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PubMed2004

The effect of intellectual disability on children's recall of an event across different question types.

This research examined the performance of 80 children aged 9-12 years with either a mild and moderate intellectual disability when recalling an innocuous event that was staged in their school. The children actively participated in a 30-min magic show, which included 21 specific target items. The first interview (held 3 days after the magic show) provided false and true biasing information about these 21 items. The second interview (held the following day) was designed to elicit the children's recall of the target details using the least number of specific prompts possible. The children's performance was compared with that of 2 control groups; a group of mainstream children matched for mental age and a group of mainstream children matched for chronological age. Overall, this study showed that children with either a mild or moderate intellectual disability can provide accurate and highly specific event-related information. However, their recall is less complete and less clear in response to free-narrative prompts and less accurate in response to specific questions when compared to both the mainstream age-matched groups. The implications of the findings for legal professionals and researchers are discussed.

Case-Control Studies↗

PubMed2005

The acculturation gap-distress hypothesis among high-risk Mexican American families.

The authors tested the acculturation gap-distress hypothesis by examining whether parent-adolescent acculturation gaps were associated with greater conflict and youth conduct problems among 260 high-risk Mexican American families. The authors operationalized acculturation gaps in 2 ways: parent-youth mismatches in acculturation style, and parent-youth discrepancies in acculturation toward both mainstream and heritage cultures. Acculturation gaps were common, but results of hierarchical regression analyses indicated that parent-youth discrepancies in acculturation toward mainstream and heritage cultures were not related to increased conflict or youth conduct problems. Conduct problems were no higher in families in which the adolescent was more aligned with mainstream culture than the parent. Unexpectedly, the authors found more youth conduct problems in families in which the youth was more aligned with traditional culture than the parent. The results call into question the assumption that the more rapid acculturation of adolescents to American culture inevitably leads to distress in minority families.

Acculturation↗

PubMed1998

A 3-year progress report on the implementation of LAAM in the United States.

AIMS: LAAM, a long-acting opioid agonist, was approved by the US Food and Drug Administration in 1993 for use in licensed narcotic treatment programs. These programs have the exclusive authority in the United States to dispense methadone and LAAM for the treatment of opiate dependence. The purpose of this report is to describe the course of LAAM's implementation and to document some of the factors that have influenced the time course and extent of this process. DESIGN: Narcotic treatment programs approved for LAAM use were contacted by telephone at three timepoints following the FDA approval of LAAM in 1993. FINDINGS: Regulatory hurdles have been the most significant factor in slowing the use of LAAM. Some clinics have enthusiastically moved LAAM into mainstream use with great success. At other clinics LAAM implementation has been impeded by staff resistance and management reluctance. Some specific clinical practices, such as provision of adequate dose levels and flexible dosing practices, appear to be associated with superior clinical response, but issues of staff and organizational attitude toward the new medication are probably the most important impediments to a more positive response. CONCLUSIONS: The tasks involved with introducing a new opiate agonist treatment into mainstream use in the United States are numerous and complex. Clinical policies, fiscal issues and regulatory factors must all be addressed. The introduction of LAAM into the treatment system provides some useful lessons as other new addiction pharmacotherapies are moved into mainstream use.

Female↗

PubMed1999

Quick recovery in the generation of self-reactive CD4low natural killer (NK) T cells by an alternative intrathymic pathway when restored from acute thymic atrophy.

The thymus comprises the mainstream of T cell differentiation which produces conventional T cells and an alternative pathway which produces primordial T cells with intermediate density of T cell receptor (TCR)-CD3 complex on the surface (i.e. intermediate TCR cells or TCRint cells). We induced acute thymic atrophy in mice by an administration of hydrocortisone (10 mg) or irradiation (6.5 Gy). It was demonstrated that CD3intCD4lowNK1.1+ T cells were immediately generated by an alternative intrathymic pathway without passing through the double-positive CD4+8+ stage, when restored from thymic atrophy (days 3-14). These CD3intCD4lowNK1.1+ T cells mediated self-reactivity and appeared even in the periphery. mRNA of an invariant chain of TCR Valpha14Jalpha281 gene product was detected in these CD4low T cells, but not remaining CD4high T cells. The mainstream of T cell differentiation in the thymus was not restored up to day 14 and there was no leakage of self-reactive clones into the population generated through the mainstream. These results reveal that an alternative intrathymic pathway is associated with the generation of self-reactive T cells, in an early restoration phase after thymic atrophy.

Acute Disease↗

PubMed2000

Factors affecting progress of Australian and international students in a problem-based learning medical course.

CONTEXT: Research on the factors affecting progress in medical schools has typically focused on mainstream (non-Indigenous Australian, non-international) students in traditional, didactic programmes. These results may not be applicable to students, particularly those from culturally diverse backgrounds, undertaking problem-based learning courses. OBJECTIVE: This study used qualitative methodology to explore and compare factors affecting progress for mainstream Australian students (non-Indigenous Australian, non-international) and international students (full fee-paying students who had relocated countries to study) in a problem-based learning medical course. Intervention strategies were devised on the basis of the participants' experiences. METHODS: Six focus group discussions were conducted (three with mainstream Australian and three with international participants). Transcripts of these discussions were coded and analysed independently by two researchers and discussed until consensus was attained. RESULTS: Participants identified both positive and negative experiences related to the course structure, which were consistent with previous findings. The participants' experiences demonstrated a relationship between sense of 'belongingness' to the medical school community, participation in learning opportunities and progress through the course. CONCLUSIONS: The results suggest that interventions aimed at reducing barriers to progress need to promote students' confidence, motivation and subsequent participation in course learning opportunities. These results have application to other problem-based learning courses particularly those which face the challenge of providing an optimal learning environment for students from diverse backgrounds.

Adult↗

PubMed2003

The transition from paediatric to adult health care services for young adults with a disability: an ethical perspective.

Young children with disabilities and their carers or parents tend to form a long-term dependent relationship with a paediatrician throughout childhood. At some stage when the young person with a disability reaches early adulthood, the relationship is severed. This paper draws upon recent research undertaken by the authors that describes the difficulties experienced by young people with disabilities as they go through the transition from paediatric care to adult mainstream health care services. The purpose of this article is to present the argument that the dependent, paternalistic relationship that tends to exist between young people with disabilities (and/or their carers) and paediatricians throughout childhood does not facilitate the successful negotiation of adult mainstream health care services, nor optimally promote the well-being of these young people with disabilities. It is proposed that the promotion of autonomy (or self-determination) via a well planned transition program will increase the likelihood that young adults with disabilities and/or their carers will be empowered to successfully negotiate the current mainstream health care system in Australia, and will enhance the well-being of young adults with disabilities.

Adolescent↗

PubMedDate not supplied

Increasing selenium in cigarettes and smoke: transfer to smoke.

The selenium content of some American tobaccos and cigarettes was determined. The quantities of added selenium that were transferred from cigarettes to inhaled, mainstream smoke were examined for several commercial and experimental cigarettes of different tar levels. For high-tar cigarettes, as much as 10% of added selenium was found in mainstream smoke, while low-tar cigarettes delivered about 3% of added selenium. Transfer rates of selenium to mainstream smoke are reported for various levels of fortification (0-25 micrograms/cigarette) and the rationale for selenium fortification is discussed. Based on highly favorable reports in the literature on the antitumor activity of selenium, the fortification of tobacco with selenium may become a viable way of producing a safer tobacco product. It is proposed that such selenium-fortified smoking products be developed and evaluated extensively.

Agriculture↗

PubMed2003

Rat subchronic inhalation study of smoke from cigarettes containing flue-cured tobacco cured either by direct-fired or heat-exchanger curing processes.

A subchronic, nose-only inhalation study compared the effects of mainstream smoke from a cigarette containing 100% flue-cured tobacco cured by a direct-fired process to that of a cigarette containing 100% flue-cured tobacco cured by a heat exchanger process. The tobaccos and mainstream smoke from tobaccos cured by the heat exchanger process have been shown to have significantly lower levels of tobacco-specific nitrosamines than tobaccos cured by a direct-fired process. Male and female rats were exposed for 1 h/day, 5 days/wk, for 13 wk to mainstream smoke at 0, 0.06, 0.20, or 0.80 mg wet total particulate matter per liter of air. Clinical signs, body and organ weights, clinical chemistry, hematology, carboxyhemoglobin, serum nicotine, plethysmography, gross pathology, and histopathology were determined. When histologic changes resulting from exposure to smoke from the two types of cigarettes were compared, the only significant difference was increased epithelial hyperplasia of the anterior nasal cavity in males in the high-exposure group for the heat-exchanger cigarette. At the end of the exposure period, subsets of rats from each group were maintained without smoke exposures for an additional 13 wk (recovery period). At the end of the recovery period, there were no statistically significant differences in histopathological findings observed between the heat-exchanger-cured tobacco cigarette when compared to the direct-fired cured tobacco cigarette. The complete toxicological assessment in this study of heat exchanger and direct-fired tobaccos suggests no overall biologically significant differences between the two cigarettes.

Animals↗

PubMed2007

A new method for estimating the retention of selected smoke constituents in the respiratory tract of smokers during cigarette smoking.

This report describes a new method for estimating the retention of selected mainstream smoke constituents in the respiratory tract of adult smokers during cigarette smoking. Both particulate-phase (PP) constituents including nicotine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), and N'-nitrosonornicotine (NNN), two tobacco-specific nitrosamines (TSNA), and gas-vapor-phase (GVP) constituents including carbon monoxide (CO), isoprene (IP), acetaldehyde (AA), and ethylene, were studied. To estimate the amounts of smoke constituents delivered during smoking, we used predetermined linear relationships between the measured cigarette filter solanesol content and machine-generated mainstream deliveries of these selected compounds. To determine the amounts of smoke constituents exhaled, the expired breath was directed through a Cambridge filter pad (CFP) attached to an infrared spectrometer. PP compounds were trapped on the CFP for later analysis and GVP compounds were analyzed in near real time. The smokers' respiratory parameters during smoking, such as inhalation/exhalation volume and time, were monitored using LifeShirt(R), a respiratory inductive plethysmography (RIP) device. The retention of each smoke constituent, expressed as a percentage, was then calculated as the difference between the amount delivered (estimated) and the amount exhaled relative to the amount delivered. We studied 16 adult male smokers who smoked cigarettes according to 3 predefined smoking patterns: no inhalation (pattern A), normal inhalation (pattern B), and deep inhalation (pattern C). For the three PP constituents, the mean retentions for pattern A ranged between 10 and 20%; and while the mean retentions of the two TSNAs were significantly higher for pattern C (84% for NNK and 97% for NNN) than those for pattern B (63% for NNK and 84% for NNN), the mean retentions of nicotine were basically the same between patterns B and C, which were both greater than 98%. For the GVP constituents, the retentions were similar between pattern B and pattern C, although different constituents were retained to different degrees (average values of 33%, 52%, 79%, and 99% for ethylene, IP, CO, and AA, respectively). The differences in the retention between different constituents could be interpreted in terms of each constituent's physical properties such as volatility and solubility. In conclusion, the method described is suitable for studying the retention of selected mainstream smoke constituents in the respiratory tract of smokers.

Acetaldehyde↗

PubMed2003

Toxicological evaluation of honey as an ingredient added to cigarette tobacco.

A tiered testing strategy has been developed to evaluate the potential for new ingredients, tobacco processes, and technological developments to increase or reduce the biological activity that results from burning tobacco. In the manufacture of cigarettes, honey is used as a casing ingredient to impart both aroma and taste. The primary objective of this document is to summarize and interpret chemical and toxicological studies that have been conducted to evaluate the potential impact of honey on the biological activity of either mainstream cigarette smoke or cigarette smoke condensate. As part of ongoing stewardship efforts, cigarettes produced with honey (5% wet weight) as an alternative to invert sugar in tobacco casing material were subjected to extensive evaluation. Principal components of this evaluation were a determination of selected mainstream smoke constituent yields, Ames assay, sister chromatid exchange assay in Chinese hamster ovary cells, a 30-wk dermal tumor promotion evaluation of cigarette smoke condensate in SENCAR mice, and a 13-wk inhalation study of cigarette smoke in Sprague-Dawley rats. Comparative analytical evaluations demonstrated that the substitution of honey for invert sugar as a casing material in cigarettes had no significant impact on mainstream smoke chemistry. In addition, in vitro and in vivo studies demonstrated that cigarettes containing tobacco cased with honey had comparable biological activity to cigarettes containing invert sugar. Collectively, these data demonstrate that the use of honey as an alternative casing material in the manufacture of cigarettes does not alter the potential toxicity of cigarette smoke condensate (CSC) or cigarette smoke; therefore the use of honey as an ingredient added to cigarette tobacco is acceptable from a toxicological perspective.

9,10-Dimethyl-1,2-benzanthracene↗

PubMed1982

Cadmium and nickel in smoke of cigarettes prepared from tobacco cultured on municipal sludge-amended soil.

Cigarettes prepared from tobacco grown on municipal sludge-amended soil were smoked, and the mainstream particulates and gaseous fractions were analyzed for total cadmium and nickel content. Sludge-grown and control (soil-grown) tobaccos contained, respectively, 67.4 and 3.18 ppm of cadmium and 19.4 and 1.29 ppm of nickel. The quantities of cadmium (microgram per cigarette) found in the mainstream particulate and gaseous fractions were, respectively, 6.67 and 0.04 for the sludge-grown and 0.21 and 0.03 for the control treatments. The quantities of nickel (microgram per cigarette) found in the mainstream particulates and gaseous fractions were, respectively, 0.11 and 0.07 for the sludge-grown and 0.01 and 0.01 for the control treatments. The potential public health implications of these results and modifying factors are discussed.

Cadmium↗

PubMed1994

Induction of interleukin 2 receptor beta chain expression by self-recognition in the thymus.

1-2% of adult mouse thymocytes express the T cell receptor alpha/beta (TCR-alpha/beta) together with the interleukin (IL) 2R beta (p70), but not the alpha (p 55) chain. We show that the previously described alpha/beta-TCR +CD4-8- and the partially overlapping Ly6C+ thymocytes are contained within this subset. Most IL-2R beta+ alpha/beta-TCR+ cells have a mature and activated (heat stable antigen [HSA]-, thymic shared antigen 1 [TSA-1]-, CD44high, CD69+) phenotype. Overrepresentation of V beta 8.2 in both CD4-8- and CD4 and/or CD8+ IL-2R beta+ thymocytes suggests that IL-2R beta expression is induced by a TCR-mediated activation event. In mice transgenic for an H-2Kb-specific TCR, IL-2R beta+ cells were abundant under conditions of mainstream negative selection, i.e., in the presence of Kb, but absent under conditions of mainstream positive selection or in a nonselecting environment. Together, these results show that in addition to clonal deletion, self-recognition by immature thymocytes leads to phenotypic maturation of a small subset of thymocytes expressing IL-2R beta. IL-2-deficient mice contain normal numbers of IL-2R beta+ alpha/beta-TCR+ thymocytes, indicating that like mainstream T cell development, this minor pathway of positive selection does not depend on IL-2. However, in the absence of IL-2, the CD4/CD8 subset composition of IL-2R beta+ thymocytes is skewed towards CD4-8+, mostly at the expense of CD4-8-. A possible relevance of this finding for the development of the immune pathology of IL-2-deficient mice is discussed.

Animals↗

PubMed1989

Ethnicity and stress among older Australians.

The impact of ethnicity on the stress process in old age was examined using two surveys of Australians aged 60 years and older. Four different "ethnic strata" were defined: namely, mainstream Australians, British migrants, and non-British migrants--who were split on the basis of whether their English proficiency was good or poor. The ethnic stratum most different from mainstream Australian, non-British migrants with poor English proficiency, was a significant predictor of psychological distress in the context of other relevant variables. Within the four "ethnic" strata, network variables were significantly related to psychological distress only for non-British migrants, with relatives being important for those with poor English and nonrelatives for those with good English. For mainstream Australians, female gender, poor health, and specific living arrangements were significant predictors of psychological distress.

Aged↗

PubMed2005

Bypassing districts? Implications of sector-wide approaches and decentralization for integrating gender equity in Uganda and Kenya.

While the concept of gender mainstreaming has gained acceptance among many national and international development organizations, many obstacles are faced in translating the concept into tangible improvements in the health and well-being of women and men. This paper presents two qualitative case studies, one from Kenya and one from Uganda, of experiences of mainstreaming gender at district level; experiences which are set against the context of decentralization and sector-wide approaches (SWAPs). The conceptual framework of social movement theory, as used by Hafner-Burton and Pollack, is drawn upon to analyze the findings of both case studies. This paper has been written in conjunction with a paper by Theobald et al. which explores gender mainstreaming at national level.

Female↗

PubMedDate not supplied

Pyrolytic fate of piperidinocyclohexanecarbonitrile, a contaminant of phencyclidine, during smoking.

The pyrolysis products of 1-(1-piperidino)cyclo-hexanecarbonitrile (PCC), the major contaminant of illicit phencyclidine (PCP), have not been previously reported. In order to quantify PCC in mainstream smoke as well as to identify the pyrolysis products, [3H]piperidino-[14C]cyano-PCC was synthesized. Marijuana placebo cigarettes were impregnated with this double-labeled PCC and burned with an apparatus that simulated smoking. The mainstream smoke was passed through a series of traps containing glass wool, H2SO4, or NaOH. Approximately 75% of the 3H was collected in these traps, and 46, 11, and 5% of the 14C was found in the glass wool, H2SO4, and NaOH traps, respectively. Contents of the traps were analyzed by GC/MS. The glass wool trap contained 1-(1-piperidino)-1-cyclo-hexene, PCC, piperidine, and N-acetylpiperidine, and cyanide ion was detected in all three traps. Approximately 47% of the PCC was found intact in mainstream smoke. Approximately 58% was cleaved to form cyanide and 1-(1-piperidino)-1-cyclohexene. The latter was further broken down to cyclohexanone (which represented 21% of the starting material), piperidine (29%), and N-acetylpiperidine (7%), and about 2% remained intact.

Drug Contamination↗

PubMed2003

Background and educational characteristics of prelingually deaf children implanted by five years of age.

PURPOSE: This study documents child, family and educational characteristics of a large representative sample of 8- to 9-yr-old prelingually deaf children who received a cochlear implant by 5 yr of age. Because pre-existing factors such as the child's gender, family characteristics, additional handicaps, age at onset of deafness and at implant, may affect postimplant outcomes, these variables must be accounted for before the impact of educational factors on performance with an implant can be adequately determined. Classroom variables that may affect postimplant outcomes include placement in public or private, mainstream or special education, oral or total communication environments. Other intervention variables include type and amount of individual therapy, experience of the therapist and parent participation in therapy. Documenting these characteristics for a large representative sample of implanted children can provide clinicians and researchers with insight regarding the types of families who sought early cochlear implantation for their children and the types of educational programs in which they placed their children after implantation. It is important to undertake studies that control for as many of these factors as possible so that the relative benefits of specific educational approaches for helping children to get the most benefit from their cochlear implant can be identified. METHOD: Over a 4-yr period, 181 children from across the US and Canada, accompanied by a parent, attended a cochlear implant research camp. Parents completed questionnaires in which they reported the child's medical and educational history, characteristics of the family, and their participation in the child's therapy. The parent listed names and addresses of clinicians who had provided individual speech/language therapy to the child and signed permission for these clinicians to complete questionnaires describing this therapy. RESULTS: To the extent that this sample is representative of those families seeking a cochlear implant for their child, especially during the initial period of device availability, this population can be characterized as follows. Most parents had normal hearing, were of majority (white) ethnicity and had more education and higher incomes than the general population. The families tended to be intact with both a mother and a father who involved their hearing-impaired child in family activities on a regular basis. The children were enrolled in the full range of educational placements available across the United States and Canada. Fairly even distributions of children from public and private schools, special education and mainstream classes and oral and total communication methodologies were represented. Educational placement changed as children gained increased experience with a cochlear implant. They received an increased emphasis on speech and auditory skills in their classroom settings and tended to move from private school and special education settings to public school and mainstream programs. These data support the position that early cochlear implantation is a cost effective procedure that allows deaf children to participate in a normal school environment with hearing age mates.

Canada↗

PubMed2005

Examining leadership through critical feminist readings.

PURPOSE: This paper seeks to explore a critique of the limitations of mainstream leadership research and publications and offers a critical management analysis through drawing on a feminist reading of leadership in organizations. DESIGN/METHODOLOGY/APPROACH: There has recently been witnessed a growing interest in the promotion of effective leadership within both organizational studies literature and organisational policy as the route to ensuring employee commitment and enhanced organisational performance and the achievement of ever demanding goals and targets. This turn to leadership is represented in both an upsurge of research studies and a proliferation in the promotion of leadership as the organisational panacea. An analysis of the literature on leadership was undertaken, giving due consideration to mainstream and more critical accounts in relation to illustrations drawn from the UK National Health Service (NHS). FINDINGS: This paper explores mainstream literature on leadership and finds it wanting, in terms of its failure to deliver a common understanding of the concept, in its generally uncritical accounts, and its inability to expose the androcentric nature of the core assumptions within hegemonic discourses of leadership. Drawing on critical feminist readings in relation to the UK NHS, a more critical account of leadership is presented. PRACTICAL IMPLICATIONS: Greater awareness is required for the adoption of culturally sensitive and locally-based approaches that take account of individuals' experiences, identities and power relations and that allows for the presence of a range of masculine and feminine workplace behaviours. ORIGINALITY/VALUE: This paper provides an overview of the dominant themes within the literature on leadership as they relate to the UK NHS, and presents a feminist critique of the more subtle ways in which notions of leadership in organisations fail to consider their potential for bias.

Feminism↗

PubMed2006

Psychiatric inpatient units for children and adolescents with intellectual disability.

BACKGROUND: Inpatient beds for the psychiatric assessment and treatment of young people (under the age of 18 years) with intellectual disability have become scarce although there is pressure to redevelop them. In the UK, 63% of the NHS beds are at Prudhoe Hospital. This study examines their rôle and utility in relation to community services, both local and national. METHOD: A case note study of the 96 young people admitted over three years was supplemented by a standardised interview canvassing the opinion of the staff involved, both within the units and in the community. RESULTS: Two groups emerged: those with more severe disability who were admitted for neuropsychiatric management (63%) and those, predominantly adolescent, whose problems were closer to mainstream psychiatry but whose intellectual disability prevented their needs being met adequately by mainstream services (37%). Admissions were equally divided between those from the immediate vicinity and nationally. For 43% the primary aim was to disentangle the extent of the environmental effect on the individual: the remainder were admitted for various reasons including, for example, the need to protect the individual from harming themselves or others, unusually complex or hazardous treatment or the carers inability to cope with the treatment plan. All admissions were thought appropriate but, had the community resources been better, 18% were avoidable. CONCLUSIONS: Admission is necessary for a small number of young people who are not readily managed within mainstream units. While the number may be reduced by better community provision, this is likely to partially offset by better case finding. Inpatient facilities should be closely linked with community services; a point reinforced by the prolongation of admissions because a shortfall in community resources.

Adolescent↗