2 interventions to reduce UV exposure in college students prior to an opportunity for high-intensity exposure. Participants of 1 college campus were assigned randomly to 1 of 2 interventions prior to their spring holiday spent in a warm, sunny location: (1) a community-based informational campaign, or (2) a combination of the campaign and a cognitive-behavioral small group intervention. Participants of a second college campus served as a comparison group. The cognitive-behavioral group exhibited increased knowledge, more positive attitudes toward UV protection, greater advancement through stages of change, and greater protective clothing use relative to the comparison or community-education groups. The informational campaign had little apparent impact in this study.
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