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PubMedDate not supplied

Japanese and American children's evaluations of peer exclusion, tolerance of differences, and prescriptions for conformity.

Children and adolescents (N = 1,057), divided by gender, at fourth, seventh, and tenth grades, from two mid-sized cities in the United States and in Japan, were surveyed regarding their evaluations of peer group exclusion of atypical peers. Six reasons for atypicality were being aggressive, having an unconventional appearance, acting like a clown, demonstrating cross-gender behavior, being a slow runner, and having a sad personality. Analyses revealed significant effects for age, gender, country membership, and the context of exclusion. With age, children demonstrated context sensitivity, and believed that the excluded child should not change him- or herself to be accepted by the group. Across contexts, girls were less willing to exclude than were boys, and were more tolerant of differences. The context of exclusion had an effect on all forms of judgments about exclusion, and there were very few overall effects for culture. Most children disagreed with the decision to exclude, believed that they were different from the atypical child, and believed that the excluded child should change him- or herself to be accepted by the group. The results support a theory of developmental social cognition in which multiple sources of influence have a significant effect on social decision making involving the exclusion of others.

Child↗

PubMed1996

Circadian variation of growth hormone secretion in normal prepubertal children. Comparison to constitutional growth delay and growth hormone deficiency.

When studying short slowly growing children, several investigators have found differences in spontaneous circulating growth hormone (GH) levels in some short children as compared with children of normal stature. The circadian and ultradian characteristics of GH secretion have not been considered in most of those studies. With the aim to study possible differences in rhythm characteristics of plasma GH with stature, we analyzed data from a total of 141 prepubertal children: 1) 13 GH-deficient children; 2) 36 children with short stature (up to 2 standard deviations below their peer group mean); 3) 61 children with very short stature (up to 4 standard deviations below their peer group mean); and 4) a reference group of 31 children with standard stature. Subjects were living at the hospital setting on a diurnal waking (07:30 a.m. to 10:30 p.m.), nocturnal resting routine during sampling, consuming the usual hospital diet at fixed times. GH concentrations were determined by immunoradiometric assay in plasma obtained at about 2-3 hour intervals during most of the day and at about half-hour intervals between 9:00 p.m. and 3:00 a.m. Circadian rhythm characteristics obtained by least-squares estimation were compared between groups divided according to gender and stature with a parameter test. Results show a statistically significant circadian rhythm in GH secretion for all groups studied (p<0.001 for standard, short and very short children; p=0.013 for GH-deficient children). A comparison of circadian parameters indicates similar characteristics between subjects of short, very short and standard stature. The difference in rhythm-adjusted mean and amplitude is, however, of borderline statistical [correction of statistically] significance when comparing non-deficient with GH-deficient children.

Body Height↗

PubMed1999

[Other perception and play-group entry in a preschoolers class].

Kindergarten children accumulate classmate information through their experience of spending time and doing things together. In the course of preschool lives, a class changes from an aggregation of children to a peer group with own history of interaction and involvement. In such a peer group, whether a child becomes a play-group member is likely to depend not only on his/her social skills, but also on perception based on classmate information, especially whether the other is seen as someone whom the child would like to play with. Relationship between such perception and play-group entry was investigated in a kindergarten class for two years, from entrance as four-year olds to graduation. At the beginning, the two were unrelated, but they became related in later periods. A child was accepted into a play group without trouble when the group members thought he/she was someone they would like to play with. These results supported the hypothesis that other perception based on classmate experience and group history influenced the entry into classroom play groups.

Child, Preschool↗

PubMed1997

Vocal reaction times of children with CAPD, age-matched peers, and young adults to printed words.

The purpose of this study was to determine if there were differences between children identified in a clinical setting as having Central Auditory Processing Disorder (CAPD), an age-matched peer group, and young adults when tested using a vocal reaction time (VRT) format. The children with CAPD were matched by gender and age to peers between the ages of 8 and 10 years. All speakers were presented visually with printed third-grade-level one- and two-syllable words (e.g., boy, mother) as well as the syllable "uh". Participants spoke each word according to the criteria of seven separate conditions, which included immediate naming tasks (0 s delay), a short delay before speaking (M = 1.5 s), and a longer delay before speaking (M = 4.0 s). Speakers VRTs were measured, and production errors were recorded. All speakers took longer to respond in the immediate-response conditions than the delayed-response conditions. Statistically significant differences were found for the immediate-response conditions, with means for the children with CAPD reflecting slower performance than that of their peers. The peer group was slower than the adults. For the delayed conditions, both groups of children responded with significantly longer VRTs than the adults. The two groups of children did not differ for these tasks. The children with CAPD produced a significantly greater number of errors than their peers, specifically for the long-delay conditions. The adults showed no performance differences across the immediate response conditions nor across the delayed conditions. These results suggested that children with CAPD may have processing difficulties with visual stimuli.

Adult↗

PubMed2004

Development of clinical practice guidelines: evaluation of 2 methods.

The aim of this study was to compare 2 methods for developing a clinical practice guideline (CPG) on the management of asymptomatic, impacted mandibular third molars. Outcome measures were the mean time invested by the participants for each method, the quality of the CPGs measured using the Appraisal of Guidelines for Research and Evaluation (AGREE) indicator and observations of the group discussions. We used a national consensus procedure following the Rand modified Delphi procedure (2 panels) and a local consensus procedure (2 existing dental peer groups). The mean time spent was about equal for the 2 methods. The quality of the CPGs developed by the expert panels was higher than that of the CPGs developed by the dental peer groups. Observation indicated that all group processes were influenced by the chairperson. We concluded that the expert panel method is suitable for developing reliable CPGs on a national or regional level.

Consensus↗

PubMed1989

AIDS-related beliefs and behaviours of Australian university students.

Parallel questionnaires that enquired into the beliefs and behaviours which related to the acquired immunodeficiency syndrome (AIDS) were administered by postal survey during August and September 1987 to two separate samples of students. Each sample comprised 300 students who were selected at random, were aged up to 30 years, and at the time were enrolled at The University of Sydney; the response rate was 70%. Results showed a high level of "correctness" of belief about AIDS and safer sexual practices. More than half the population had experienced sexual intercourse during 1987, 25% of whom had experienced sexual intercourse on a casual basis. A marked discrepancy was found between the knowledge of and the performance of safer sexual behaviours, as measured by two sets of key questions, which covered condom use in casual vaginal encounters and enquiry into a casual partner's history with regard to sexual experience, abuse of intravenous drugs and history of blood transfusions. A log-linear regression analysis showed no correlation between scores on the two sets of key questions on knowledge of safer sexual practices and the demographic variables of age, sex, sexual experience or religious commitment. It is suggested that an educational campaign that is directed at the problem of behavioural change will fail to be productive if it is focused narrowly on the knowledge of safer sexual techniques; in addition, it should take into account other attitudinal components, such as the perception of social pressures from peer-groups. Within this particular student population, the most-effective immediate stratagem may be to restructure the perceived personal and peer-group risks.

Acquired Immunodeficiency Syndrome↗

PubMed1980

Experiences in a general practitioner workshop.

The organization and working of a general practitioner workshop are described, with analyses of subjects, participants, and group dynamics. An unusual form of peer group has arisen, with trainees, trainers, and principals all contributing on an equal basis. The workshop group is suggested as a useful method of continuing education for general practitioners, using existing postgraduate facilities, with minimal financial outlay.

Congresses as Topic↗

PubMedDate not supplied

[The model of action in early schizophrenia].

I will present the model of thinking of the Cracow society in dealing with first episodes of schizophrenia in adolescents. During adolescence schizophrenia brings about diagnostic difficulties, because it is a period of stormy psychosocial and biological changes in the patient. Also, the responsibility of the therapists seems to be different--perhaps even more so than in their work with an adult. Importance of the environment of the psychiatric ward and group psychotherapy as well as the peer group for the patients, the role of family therapy, especially trans-generational transmission, place of individual psychotherapy and biological therapy in this system, all will be discussed. I will describe the importance of both, pedagogical therapy and the school in the course of the therapeutic process of the adolescent patients. In a closer manner, I will also describe the emotional problems of therapists dealing with adolescents having psychosis.

Adolescent↗

PubMed1996

Three-year results of prevention programs on marijuana use: the New Hampshire study.

The effects on marijuana use of 1) a drug prevention curriculum, or 2) this curriculum with added parent and other adult community activities in comparison with 3) a control community were investigated. Baseline information on drug-related behaviors from a sample of fourth, fifth, and sixth graders aged nine to fourteen years in rural New Hampshire (N = 1200) were obtained. The children completed these initial questionnaires in classrooms in 1987. In the comprehensive community intervention regular marijuana use was reduced by over 50 percent. No program had a significant effect on the initiation of marijuana use. The predictors of initiation were being in a higher grade, low school satisfaction, poor academic achievement, feeling unloved by one's family, feeling unpopular, and being part of a drug-using peer group. The baseline predictors of subsequent regular marijuana use were poor academic achievement, feeling unpopular, and being part of a drug-using peer group. In interviews the cultural and social contexts of marijuana use were explored. Strategies to prevent marijuana use need to take into account the profile of the marijuana-using child, the adult community's attitudes and beliefs about drugs, and the access of drug sellers and users to children.

Adolescent↗

PubMedDate not supplied

Prioritization of prevention activities to combat the spread of HIV/AIDS in resource constrained settings: a cost-effectiveness analysis from Chad, Central Africa.

In Chad, as in most sub-Saharan Africa countries, HIV/AIDS poses a massive public health threat as well as an economic burden, with prevalence rates estimated at 9% of the adult population. In defining and readjusting the scope and content of the national HIV/AIDS control activities, policy makers sought to identify the most cost-effective options for HIV/AIDS control. The cost-effectiveness analysis reported in this paper uses a mixture of local and international information sources combined with appropriate assumptions to model the cost-effectiveness of feasible HIV prevention options in Chad, with estimates of the budget impact. The most cost-effective options at under US$100 per infection prevented were peer group education of sex workers and screening of blood donors to identify infected blood before transfusion. These options were followed by mass media and peer group education of high risk men and young people, at around US$500 per infection prevented. Anti-retroviral therapy for HIV infected pregnant women and voluntary counselling and testing were in the order of US$1000 per infection prevented. The paper concludes with recommendations for which activities should be given priority in the next phase of the national HIV/AIDS control programme in Chad.

AIDS Serodiagnosis↗

PubMed1985

Psychotherapeutic interventions with substance abusers--the clinical context.

Drug/alcohol dependent individuals need to discover and understand how they have adopted extraordinary drug solutions for a range of problems. I believe human relationships can best provide this opportunity through either a professional psychotherapeutic relationship or peer group experiences such as group therapy and self-help groups such as AA or NA. Addicts need to learn that drug solutions preclude more ordinary solutions to life problems, and that therapeutic and peer groups experiences can provide the creative challenges, tools, and impetus to find alternative solutions. Clinical work with severe and disabling human problems teaches the humbling nature of our work as health care professionals. Clearly, work with substance abusers is no exception. As we gain in our scientific, technical and clinical understanding of these problems, we are able to help our patients make enlightened choices about what is useful and effective in their treatment and recovery. However, there is much we do not understand about substance abuse, and there are many affected by the problem who cannot accept what we have to offer. Effective practice in this case, then, must still be guided by practical and empirical measures of what is safe and what works. Health care professionals do not have a corner on this market of what is safe and what works. Practitioners need to honor their traditions where treatment is guided by careful collection of data and continual pursuit of root causes, mechanisms, and etiologies. But, above all, rigid attitudes about the advantages of our own approach and the limitations of other approaches need to be avoided. In this respect we honor "above all" the primary tradition in clinical practice--"to do no harm".

Alcoholism↗

PubMed2001

Peer rejection as an antecedent of young children's school adjustment: an examination of mediating processes.

A short-term longitudinal design (N = 399) was used to examine peer relations processes that may mediate the relation between peer rejection and children's emotional and academic adjustment during kindergarten. These proposed mediating processes extend the current literature by explicating behavioral pathways via which the attitudinal construct of peer rejection may affect adjustment outcomes. Structural equatiton modeling results supported the hypothesis that negative peer treatment (e.g., victimization, refusal of peer group entry bids, and exclusion from peer activities) and classroom participation partially mediate the relationship between rejection and adjustment outcomes. Rejected children were more likely to experience negative peer treatment, more likely to show decreases in classroom participation, and more likely to report loneliness, to express a desire to avoid school, and to perform less well on achievement measures.

Achievement↗

PubMed1990

Identification with peers as a strategy to muddle through the troubles of the adolescent years.

This study was designed to explore critical events during adolescence and coping processes as dependent, first, on the relationship with peers, and second, on the type of peer-groups teenagers join. In all, 75 young people, members of four street groups and two religious groups, were given a questionnaire assessing identification with their peers and demographic characteristics, and then interviewed about critical events. The results show that the nature of the group individuals join is of minor importance, whereas the relationship established with peers is crucial: highly identified subjects not only more often join their peers but seem to derive more profit from interactions with people in general, both peers, friends, and parents. The peer-group is important, not to substitute for contacts with the family or other persons, but as a social entity to fill a vacuum during adolescent years.

Adaptation, Psychological↗

PubMed1990

Anger reactions of Iranian adolescents.

The purposes of this study were to examine the anger reactions of Iranian adolescents directed against their peer groups, parents, and teachers, or school faculties, and also to compare the results with Gesell's data from 1956. A questionnaire was developed according to Gesell's study to investigate the kinds of anger reactions 454 high school students (258 girls and 196 boys) expressed against their peer groups, parents and teachers, or school faculties. Adolescents used more crying against their fathers than mothers, peers, and teachers and more verbal aggression against their peers than their parents and teachers. For kind of anger reaction against parents and teachers or school faculties chi squared was significant across sex of adolescents. Finally, the kinds of anger reactions against mothers and stronger peers were significantly related to mothers' education.

Adolescent↗

PubMed1984

Methodological limitations in case mix hospital reimbursement, with a proposal for change.

We have found five methodological limitations in the creation and implementation of the diagnosis related group (DRG) patient classification system, which is used to define a hospital's case mix. There are four methodological limitations in the system that Klastorin and Watts have proposed to identify hospital peer groups. We conclude that the effects of these limitations should be sought, and we propose studies to measure their extent. We also propose that these two approaches can be combined to create an improved hospital reimbursement program that accurately measures differences between hospitals caused by case mix and peer group characteristics.

Costs and Cost Analysis↗

PubMed2000

Improving drug treatment in general practice.

In the international Drug Education Project, an educational program involving auditing and feedback in peer groups to improve the treatment of asthma and urinary tract infections (UTI) was developed and tested in primary care. Individualized feedback was provided and discussed in 24 Dutch peer groups showing doctors their prescribing practices and underlying reasons for treatment. A parallel, randomized controlled design was used to test the effect on competence and actual prescribing; in one study arm doctors received feedback on asthma treatment and in the other on UTI treatment. Especially the messages to treat asthma exacerbations with oral corticosteroids (17% increase) and to prescribe short courses for UTI (decrease duration of 1.8 days) brought about large improvements. Both messages concerned acute situations, and were clear and relatively easy for GPs to implement. GPs will experience more barriers when changing maintenance treatment of an asthma patient, which could explain the more limited success of this part of the educational program: the proportion of patients treated with inhaled corticosteroids increased 5%. A ceiling effect was experienced regarding drug choice for UTI.

Adult↗

PubMed2000

The impact of the prospective payment system on the technical efficiency of hospitals.

In a longitudinal panel study design, 80 hospitals in Virginia were selected for analysis to test the hypothesis that the introduction of the prospective payment system (PPS) in October 1983 had helped hospitals enhance their operational performance in technical efficiency. A non-parametric method called Data Envelopment Analysis (DEA) was used to calculate and compare the efficiency scores for each peer group of hospitals (by bed size) between the year 1984 and the year 1993. Contrary to expectations, no significant difference in technical efficiency was found in each hospital peer group over the study period. Nevertheless, the case study demonstrates that if hospital managers use this analytical tool appropriately, they may spot where any organizational weakness lies and how they can improve it.

Ambulatory Care↗

PubMed1985

Occupational stress and the professional pilot: the role of the Pilot Advisory Group (PAG).

This paper discusses the role of pilot peer group involvement, using the Pilot Advisory Group (PAG), in assisting pilots who manifest personal problems which derive from occupational and other stressors. Some general aspects of "background" occupational stress are discussed. Attitudes and opinions of professional aviators are identified and their role in denial of symptomatology is developed. The concept of the Pilot Advisory Group (PAG) is then discussed in detail before its role in relation to occupational stress is introduced. While some of the better known problems associated with occupational stress in pilots are mentioned, the emphasis in the paper is on developing new perspectives regarding the identification of stress-induced dysfunction, and also in exploring the suitability of PAG involvement. The formal obligations of management and regulatory authorities are contrasted with what the author sees as the countervailing imperatives of pilot attitudes and beliefs.

Aerospace Medicine↗