Biomedical subjects

John R Knight

Publications and source records attributed to John R Knight.

23 records · Page 2Linked to original sources

PubMed2002

Office-based intervention for adolescent substance abuse.

Because substance use is highly prevalent among teens, primary care clinicians may not be able to refer all adolescents to drug counselors or mental health care professionals. Pediatricians may therefore find it useful to use the basic principles of office intervention and reserve referral for those patients with the most significant drug and alcohol problems. Brief interventions have proven effective in reducing problematic drinking among adults, and early work among adolescents is promising. Effective interventions include feedback on risks and problems, an emphasis on personal responsibility, a menu of alternatives for change, an empathetic approach, and reinforcement of patient self-efficacy. Motivational interviewing is an effective means of enhancing success in counseling. When a referral is necessary, motivational interviewing can be used to maximize adherence.

Adolescent↗

PubMed2002

Monitoring physician drug problems: attitudes of participants.

The objective of this study was to measure satisfaction with a physician alcohol/drug and behavioral health monitoring program. Participating physicians rated the program's effectiveness, staff professionalism, monitoring and advocacy, relapse services, and sensitivity to women's issues. Correlations between satisfaction and successful recovery, source of referral, and legal involvement were computed. Responders' (N = 87, 82% male) contracts were 82% alcohol/drug and 9% behavioral health; 76% first contracts (no relapse). Sources of referral were self (32.2%), a friend/colleague (31%), the state medical board (14.9%), a hospital chief (11.5%), or a family member (3.4%). Satisfaction was associated with no relapse (mean rank = 47.6 vs. 30.0, p = .005), but not with gender (p = .47), type of contract (p = .39), source of referral (p = .75-.05), or board involvement (p = .24). Participants' reactions to the PHS program were influenced more by positive clinical outcome than other factors.

Attitude of Health Personnel↗

PubMed2002

Alcohol abuse and dependence among U.S. college students.

OBJECTIVE: To estimate the prevalence of alcohol abuse and dependence among U.S. college students, and to identify characteristics associated with these diagnoses. METHOD: More than 14,000 students at 119 4-year U.S. colleges completed a questionnaire that included items corresponding to DSM-IV diagnostic criteria for alcohol abuse and dependence. Frequencies were computed, and correlations used to identify demographic, drinking and other variables associated with these diagnoses. RESULTS: 31% percent of students endorsed criteria for an alcohol abuse diagnosis and 6% for a dependence diagnosis in the past 12 months. More than two of every five students reported at least one symptom of abuse or dependence. Students who were heavy episodic drinkers were more likely than those who were not to have an alcohol disorder. Students who were frequent heavy episodic drinkers had 13 times greater odds for abuse and 19 times greater odds for dependence. One of every five heavy episodic drinkers was classified with dependence. Few reported seeking treatment since coming to college. Students from heavy drinking college environments were more likely to have abuse and dependence diagnoses. CONCLUSIONS: Many college students report behaviors and symptoms that meet the diagnostic standard for alcohol abuse or dependence. In addition to strengthening prevention programs, colleges should implement new strategies for screening and early identification of high risk student drinkers and ensure that treatment is readily available for those with alcohol disorders.

Adolescent↗

PubMed2002

Comparing tolerance of Ichthyophthirius multifiliis and Tetrahymena thermophila for new cryopreservation methods.

Ichthyophthirius multifiliis is an obligate protozoan parasite of freshwater fishes that has a complex developmental cycle. It has not been successfully cryopreserved, so management studies are restricted to parasites obtained during outbreaks or perpetuated by passage in live fishes. To overcome this serious limitation, free-swimming I. multifiliis parasites were tested in a cryopreservation protocol routinely used for a related ciliate, Tetrahymena. In this protocol, I. multifiliis theronts retained infectivity for 3 days, although the protocol itself was ultimately lethal. Exposure of I. multifiliis and Tetrahymena thermophila to a battery of media and cryopreservative reagents showed that I. multifiliis was less hardy than T. thermophila and likely had significant biological and cytoskeletal differences. No combination of reagents, media, freezing rates, or dilution media permitted cryopreservation of I. multifiliis parasites that could then undergo development or infect fish. However, a vitrification protocol was formulated using Ficoll, 1,2-propanediol, and N,N-dimethylacetamide from which intact cryopreserved theronts with some motility were recovered. Understanding the effects of these reagents may lead to both a cryopreservation method for I. multifiliis and to improved understanding of the biology of ciliates.

Animals↗

PubMedDate not supplied

A new, experiential curriculum in child advocacy for pediatric residents.

OBJECTIVE: To design, implement, and evaluate an experiential child advocacy curriculum for pediatric residents. DESIGN: Pilot study including before-after 2-group trial of an educational intervention and a qualitative component. SETTING: A large, hospital-based, urban resident continuity clinic. PARTICIPANTS: General pediatrics residents (N = 29 [PGY: 1-4]). INTERVENTION: Residents and faculty designed a longitudinal curriculum in child advocacy for the continuity clinic, which included community-based and legislative experiences for individual residents as well as clinic-based group activities. Residents reported their experiences to their clinic group at weekly preclinic conferences. In addition, residents presented posters at their year-end residency retreat and wrote grants to fund community projects based on their original findings. EVALUATION: We used a quantitative assessment of child advocacy knowledge, attitudes, skills, and self-reported practices, which residents completed pre- and postintervention (2 clinics) or, for comparison residents, at the beginning and end of the academic year (3 clinics). In addition, we conducted focus-group discussions with residents in the 2 intervention groups to explore unanticipated responses to the new curriculum. RESULTS: Residents who received the intervention (n = 13) had a greater increase in advocacy knowledge (2.62 vs 0.19, P =.005), ability to identify community resources (0.62 vs 0.16, P =.03), self-reported advocacy skills (2.0 vs -0.21, P =.002), and perceived value of advocacy training (0.31 vs -0.19, P =.03) compared with residents who did not (n = 16). In focus groups, intervention residents (n = 17) reported being surprised by community groups' and legislators' responsiveness to resident inquiries, and they expressed enhanced confidence in engaging these groups in dialogue about child policy issues. CONCLUSIONS: A longitudinal continuity clinic-based curriculum in child advocacy had significant positive impact on pediatric residents.

Child↗