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      Public health engagement: detection of suspicious skin lesions, screening and referral behaviour of UK based chiropractors

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          Abstract

          Background

          UK morbidity and mortality rates from skin cancer are increasing despite existing preventative strategies involving education and early detection. Manual therapists are ideally placed to support these goals as they see greater quantities of exposed patient skin more often than most other healthcare professionals. The purpose of this study therefore was to ascertain the ability of manual therapists to detect, screen and refer suspicious skin lesions.

          Method

          A web-based questionnaire and quiz was used in a sample of UK chiropractic student clinicians and registered chiropractors to gather data during 2011 concerning skin screening and referral behaviors for suspicious skin lesions.

          Results

          A total of 120 questionnaires were included. Eighty one percent of participants agreed that screening for suspicious skin lesions was part of their clinical role, with nearly all (94%) assessing their patients for lesions during examination. Over 90% of the participants reported regularly having the opportunity for skin examination; with nearly all (98%) agreeing they would refer patients with suspicious skin lesions to a medical practitioner. A third of respondents had referred a total of 80 suspicious lesions within the last 12 months with 67% warranting further investigation.

          Conclusions

          Nearly all respondents agreed that screening patients for suspicious skin lesions was part of their clinical role, with a significant number already referring patients with lesions.

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          Most cited references9

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          How can chiropractic become a respected mainstream profession? The example of podiatry

          Background The chiropractic profession has succeeded to remain in existence for over 110 years despite the fact that many other professions which had their start at around the same time as chiropractic have disappeared. Despite chiropractic's longevity, the profession has not succeeded in establishing cultural authority and respect within mainstream society, and its market share is dwindling. In the meantime, the podiatric medical profession, during approximately the same time period, has been far more successful in developing itself into a respected profession that is well integrated into mainstream health care and society. Objective To present a perspective on the current state of the chiropractic profession and to make recommendations as to how the profession can look to the podiatric medical profession as a model for how a non-allopathic healthcare profession can establish mainstream integration and cultural authority. Discussion There are several key areas in which the podiatric medical profession has succeeded and in which the chiropractic profession has not. The authors contend that it is in these key areas that changes must be made in order for our profession to overcome its shrinking market share and its present low status amongst healthcare professions. These areas include public health, education, identity and professionalism. Conclusion The chiropractic profession has great promise in terms of its potential contribution to society and the potential for its members to realize the benefits that come from being involved in a mainstream, respected and highly utilized professional group. However, there are several changes that must be made within the profession if it is going to fulfill this promise. Several lessons can be learned from the podiatric medical profession in this effort.
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            Thorough skin examination for the early detection of melanoma.

            Melanoma is a major public health problem for which early detection may reduce mortality. Since melanoma is generally asymptomatic, this requires skin examination. We sought to evaluate the extent to which the general public has their skin examined by themselves, their partners, or health care providers and the frequency of these examinations. Random-digit-dial survey of adult Rhode Islanders. Only 9% performed a thorough skin examination (TSE) at least once every few months, although over half of the sample reported conducting skin self-examination "deliberately and systematically." Participants were more likely to perform TSE if they were women and if their health care provider had asked them to examine their skin. Most participants reported that their health care provider never or rarely looked at the areas of their skin in which melanoma is most likely to arise. The reported frequency of skin self-examination depends critically on the manner of inquiry. TSE by self or a partner is uncommon, and health care providers do not routinely examine the areas of the skin on which melanomas commonly arise.
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              Cost of skin cancer in England.

              This paper estimates the financial cost of skin cancer in England. National Health Service (NHS) costs were calculated by combining published data on health service use by patients with skin cancer with published data on the unit cost of services. Indirect costs arising from individuals' inability to function in their usual role as a result of skin cancer were estimated from incapacity benefit claims and numbers of registered deaths due to skin cancer. The total costs of skin cancer were around pound240 million. Costs to the NHS represented 42% of the total.
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                Author and article information

                Contributors
                sglithro@bournemouth.ac.uk
                dnewell@aecc.ac.uk
                AHunnisett@mctimoney-college.ac.uk
                ChristinaCunliffe@bpp.com
                Journal
                Chiropr Man Therap
                Chiropr Man Therap
                Chiropractic & Manual Therapies
                BioMed Central (London )
                2045-709X
                23 January 2015
                23 January 2015
                2015
                : 23
                : 1
                : 5
                Affiliations
                [ ]McTimoney College of Chiropractic, Abingdon, UK
                [ ]Anglo European College of Chiropractic (AECC) and Bournemouth University, Dorset, UK
                [ ]Salisbury NHS Foundation Trust, Salisbury, UK
                Article
                47
                10.1186/s12998-014-0047-2
                4314793
                ed73a9ed-b920-40b4-82c1-20fcb59da846
                © Glithro et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 July 2014
                : 19 December 2014
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Complementary & Alternative medicine
                skin lesion,skin cancer,screening,referral behaviour,prevention,detection,dermatology,chiropractor,manual therapist

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