From the Paper
"COLON CANCER: ETIOLOGY, SYMPTOMS, DIAGNOSIS, AND TREATMENT
Colon cancer is the second most prevalent cancer in the United States, lung cancer being the first. It is also second to lung cancer in mortality rate (19:816). In 1990 there were about 155,000 new cases of colorectal cancer reported, and 61,000 deaths. The incidence in the general population is 5% (15:80). Although the number of cases is increasing, the rate is proportional to the population increase (8:301).
Yet in spite of the high incidence of colon cancer, we still do not have a sound basis for delineating the causes and mechanism of colon carcinoma growth (15:80). Nor do we have a means of curing the disease in every case. The five-year survival rate is about 50% (10:241). Nevertheless considerable advances have been made within the last 10 years in confirming the.."

Abstract
This paper examines lifestyle and dietary habits as contributing factors to the development or prevention of CRC. The paper also points to a number of contributing factors to the development of CRC such as a diet high in red and processed meats, smoking, obesity, heavy alcohol usage and physical inactivity. On the other hand, a diet high in fruits and vegetables, daily intakes of calcium, folate, magnesium and vitamin D and physical activity decrease risk. In light of these factors, the paper contends that a comprehensive screening program designed to detect early noncancerous growths, such as colonoscopy or fecal occult blood test products, should also include nutrition and lifestyle information.

Outline:

The Prevalence of Colorectal Cancer
Partners for the Prevention of Colorectal Cancer in Lycoming County
Evidence for Program Intervention:
Concurrent Screening and Lifestyle Counseling
Hypothetical Program for Lifestyle Counseling in the Prevention of CRC

From the Paper
"Public health in Pennsylvania has evolved over several decades, and has come to understand the importance of the community's involvement in several health programs. Stakeholders for a CRC prevention program would include medical personnel such as gastroenterologists, oncologists, surgeons and primary care physicians. Not-for-profit organizations may include the local Office for the Aging, Department of Health, and patient advocacy groups such as the American Cancer Society (ACS) and Susquehanna Health in Lycoming County. Other stakeholders to be considered are university students who can be offered paid incentives to perform relevant research, and health insurance companies. Finally, concerned individuals and the general public should be invited to volunteer time and support (including alternative health practitioners, psychologists, health clubs and other interested professionals. To begin a constituent search, Lycoming County's directory for health advocacy is the Lycoming County Health Improvement Coalition (LCHIC), an excellent resource for health professionals as well as the public)."

Tags:cancer, food, exercise, screening, bio-medicine, nurses, dieticians, physiotherapists, cardiovascular, colonoscopy

Abstract
This paper asks and answers the questions "Will services in managed care depend on some form of gatekeeping/rationing?" and "What are the ethical dilemmas involved in gatekeeping?" The paper acknowledges that many ethical dilemmas are involved in gatekeeping, particularly with the chronically or seriously ill patient. The paper explains that gatekeeping due only to costs could keep patients from receiving the care they need, and it could compromise care only based on cost, something that seems to go against the very fabric of the medical community. The paper provides examples of a letter proposing an alternative colonoscopy treatment for an incapacitated patient, and a memo proposing methods for reducing the Meals on Wheels recipient list.

From the Paper
"One colonoscopy center in the city does offer the new, camera-based technology that allows a patient to swallow a live camera and photograph the esophagus and digestive tract as the camera moves through the body. This procedure is far less invasive than the traditional colonoscopy, and it warranted in cases such as patient Doe's, who have medical and physical constraints to the traditional procedure. I recommend the patient receive this treatment, even though the cost is higher. Due to Doe's weight and other health concerns, it is doubtful she could maintain the physical positions necessary for a traditional colonoscopy, and she could be injured, therefore, I recommend the alternate procedure."

Tags:reform, alternative, invasive, procedure

Abstract
This paper discusses colon cancer, with emphasis on the difficulties of diagnosis and the wide range of options available for early detection. It considers family history and genetic factors and looks at the pros and cons of the various diagnostic tests available, including a few still in development. It covers ways to detect a genetic predisposition to the disease. Since colon cancer often does not give early symptoms, it emphasizes the need for careful monitoring, especially in people particularly susceptible to this disease. The paper describes how colon cancer is treated once diagnosed.

From the Paper
"Colon cancer is the second-highest occurring cancer in the United States, beaten out for first place only by lung cancer. In medical terms, the colon includes the entire large intestine (Columbia Ency, 2004).
Colon cancer can have several contributing causes. Diets too high in fat and not high in fiber sources, such as fruit, vegetables and whole grain, correlates with a higher incidence of colon cancer. However, it is also more common in anyone with a family history of colon cancer, and even a history of cancer in the female reproduction system. Polyps in the colon and a medical history of ulcerative colitis are risk factors."

Tags:polyps, colitis, colonoscopy

Abstract
This paper examines the role of radiographers within the radiology department focusing on the provision of a barium enema. This paper provides a retrospective review of the data currently available regarding the use of radiographers within the health system, the efficiency of this practice, safety outcomes and the quality of the studies.

Contents:
Abstract
Statement of the Problem (Introduction)
Hypothesis
Current Scope of Practice of Radiographers
Literature Review
Methods
Evaluation
Ethical Considerations
Dissemination
Budget
Discussion
Appendix

From the Paper
"We are seeing a loss of physician radiologists from our health care system as they move on to a setting which is more financially lucrative as well as under their own control in regard to schedule management, etc. This does not mean that the number of patients will reduce, and these patients still require high quality healthcare. There has been a worldwide move to the use of midlevel or allied health care providers who can practice within a certain scope under the supervision of a physician and offer medical management and evaluation of patients. We will seek to evaluate the efficacy of the use of radiographers within the radiology department in the management of patients who seek barium enemas. In specific, we will study the radiographer's degree of comfort and accuracy in the provision of the studies. We will examine the different types of training which radiographers learn their skills, and which type of consultation with the radiologist in general. Finally we will examine the degree of job satisfaction of radiographers who provide Barium Enemas as well as the satisfaction of patients who undergo the procedure under the supervision of a radiographer."

Tags:procedures, diagnostic, accuracy, dap, radiologist, colorectal, cancer, colonoscopy

Abstract
This paper presents a research proposal that hypothesizes that individuals at high risk for CRC will benefit from lifestyle counseling by possibly prevent a cancerous event. The paper relates that lifestyle choices are associated with colorectal cancer (CRC); therefore, preventive measures, which address this type of cancer are a realistic public health goal. The paper concludes with an explanation of the research methodology, including a sample of the questions and the funding position for the study.

Table of Contents:
Background
Study Purpose and Significance
A Literature Review
Research Methodology
Samples Questions
Benchmarks
Budget Proposal - Program Appropriations
Funded Positions

From the Paper
"Preventive measures that address cancer of the colon and rectum are a realistic public health goal. The success of lifestyle counseling in addition to traditional treatment can be seen in Euroaction, the largest research project to be undertaken by the European Society of Cardiology. Euroaction is a cluster randomized controlled trial of six European countries, which has shown positive results utilizing interventions that focus on lifestyle counseling . Fifty five percent of the study participants who were in high risk categories for cardiovascular disease reduced their saturated fat intake, and 72% increased their fruit and vegetable consumption."

Tags:fiber, geographical disparity, transtheoretical model, bivariate analysis, colonoscopies