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PubMed1992

A comparison of the verbal social behavior of adolescents with behavioral disorders and regular class peers.

Improved social functioning of adolescents with behavioral disorders (BD) is of critical importance for the successful integration of these students in school, domestic, vocational, and community settings. Three comparisons were addressed in the study; overall verbal responding of BD adolescents was compared to verbal responding of their regular class peers, verbal responding of the same BD adolescents was compared across their self-contained and mainstreamed settings, and responding of the BD adolescents when in mainstreamed settings was compared to responding of regular class peers. Portable microcomputers were used to collect data across 10 categories of verbal responding for 14 BD adolescents and 14 regular class peers. Results supported several general conclusions: (a) Adolescents with behavioral disorders engaged in more negative verbal responding than their regular class peers; (b) BD adolescents exhibited less inappropriate verbal behavior when in the mainstream than when self-contained; and (c) when in the mainstream, the verbal behavior of BD students was similar to that of their regular class peers. Implications of the general and specific differences that emerged from the comparisons were presented and discussed.

Adolescent↗

PubMed2005

[The trial of simple gas analysis of tobacco smoke that can be used for medical education].

OBJECTIVE: The purpose of this study was to check a simple sampling and easy gas analysis of tobacco smoke for effective tobacco intervention in medical education. METHODS: The mainstream of tobacco smoke was sampled by a syringe (50 ml) at five, ten and twenty seconds. The extracted mainstream was moved to a commercial PET bottle (2000 ml), and measured with gas detector tubes. The sidestream, which rises from the tip of the cigarette, was collected into a commercial PET bottle for a duration of 30 or 60 seconds. Formaldehyde, acetaldehyde, ammonia, hydrogen cyanide, and nitrogen oxides (NO, NO2) in the tobacco smoke were measured. Then, these gasses in the tobacco smoke of four brands of cigarettes were compared. This trial was conducted in third-year medical students, and the changes in attitudes to smokers and tobacco itself were investigated. RESULTS: The method of sampling 50 ml for 5 seconds produced the highest concentration of each gas in the mainstream. The gas concentration in the sidestream increased as the sampling time increased. The gas concentration in mainstream of "Lucia" was the highest of the used four brands, and the gas concentrations in the sidestream of "Mild Seven Prime" were higher than those of the other brands. Many medical students obtained knowledge about the toxicity of smoking by this experiment study. CONCLUSION: We studied a simple sampling method of tobacco smoke, and gas analysis with gas detector tubes. This method is recommended for tobacco education and intervention in medical education.

Acetaldehyde↗

PubMed1994

Gatekeeping through media format: strategies of voice for the HIV-positive via human interest news formats and organizations.

This research examines the extent to which HIV-positive voices are marginalized in the mainstream versus the "alternative" press. The central claim of this research is that news media format considerations, constructed around what has come to be called "media logic," leave persons who are HIV-positive with comparatively little voice in the mainstream press. By utilizing techniques of content analysis, the research examines 535 major HIV/AIDS-specific stories published in two oppositional papers toward an assessment of the level of HIV-positive voice in each outlet. While arguments of "homophobia" have been previously used to explain bias in mainstream HIV/AIDS-coverage, this article asserts that "hetero-centric" bias is, in fact, embedded in the routinized practices of mainstream "news production." The article concludes by suggesting that successful future HIV/AIDS activism demands a recognition of "media logic" and an adoption of its tactics.

HIV Seropositivity↗

PubMed1997

Gatekeeping through media format: strategies of voice for the HIV-positive via human interest news formats and organizations.

This research examines the extent to which HIV-positive voices are marginalized in the mainstream versus the "alternative" press. The central claim of this research is that news media format considerations, constructed around what has come to be called "media logic," leave persons who are HIV-positive with comparatively little voice in the mainstream press. By utilizing techniques of content analysis, the research examines 535 major HIV/AIDS-specific stories published in two oppositional papers toward an assessment of the level of HIV-positive voice in each outlet. While arguments of "homophobia" have been previously used to explain bias in mainstream HIV/AIDS-coverage, this article asserts that "heterocentric" bias is, in fact, embedded in the routinized practices of mainstream "news production." The article concludes by suggesting that successful future HIV/AIDS-activism demands a recognition of "media logic" and an adoption of its tactics.

HIV Seropositivity↗

PubMed1984

Yields of tar, nicotine, and carbon monoxide in the sidestream smoke from 15 brands of Canadian cigarettes.

Sidestream smoke yields for 15 brands of cigarettes were determined under conditions where mainstream yields were approximately equal to those used for determining the values which appear on packages of Canadian cigarettes. Sidestream yields of tar, nicotine, and carbon monoxide were much higher than mainstream yields for all brands tested. The average sidestream-to-mainstream ratios for the 15 brands were 3.5, 6.6, and 6.8 for tar, nicotine, and carbon monoxide, respectively. The highest yields of sidestream were obtained from the brands with the lowest mainstream yields.

Canada↗

PubMed1995

Return rates and outcomes from ethnicity-specific mental health programs in Los Angeles.

OBJECTIVES: The present study compared the return rate, length of treatment, and treatment outcome of ethnic minority adults who received services from ethnicity-specific or mainstream programs. METHODS: The sample consisted of 1516 African Americans, 1888 Asian Americans, and 1306 Mexican Americans who used 1 of 36 predominantly White (mainstream) or 18 ethnicity-specific mental health centers in Los Angeles County over a 6-year period. Predictor variables included type of program (ethnicity specific vs mainstream), disorder, ethnic match (whether or not clients had a therapist of the same ethnicity), gender, age, and Medi-Cal eligibility. The criterion variables were return after one session, total number of sessions, and treatment outcome. RESULTS: The study indicated that ethnic clients who attended ethnicity-specific programs had a higher return rate and stayed in the treatment longer than those using mainstream services. The data analyses were less clear cut when treatment outcome was examined. CONCLUSIONS: The findings support the notion that ethnicity-specific programs seem to increase the continued use of mental health services among ethnic minority groups.

Adult↗

PubMed2000

Defining mental illness and accessing mental health services: perspectives of Asian Canadians.

Asian Canadians consistently underutilize mainstream mental health services. This study investigates how the definition and meaning of mental illness relates to barriers Asian Canadians find in accessing mental health services. Personal interviews were conducted with 60 Asian Canadians in a northern community in the province of British Columbia. Content analyses revealed six themes that defined a mental health problem: (a) feeling a lack of purpose in life, (b) feeling lonely, (c) difficulties understanding and dealing with a new environment, (d) high anxiety levels, (e) descriptions of mental health problems as somatic illnesses, and (f) perceptions of mental illness as serious and potentially not treatable. It was also found that poor English language ability and a lack of understanding of mainstream culture were major barriers to accessing mental health facilities. Findings of this study provided valuable insights concerning Asian immigrants' hesitancy accessing and utilizing mainstream mental health facilities. The many poignant personal anecdotes illustrate that the migration and adaptation processes can be painful and full of anguish. Unless their experiences are better understood and accepted, many Asian Canadians will likely remain outside of the available mainstream mental health facilities.

Adolescent↗

PubMed1999

[Portable capnographs in emergency care: a comparison of equipment].

Recently, transportable capnographs fulfilling the practical demands of emergency medicine have become commercially available (NPB-75, sidestream, Nellcor Puritan Bennett; and Tidal Wave, mainstream, Novametrix). A prerequisite for their use is an accuracy as required for clinical purposes (i.e., pCO2 +/- 2 mmHg). Additionally, environmental conditions in emergency medicine (e.g., changes in ambient temperature) should not have a significant impact on accuracy. The objective of this investigation was to analyse the accuracy of the two capnographs. The accuracy of the pCO2 measurement was evaluated under the following conditions: (1) measurement with three gas mixtures of defined concentrations (gas A: 5% CO2, 95% O2; gas B: 5% CO2, 20% O2, 75% N2; gas C: 10% CO2, 90% N2) related to STPD conditions (STPD = Standard Temperature and Pressure, Dry); and (2) exposure to changes in temperature (from +22 degrees C to -20 degrees C, and from -20 degrees C to +22 degrees C) applying the aforementioned 3 gas mixtures (STPD); and (3) in 20 patients manually ventilated with pure oxygen following endotracheal intubation (i.e., BTPS conditions = body temperature and pressure, saturated). Adequacy of the results was compared to the alveolar gas monitor AGM 1304 (Bruel & Kjaer, Copenhagen, Denmark; sidestream) which served as the reference method (providing an accuracy for the alveolar carbon dioxide partial pressure (pACO2) of +/- 1 mmHg). In the 3 dry gas mixtures, mean inaccuracy proved to be +4.5 +/- 4.1, +2.8 +/- 3.7, and +2.2 +/- 7.0 mmHg (gas A, gas B, gas C; STPD) with the Nellcor sidestream device. Using the Novametrix mainstream capnograph the results were found as follows: (1) -1.1 +/- 0.6, +2.9 +/- 0.6, and +5.6 +/- 2.3 mmHg (oxygen compensation enabled); and (2) +0.2 +/- 1.6, +2.2 +/- 0.6, and +3.2 +/- 4.2 mmHg (oxygen compensation disabled). After changing the environmental temperature (-20 degrees C / +22 degrees C), the resulting deviations (gases A-C, STPD) found with the Nellcor device averaged -12 +/- 4% and +15 +/- 3% (Nellcor); with the Novametrix mainstream device the deviations averaged -1 +/- 2% and +1 +/- 1%, and -2 +/- 1% and +1 +/- 1% (oxygen compensation enabled/disabled). Mean inaccuracy of the pCO2 measurement during ventilation of patients with pure oxygen (BTPS) was found to average -0.9 +/- 0.9 (Nellcor), and either +3.9 +/- 0.8 or +2.1 +/- 0.7 mmHg with the Novametrix (oxygen compensation enabled/disabled). Under BTPS conditions, both devices showed an acceptable deviation of the measurement accuracy up to a maximum of +/- 2 mmHg. The higher deviations of the "NPB-75" (Nellcor Puritan Bennett, sidestream) when using dry gas mixtures (STPD) may be explained by the automatic water vapour correction. Under the conditions of low and changing ambient temperature (-20 degrees C, +22 degrees C), only the "Tidal Wave" (Novametrix; mainstream) remained uninfluenced, whereas deviations of -12% and +15% were found with the "NPB-75".

Capnography↗

PubMed2002

Perspectives: parity--prelude to a fifth cycle of reform.

BACKGROUND: Based on 2000 Carl Taube Lecture at the NIMH Mental Health Economics Meeting. AIMS OF THE STUDY: This perspective article examines the relationship between a policy of parity in financing mental health services and the future of reform in service delivery. METHODS: Applying theories of static and dynamic efficiency to an understanding of parity and the evolution of mental health services, drawing upon Burton Weisbrod s concept of the health care quadrilemma . RESULTS: Each of four cycles of reform in mental health services have contended with issues of static and dynamic efficiency. Each cycle was associated with static efficiency in the management and financing of services, and each was associated with a set of new treatment technologies intended to improve dynamic efficiency. Each reform proved ultimately unsuccessful primarily because of the failure of the treatment technologies to prevent future patient chronicity or to achieve sustained recovery. Recent advances in treatment technology and management of care can permit an unprecedented level of efficiency consistent with a policy of improved access to mainstream health and social welfare resources, including insurance coverage. This policy of so-called financing parity can improve current mental health service delivery, but it may also portend a future fifth cycle of reform. If new technologies continue to advance as full technologies - simple to deliver and producing true recovery - and mainstream resources are made available, then the specialty mental health services may contract dramatically in favor of effective care and treatment of mental illness in primary care and other mainstream settings. DISCUSSION: Predicting the future of health care is speculative, but it may be easier using the Weisbrod formulation to understand the process of mental health reform. Over-reliance on administrative techniques for building static efficiency and false optimism about dynamic efficiency from new technology have stymied previous reforms. All the same, a fifth cycle of reform could succeed, if the right conditions are met and mainstream resources are available.

Community Mental Health Services↗

PubMedDate not supplied

Making the connections: AIDS and water.

OBJECTIVE: Acknowledging AIDS as a crosscutting development issue, a Zambian rural water supply project that provides safe accessible water to rural communities embarked on a new initiative to mainstream AIDS into the water sector. SETTING AND PARTICIPANTS: The work of providing safe water takes the predominantly male workforce away from their spouses and families, into the rural villages of Zambia's Eastern Province, for long periods of time. With an HIV prevalence rate of 16.1%, the risk of HIV exposure exists for both employees and rural villagers. AIDS mainstreaming activities were designed to target both groups. INTERVENTION: An AIDS mainstreaming strategy was developed by identifying components that could be influenced in the external domain (the organization's usual work) and the internal domain (the workplace). Basic questions were addressed such as: how does AIDS affect the organization, how might the usual work aggravate susceptibility to HIV infection, and where is the comparative advantage? OUTCOMES: A workplace program including peer education, employee health education (including condoms) and a workplace policy was established for employees. For the target population, a series of five messages connecting safe water and AIDS was developed and disseminated through educational drama, community meetings and trainings, and integrated into the regular water, sanitation and hygiene activities. CONCLUSIONS: As an efficient utilization of resources that makes a broad impact, AIDS mainstreaming does not change the sector's mandate but takes advantage of the extensive geographic coverage and natural distribution system of water projects to disseminate AIDS information and make linkages with AIDS partners.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Comparative study of DNA adduct formation in mice following inhalation of smoke from cigarettes that burn or primarily heat tobacco.

The genotoxic potential of mainstream smoke from a test cigarette (TOB-HT) that primarily heats tobacco and a representative tobacco-burning cigarette (Kentucky reference 1R4F) was compared in male B6C3/F1 mice after nose-only inhalation exposure. Mice were exposed 1 hr per day, 5 days/ week for a 4 week period to mainstream smoke at concentrations of 0, 0.16, 0.32, and 0.64 mg total particulate matter/liter of air. Micronuclei formation in bone marrow and peripheral blood polychromatic erythrocytes (PCE) of animals exposed to either the TOB-HT or 1R4F cigarette was not significantly different compared with control animals exposed nose-only to filtered and humidified air (sham controls). DNA adduct measurement by the 32P-post-labeling method indicated an exposure-dependent increase in lung adducts of animals exposed to 1R4F cigarette smoke at all three concentrations with the mid and high exposure groups exhibiting statistically significant increases (P < 0.05) in adduct formation compared to sham-exposed animals. The concentration of DNA adducts in the lungs of animals exposed to the TOB-HT cigarette was not significantly increased (P < 0.05) at any concentration compared to sham-exposed controls. A statistically significant (P < 0.05) concentration-dependent formation of DNA adducts was also observed in the heart tissues of animals exposed to smoke from the 1R4F cigarette at all three concentrations, but no significant increase in adduct formation was observed in heart DNA of the animals exposed to the TOB-HT cigarette (P < 0.05). Under the conditions of this experiment, the mainstream smoke from the TOB-HT cigarette was demonstrated to be less genotoxic in mice than mainstream smoke from the 1R4F cigarette, which is representative of cigarettes in the current U.S. market.

Animals↗

PubMed2004

Mode of communication and classroom placement impact on speech intelligibility.

OBJECTIVE: To examine the impact of classroom placement and mode of communication on speech intelligibility scores in children aged 8 to 9 years using multichannel cochlear implants. DESIGN: Classroom placement (special education, partial mainstream, and full mainstream) and mode of communication (total communication and auditory-oral) reported via parental rating scales before and 4 times after implantation were the independent variables. Speech intelligibility scores obtained at 8 to 9 years of age were the dependent variables. PARTICIPANTS: The study included 131 congenitally deafened children between the ages of 8 and 9 years who received a multichannel cochlear implant before the age of 5 years. RESULTS: Higher speech intelligibility scores at 8 to 9 years of age were significantly associated with enrollment in auditory-oral programs rather than enrollment in total communication programs, regardless of when the mode of communication was used (before or after implantation). Speech intelligibility at 8 to 9 years of age was not significantly influenced by classroom placement before implantation, regardless of mode of communication. After implantation, however, there were significant associations between classroom placement and speech intelligibility scores at 8 to 9 years of age. Higher speech intelligibility scores at 8 to 9 years of age were associated with classroom exposure to normal-hearing peers in full or partial mainstream placements than in self-contained, special education placements. CONCLUSIONS: Higher speech intelligibility scores in 8- to 9-year-old congenitally deafened cochlear implant recipients were associated with educational settings that emphasize oral communication development. Educational environments that incorporate exposure to normal-hearing peers were also associated with higher speech intelligibility scores at 8 to 9 years of age.

Child↗

PubMed1990

Modifications of speech language levels by preservice educators based on language features.

Increased efforts to mainstream handicapped learners have been accompanied by a growing concern for the ability of mainstream educators to accommodate the special needs of these students. A particular concern involves the ability of mainstream educators to adjust their levels of spoken language when conversing with hearing-impaired learners. The present study compared the language levels produced by preservice educators with either high or low levels of previous experience with hearing-impaired individuals. Results indicated that (1) neither group adjusted their spoken language to levels understood by two hearing-impaired women and (2) members of the high experience group produced higher language levels than members of the low experience group. Discussion of these results focuses on implications for interactions with hearing-impaired learners.

Adult↗

PubMed1999

Fragile-X syndrome, Down's syndrome and autism: awareness and knowledge amongst special educators.

Fragile-X syndrome is the commonest cause of inherited intellectual disability. There is good evidence for a behavioural phenotype. This has implications for school staff using standard educational techniques. Similarly, autism is known to create particular educational requirements. The present study examined the awareness and knowledge of fragile-X syndrome, Down's syndrome and autism amongst staff in special and mainstream education. One hundred and two special school staff and 40 mainstream school staff completed questionnaires. Most staff offered a variety of features 'typical' of Down's syndrome and autism. In contrast, staff knew less about fragile-X syndrome. Specific knowledge about the learning styles of these children was very poor, but was associated with having taught an affected child. Mainstream and special school staff offered similar levels of knowledge for all three conditions. Staff did not demonstrate a sufficiently specialized knowledge of fragile-X syndrome to ensure that the special educational needs of these children were being met fully.

Adult↗

PubMed2001

Depressive mood in students with mild intellectual disability: students' reports and teachers' evaluations.

The present study examined 310 students with mild intellectual disability (ID) who attended special schools and self-contained classes in mainstream schools with regard to their reports of depressive mood, and loneliness and social skills, and teachers' perception of the students' academic, social and behavioural competencies. A multivariate analysis of variance (MANOVA) revealed that: students in special schools reported higher levels of depression and felt lonelier than mainstream school students; girls exhibited a greater sense of depressive mood than boys; teachers assessed boys as having higher academic competencies than girls; and boys were considered more easily distracted and less independent. However, teachers considered girls to have more adequate social adjustment, and be more task-oriented and more independent. For both groups, depressive mood can be predicted by distractibility and loneliness; by gender and lower academic competencies for special school students; or mainly by difficulties in social adjustment in the case of mainstream school students.

Child↗

PubMedDate not supplied

Different school placements following language unit attendance: which factors affect language outcome?

The study compared the outcomes of two groups of children who were attending language unit provision at 7 years of age. Of 242 children in the original study, 62 (28%) transferred to mainstream school placements at age 8 years. These children were then closely matched to children still attending language unit provision at this age using measures of non-verbal IQ, expression and comprehension. These two groups of children were compared on outcome at 11 years in the areas of language skill, non-verbal IQ and social behaviour. Teacher/speech-language therapist opinions of placement were also examined as factors affecting outcome. Results show that children who moved to mainstream provision at 8 years were more likely to be attending mainstream at 11 years, although the majority received extra support. No further differences were evident in outcome according to placement type. However, there was a main effect of teacher/therapist opinion on outcome--children whose teachers were not entirely happy with the 8-year placement performed more poorly at 11 years on language measures. There were no differences on any other measures. The findings suggest that follow-on placements for children attending language units need to be more closely in line with teacher's opinions and that more flexibility needs to be evident in school placement policy in order that appropriate educational settings can be arranged.

Child↗

PubMedDate not supplied

'I never even gave it a second thought': PGCE students' attitudes towards the inclusion of children with speech and language impairments.

Approximately 7% of young school-aged children have specific language impairments. Many such children are now being educated in mainstream settings. However, there is a dearth of up-to-date and valid research that considers UK (student) teachers' attitudes towards such children. This study aimed to investigate trainee teachers' attitudes towards teaching children with speech and language impairments, to investigate the reported effects of those attitudes on participants' acceptance of teaching such children, and to consider any implications for speech and language therapy (SLT) services and inclusive education. Nineteen trainee teachers (PGCE students) from a university in the North West of England took part in semistructured group interviews. The data were transcribed and analysed qualitatively, and recurrent themes identified. A range of attitudes was expressed, and six major themes were identified from the data. Participants discussed concerns about the resources and knowledge they considered necessary to support fully children with specific language impairments. There was some differentiation of attitudes related to the types of disability that a child may have and the subject being taught. Much of the discussion was about disabilities in general rather than specific to speech and language impairments. Many of the participants reflected on their own previous experiences to inform their opinions. Although many of the participants expressed positive attitudes, some had concerns about workload and at least one was openly hostile to the idea of teaching children with disabilities within mainstream settings. The implications of these findings are discussed in relation to previous research, the quantitative data obtained in this project, SLT services and the increases in the inclusion of children with specific language impairments into mainstream educational settings.

Adult↗

PubMed2002

Outcome of cochlear implantation at different ages from 0 to 6 years.

OBJECTIVE: To evaluate the outcome of cochlear implantation in young children in relation to the age at implantation. STUDY DESIGN: A retrospective longitudinal and cross-sectional analysis of pediatric cochlear implant patients. PATIENTS: All children with congenital deafness who underwent implantation before the age of 6 years (n = 48 for the longitudinal analysis and n = 70 for the cross-sectional analysis) INTERVENTIONS: All children received a multichannel cochlear implant. MAIN OUTCOME MEASURES: Categories of Auditory Performance (CAP) score and integration into the mainstream school system. RESULTS: For all children, the CAP score increased after implantation. Implantation beyond the age of 4 years hardly ever resulted in normal CAP scores or in integration into the mainstream primary school (20 to 30% of cases). Implantation between the age of 2 and 4 years always resulted in normal CAP scores after 3 years with a 66% probability of integration into the primary school. Implantation before the age of 2 years always resulted in immediate normalization of the CAP scores, with a 90% probability of integration into the mainstream kindergarten, well before entrance into the primary school. CONCLUSION: All children with congenital deafness who underwent implantation before the age of 6 years appeared to benefit from the implant. However, these data add evidence to the importance of early implantation (before the age of 2 years). Intervention before the age of 4 years seemed to be critical to avoid irreversible auditory performance losses, and intervention before the age of 2 years seemed to be critical to achieve optimal results.

Age Factors↗