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Biomedical subjects

J Beals

Publications and source records attributed to J Beals.

At least 19 recordsLinked to original sources
PubMed2003

Prolonged exposure to inhalational anesthetic nitrous oxide kills neurons in adult rat brain.

Short-term exposure of adult rats to nitrous oxide (N2O), an inhalational anesthetic and NMDA (N-methyl-D-aspartate) antagonist, causes a reversible neurotoxic vacuole reaction in neurons of the posterior cingulate/retrosplenial cortex (PC/RSC) which resembles that caused by low doses of other NMDA antagonists. Since high doses or prolonged exposure to other NMDA antagonists can cause neurons to die, we assessed whether prolonged N2O exposure might also cause neuronal cell death. Adult female Sprague-Dawley rats were exposed to 150-vol% N2O (approximately EC50 for N2O anesthesia in rats) for various durations from 1 to 16 h. The time course for onset and disappearance of the reversible vacuole reaction was studied, as was the time course and dose requirement for triggering cell death. A maximum vacuole reaction was observed in PC/RSC neurons in brains examined immediately after 3 h of 150-vol% N2O exposure and the same magnitude of vacuole reaction was observed when brains were examined immediately after a longer period of N2O exposure. When N2O was terminated at 3 h and the rats were killed 1 h later, the vacuole reaction was markedly diminished and if the rats were killed 3 h later the vacuole reaction had completely disappeared. Prolonged exposure to 150-vol% N2O (for 8 h or more) caused neuronal cell death which was detectable by silver staining 32 h later. Concurrently administered GABAergic agents, diazepam (an i.v. anesthetic), or isoflurane (an inhalational anesthetic), prevented this cell death reaction. Our findings demonstrate that short-term exposure of adult rats to N2O causes injury to PC/RSC neurons that is rapidly reversible, and prolonged N2O exposure causes neuronal cell death. These neurotoxic effects, including the cell death reaction, can be prevented by coadministration of GABAmimetic anesthetic agents. Duration of NMDA receptor blockade appears to be an important determinant of whether neurons are reversibly injured or are driven to cell death by an NMDA antagonist drug.

Analysis of Variance↗
PubMed2001

Sequences of substance use among American Indian adolescents.

OBJECTIVE: To determine whether the predominant pattern of the sequence of use of different classes of substances among a large sample of American Indian (AI) adolescents is consistent with Stage Theory [i.e., (1) alcohol, (2) marijuana, (3) other illicit drugs, and (4) cocaine]. METHOD: Data came from surveys completed by 1,562 AI high school students in 1993. Pairwise comparisons of age of first use for alcohol, marijuana, inhalants, cocaine, and other illicit drugs were examined, as were the prevalence rates of specific sequences of substance use. RESULTS: Thirty-five percent of the AI youths who had used both alcohol and marijuana reported using alcohol first. Seventy-five percent of youths who had used three or more substances reported a sequence of first use that was inconsistent with Stage Theory. However, a general pattern of using alcohol, marijuana, and/or inhalants prior to the use of cocaine and other illicit drugs was observed. Sequences of first use varied by gender, age of first substance use, community, and number of classes of substances used. CONCLUSIONS: To enhance the validity of Stage Theory for AI adolescents, the authors recommend its revision to include alcohol, marijuana, and inhalants as initiating substances.

Adolescent↗
PubMed2001

Comparative use of biomedical services and traditional healing options by American Indian veterans.

OBJECTIVE: This study described service use among American Indian veterans, compared use patterns across biomedical care and traditional healing options, and tested whether utilization varied as a function of need or availability. METHODS: A cross-sectional survey of 621 male combat veterans selected from tribal rolls was conducted between 1992 and 1995 in American Indian reservation communities in the Southwest and in the Northern Plains. Measures included assessments of demographic characteristics, physical and mental health conditions, and self-reports of any use during the past year of Veterans Administration (VA), Indian Health Service (IHS), and other biomedical services as well as participation in traditional ceremonies and use of indigenous healing options. RESULTS: Tribal groups were similar in sociodemographic characteristics and in number of health problems and mental and substance use problems during the past year. The same types of services from IHS were available to the two groups, and the geographic distance to these services was similar. VA facilities were more readily available in the Northern Plains than in the Southwest, where they were far from reservation boundaries. Use of IHS services was similar for the two tribal groups, but use of VA services was significantly less in the Southwest. Overall, biomedical services were used more in the Northern Plains, reflecting greater use of VA facilities. However, these differences in overall health service disappeared when traditional healing options were considered. Use of traditional healing was greater in the Southwest, offsetting lower biomedical service use. CONCLUSIONS: When the full array of options is examined, service use functions according to need for health care, but the kind of services used varies according to availability.

Adult↗
PubMed2000

Use of traditional health practices among Native Americans in a primary care setting.

BACKGROUND: This study was undertaken to ascertain the extent that traditional health practices are used by urban American Indian/Alaska Native (AI/AN) primary care patients, to identify related patient characteristics, to determine associations with health status and functioning, and to describe attitudes about care received. METHODS: This study used a brief self-report survey of 869 adult AI/AN patients randomly sampled over a 14-month period from a comprehensive urban primary care program. Current medications were determined by follow-up medical record review. RESULTS: Seventy percent of urban AI/AN patients in primary care often used traditional health practices; use was strongly associated with cultural affiliation. In bivariate analyses, use was significantly associated with male gender, cultural affiliation, poor functional status, alcohol abuse, and trauma and, except for musculoskeletal pain, not with specific medical problems. The multiple logistic regression model for any use versus no use was significant (P < or =0.001). Being of male gender (P < or =0.001), having more than a high school education (P < or =0.05), visiting friends/relatives on a reservation (P < or =0.01), living the Native way of life (P < or =0.001) and not the white way (P < or =0.05), experiencing back pain (P < or =0.01), and having a physical injury inflicted by a family member (P < or =0.001) were predictive of use. CONCLUSIONS: The results in this clinical setting suggest that health care providers should anticipate use of traditional health practices among urban AI/AN patients. Use was predicted by important demographic, clinical, and cultural characteristics.

Adult↗
PubMed2000

Unmet needs for substance abuse and mental health services among Northern Plains American Indian adolescents.

Use of mental health and substance abuse services was examined among 109 American Indian adolescents in a Northern Plains reservation community. Each was interviewed to assess psychiatric diagnosis and service use and to determine whether an adult had recognized a problem in the adolescent-a critical determinant of receipt of services. Of the 23 youths who had a disorder, nine (39 percent) reported lifetime service use. Of the 25 who received services, 17 were treated by a school counselor; only one received services from a mental health specialist. Eight of the 25 youths with a psychiatric or substance use diagnosis who did not receive services reported that an adult had recognized a problem.

Adolescent↗
PubMed1999

Factors associated with suicide ideation among American Indian adolescents: does culture matter?

Data from self-report surveys of 1,353 high school students representing three culturally distinct American Indian tribes were analyzed for tribal differences in factors associated with suicidal ideation. In the multivariate analysis, no single correlate of suicide ideation was common to all three tribes. The correlates of suicide ideation were consistent with each tribe's social structure, conceptualization of individual and gender roles, support systems, and conceptualization of death. These results underscore the heterogeneity of suicide ideation across three distinct American Indian tribes consistent with their cultural heterogeneity. Suicide prevention and screening programs may be difficult to adapt from one tribe to another.

Adolescent↗
PubMed1998

Prevalence of common psychiatric disorders among American Indian adolescent detainees.

OBJECTIVES: To examine the prevalence of common psychiatric disorders among adolescents detained on a Northern Plains reservation. METHODS: Prevalence data were gathered using lay interviewers administering structured diagnostic instruments based on DSM-III-R criteria to 150 youths booked into a reservation-based juvenile detention center from July 1995 through April 1996. RESULTS: Approximately 49% of the sample had at least one alcohol, drug, or mental health disorder; 12.7% had two disorders; and 8.7% had three or more disorders. The most common diagnoses were substance abuse/dependence (38%), conduct disorder (16.7%), and major depression (10%). Females were significantly more likely than males to have major depression and/or anxiety disorders and were significantly more likely to have three or more disorders. These rates were higher in comparison with general and Indian adolescent community samples. CONCLUSIONS: These American Indian adolescent detainees had a high prevalence of psychiatric disorders. Local juvenile justice systems should be vigilant for the presence of psychiatric disorders and appropriately connected with psychiatric services to address this considerable need. Careful psychiatric assessment is necessary to ensure a more coordinated community service response to juvenile delinquency.

Adolescent↗
PubMed1997

The structure of problem and positive behavior among American Indian adolescents: gender and community differences.

Using Problem-Behavior Theory as framework, the latent structure of problem and positive behaviors was examined within a sample of 1,894 American Indian adolescents. Support was found for a two-factor second-order structure in which problem behaviors (antisocial behavior, alcohol use, drug use, and risky sexual behavior) and positive behaviors (school success, cultural activities, competencies, and community-mindedness) represented two relatively uncorrelated aspects of behavior. Hierarchical multiple regressions demonstrated that the positive behaviors construct contributed significant incremental construct validity in the statistical prediction of psychosocial outcomes, over and above the problem behaviors. In addition, the fit of the structure was examined across gender and the four participating communities. The importance of the inclusion of positive behaviors is discussed from the standpoint of both prevention/promotion activities and the communities' perceptions. Further recommendations are made for deeper understandings of community concerns and strengths in conducting preventive/promotive research efforts.

Adolescent↗
PubMed1997

Psychiatric disorder among American Indian adolescents: prevalence in Northern Plains youth.

UNLABELLED: This article presents data on the prevalence of psychiatric disorders among American Indian adolescents, using DSM-III-R criteria. OBJECTIVE: To generate current prevalence data using a structured diagnostic instrument, the Diagnostic Interview Schedule for Children, Version 2.1C (DISC-2.1C). METHODS: Youths from a Northern Plains tribe who had participated in an earlier study comprised the sample. At reinterview, respondents were between 14 and 16 years of age, when Indian adolescents are thought to be at particularly high risk for manifesting emotional disorders. One hundred nine of the original sample of 251 were still in schools on the reservation. Trained indigenous lay interviewers administered the DISC-2.1C to respondents in a private setting within the school. RESULTS: The findings indicate that rates of some psychiatric problems (e.g., disruptive behavior disorders, substance-related disorders, and their comorbidity) are high among these high school students. CONCLUSIONS: These data, as well as national statistics, suggest that, compared with non-Indian populations, a greater percentage of Northern Plains adolescents manifest significant psychiatric symptoms which warrant treatment.

Adolescent↗
PubMed1996

Substance abuse treatment of American Indian adolescents: comorbid symptomatology, gender differences, and treatment patterns.

OBJECTIVE: To describe the patient population and use of mental health treatment at a residential substance abuse treatment program for American Indian and Alaska Native adolescents. Specifically, this article (1) reports the level of psychiatric symptomatology among the patient population; (2) compares male and female patients in terms of demographics, symptomatology, and receipt of mental health treatment; and (3) examines the degree of association between patient psychiatric symptomatology and the receipt of mental health treatment. METHOD: Medical records were reviewed for all 64 patients admitted over a 1-year period. Data included patient characteristics such as substance use and psychiatric symptomatology as well as the receipt of mental health treatment. RESULTS: Sixty-eight percent of patients screened positive for at least one psychiatric symptom type. Females reported greater substance use and were more likely to report that they were victims of abuse. Females also were more likely than males to receive mental health treatment even though males had at least equal need. Finally, there was no significant relationship between measures of psychopathology and subsequent receipt of mental health treatment. CONCLUSIONS: Reassessment of the methods for identifying and treating patients with comorbid psychopathology within programs of this nature is indicated.

Adolescent↗
PubMed1995

Screening for depression among newly arrived Vietnamese refugees in primary care settings.

A brief, culture-specific, self-report screening measure for depression, the Vietnamese Depression Scale, was used to determine the prevalence of depressive symptoms among 1,998 consecutive adult Vietnamese refugees who presented at 10 public health clinics within 2 months of their arrival in the United States. Of these patients, 6% met the criterion for a probable case of depression ("positive"). Being divorced, separated, or widowed and poorly educated were strongly associated with a greater likelihood of screening positive. Somatic complaints were common and induced considerable anxiety about physical health status. Nearly a third of the patients reported sadness and dysphoria; culture-specific symptoms of depression also were prevalent. Our findings document the feasibility of screening for depression using the Vietnamese Depression Scale among Vietnamese refugees, particularly in primary care settings where they are first likely to be seen by health professionals after arrival in their host country.

Adult↗
PubMed1993

Criterion validity of the Center for Epidemiologic Studies Depression Scale in a population sample from an American Indian village.

The criterion validity of the Center for Epidemiologic Studies Depression Scale (CES-D) is examined in 120 adult Northwest Coast American Indians. The criterion was a DSM-III-R diagnosis derived from the Lifetime version of the Schedule for Affective Disorders and Schizophrenia. Sensitivity for major depression was 100% (95% confidence limits 36%, 100%); specificity was 82.1% (75.1%; 89%). For a broad category of depressive disorders (n = 9), sensitivity was 77.8% and specificity was 84.7%. Cut points based on receiver operating characteristic analyses did not greatly improve the performance of the CES-D. The use of factor scores instead of total scores made little difference.

Adolescent↗
PubMed1993

Alcohol use among male and female Native American adolescents: patterns and correlates of student drinking in a boarding school.

This study examined the patterns and correlates of alcohol use in a Native American boarding school. Specifically, stressful life events, social support and emotional distress were associated with quantity as well as frequency of alcohol use in this population. A sample of 188 students (52% female) in grades 9-12 attending a boarding school in the midwest were administered self-report measures of these above constructs as part of a larger battery. Family support, and to some degree stressful life events and emotional distress, correlated significantly with alcohol use. The implications of these findings for Native American adolescents in general, and in a boarding school population specifically, are discussed. The need for longitudinal research to explore further the temporal sequence of depression, stressful life events and social support in relation to alcohol use is addressed.

Adaptation, Psychological↗
PubMed1992

Linking empirically based theory and evaluation: the Family Bereavement Program.

Evaluated the effects of a theoretically derived program to prevent mental health problems in children who had experienced the death of a parent. The program was designed to improve variables in the family environment which were specified as mediators of the effects of parental death on child mental health. The evaluation design involved the random assignment of families to either an intervention or control group. The program led to parental ratings of increased warmth in their relationships with their children, increased satisfaction with their social support, and the maintenance of family discussion of grief-related issues. The program also led to parent ratings of decreased conduct disorder and depression problems and overall problems in older children. Significant correlations between the family environment variables and child mental health problems provided further empirical support for the theory underlying the program. Implications for program redesign were derived by reconsidering the adequacy of the program components to change theoretically mediating variables.

Adaptation, Psychological↗
PubMed1991

Epidemiology and preventive interventions: parental death in childhood as a case example.

Illustrates how standard epidemiologic principles form the knowledge base to justify a preventive intervention for an at-risk population. These principles were applied to a sample of 92 from the population of children aged 8 to 15 at alleged risk for mental health disorders because a parent died. Prior work on this alleged risk population is sparse and flawed. Validly determining the population effect of an alleged risk factor requires assessing the influence of sampling bias. The bias found, underrepresentation of deaths of a mother, did not influence the relations among death of a parent and children's depression and conduct disorder, and the modifiable mediators of risk to be changed by the preventive intervention. The epidemiologic measure of effect indicated that death of a parent is a risk factor for major depression but not for conduct disorder among youth. Families recruited for the preventive intervention by epidemiologic methods (ES families) did not differ significantly from the earlier families on whom the knowledge base was formed. Families referred to the intervention by self or others significantly differed from the ES families in two ways that constituted serious biases. The implications of these biases for prevention were discussed.

Adolescent↗
PubMed1990

The role of risk and protective factors in predicting symptomatology in adolescent self-identified children of alcoholic parents.

Tested a stress process model for predicting mental health symptoms in children of alcoholics (COAs). Stress and mental health measures were completed twice over a 3-month period by 145 high school students, 43 of whom self-identified as COAs. Using structural equation modeling, a stress process model for predicting mental health symptoms in children provided a good fit to the data. COA status was related to higher levels of negative and lower levels of positive events. In turn, positive and negative life events were found to have an immediate, but not a longitudinal, direct effect on adolescent symptomatology.

Adaptation, Psychological↗