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Students' studying and approaches to learning in introductory biology.

This exploratory study was conducted in an introductory biology course to determine 1) how students used the large lecture environment to create their own learning tasks during studying and 2) whether meaningful learning resulted from the students' efforts. Academic task research from the K-12 education literature and student approaches to learning research from the postsecondary education literature provided the theoretical framework for the mixed methods study. The subject topic was cell division. Findings showed that students 1) valued lectures to develop what they believed to be their own understanding of the topic; 2) deliberately created and engaged in learning tasks for themselves only in preparation for the unit exam; 3) used course resources, cognitive operations, and study strategies that were compatible with surface and strategic, rather than deep, approaches to learning; 4) successfully demonstrated competence in answering familiar test questions aligned with their surface and strategic approaches to studying and learning; and 5) demonstrated limited meaningful understanding of the significance of cell division processes. Implications for introductory biology education are discussed.

Biology↗

Toward guidelines for evidence-based assessment of depression in children and adolescents.

We aim to provide a starting point toward the development of an evidence-based assessment of depression in children and adolescents. We begin by discussing issues relevant to the diagnosis and classification of child and adolescent depression. Next, we review the prevalence, selected clinical correlates, course, and treatment of juvenile depression. Along with some general considerations in assessment, we discuss specific approaches to assessing depression in youth (i.e., interviews, rating scales) and briefly summarize evidence on the reliability and validity of a few selected instruments. In addition, we touch on the assessment of several other constructs that are important in a comprehensive evaluation of depression (i.e., social functioning, life stress, and family history of psychopathology). Last, we highlight areas in which further research is necessary and conclude with some broad recommendations for clinical practice given the current state of the knowledge.

Adolescent↗

Grandparents and grandchildren: a "memory box" course assignment.

Grandparents want to share family stories and memories with grandchildren. Implementing a classroom "memory box" assignment, allows grandparents and grandchildren a structured opportunity to discuss and explore family memories. What types of information do grandparents want to share with their grandchildren? This course assignment was implemented with college age students in a gerontology course with 100 grandparents to explore the types of memories they would like to leave with their grandchildren. Topics discussed were family history, family stories, grandparent's role, and advice grandparents would give to their grandchildren. Common themes that emerged suggested that grandparents wanted their grandchildren to know the importance of love in the family, spirituality, and morals such as honesty and trust. The "memory box" class assignment provides teachers and faculty with an educational learning exercise that can be incorporated into a current course to provide an intergenerational gerontology component into their curriculum.

Adult↗

Narrative research: a viable methodology for clinical nursing.

TOPIC: Narrative research provides a reasonable methodology for gathering rich, multidimensional data in the clinical setting. PURPOSE: To familiarize nurses with the concept of narrative research, review pertinent narrative research literature, and identify some ways this methodology can be integrated into clinical nursing. SOURCES: A review of published literature from psychology, sociology, anthropology, and nursing, with citations from women with breast cancer. CONCLUSIONS: Narrative research can make a valid contribution to nursing science in language familiar to nurses and other healthcare professionals.

Adaptation, Psychological↗

Using host response modifiers in the treatment of periodontal disease. "The clinicians' view". [Interview].

While considerable advances have been made in the understanding of the tissue-destructive mechanisms involved in etiology of periodontitis, the adoption and application of this knowledge has not been generally incorporated into the daily management of patients with chronic periodontitis. A number of adjunctive pharmacotherapeutic agents have been investigated in clinical trials and several agents are used in everyday practice as adjuncts to mechanical nonsurgical periodontal therapy. The only systemic, host modulatory agent approved for the adjunctive use with nonsurgical periodontal procedures, however, is Periostat (20mg doxycycline hyclate, twice daily). In order to further understand the impact of adjunctive host modulatory therapy on patient management and its role in clinical practice, Montage Media interviewed dental professionals across the US. Each of the participants has direct experience with the use of Periostat in their clinical practice. The expectation is that, with the "real life" clinical experience reported by clinicians "in their own words" coupled with the extensive literature describing the results of controlled clinical trials of Periostat, it will be possible to hasten the adoption of evidence-based science into clinical practice.

Dentist-Patient Relations↗

Building a research program. Interview by Donald E.L. Johnson.

Faced with shrinking funds for medical research, hospitals have had to evaluate the role of research and reexamine how research programs are funded and structured. In the following interview with Health Care Strategic Management's Donald E.L. Johnson, Jan R. Jennings, president of Millard Fillmore Hospitals in Buffalo, N.Y., discusses how critical a research program is to a teaching hospital. The major benefits are improving the quality of care and creating a more dynamic and stimulating environment. But there are pitfalls, as well. Clinical research must be run with strict financial discipline and monitored from ethical and legal standpoints.

Chief Executive Officers, Hospital↗

A longitudinal perspective on health plan-provider risk contracting.

During the past decade many health plans adopted risk-contracting arrangements that transferred substantial financial risk and care management responsibility to physician groups and hospital-sponsored integrated delivery systems. Risk transfer arrangements are now believed to be in steep decline, but there is little empirical evidence on this topic, particularly at the local-market level. Data from the Community Tracking Study were used to examine changes in risk contracting from 1996 to 2000. A decline in reliance on risk contracting is evident in nearly all markets. However, retrenchment in risk contracting has followed different patterns ranging from refinements in the scope of risk transfer to reduced use of risk arrangements to total rejection of risk-sharing arrangements. Modified risk-transfer agreements remain viable in several markets, but continued refinement in the nature and scope of risk sharing will be necessary.

Contract Services↗

Can exposure to electromagnetic radiation in diathermy operators be estimated from interview data? A pilot study.

As preparation for a case-control study dealing with possible teratogenic property of short waves, a pilot study was conducted in order to compare exposure assessment from different sources. In 11 physiotherapy clinics, exposure assessments based on interviews within 1 week among the exposed physiotherapists were compared with exposure assessments based on observations including measurements. It was possible to discriminate between recent high and low peak exposure. Furthermore, an interview index reflecting the duration of the exposure correlated to some extent with the corresponding measurements.

Diathermy↗

The family history method using diagnostic criteria. Reliability and validity.

Data concerning familial history of psychiatric disorders are often used to assist in diagnosis, to examine the role of genetic or nongenetic familial factors in etiology, or to develop new methods of classification. Information concerning familial prevalence may be collected by two different methods: the family history method (obtaining information from the patinet or a relative concerning all family members), and the family study method (interviewing directly as many relatives as possible concerning their own present or past symptomatology). This study compares these two methods. In general, the family study method is preferred since information is likely to be more accurate. The family history method leads to significant underreporting, but this can be minimized through the use of diagnostic criteria. This study reports on an instrument that has been developed for collecting information concerning family history and that provides criteria for 12 diagnoses--the Family History-Research Diagnostic Criteria. Using diagnostic criteria leads to greater sensitivity, but underreporting remains a major problem of the family history method.

Diagnosis, Differential↗

Group therapy in family medicine. Part 3: starting the group.

This paper is the third in a four-part series and in it some issues and techniques pertaining to the pregroup screening interview are discussed as well as the initial meeting of a therapy group in a family practice setting. The screening interview enables patient and group therapists to decide whether or not the patient might benefit from group therapy. Topics covered in such an interview are discussed. Some ways of beginning and of ending the first session are described.

Family Practice↗

The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials.

A meta-analysis was conducted on controlled clinical trials investigating adaptations of motivational interviewing (AMIs), a promising approach to treating problem behaviors. AMIs were equivalent to other active treatments and yielded moderate effects (from .25 to .57) compared with no treatment and/or placebo for problems involving alcohol, drugs, and diet and exercise. Results did not support the efficacy of AMIs for smoking or HIV-risk behaviors. AMIs showed clinical impact, with 51% improvement rates, a 56% reduction in client drinking, and moderate effect sizes on social impact measures (d=0.47). Potential moderators (comparative dose, AMI format, and problem area) were identified using both homogeneity analyses and exploratory multiple regression. Results are compared with other review results and suggestions for future research are offered.

Controlled Clinical Trials as Topic↗

Feeding Infants and Toddlers Study (FITS): development of the FITS survey in comparison to other dietary survey methods.

OBJECTIVE: This article describes the steps in the planning and development of the 2002 Feeding Infants and Toddlers Study. METHODS: We describe the study's rationale, sampling methodology, survey questionnaire development, dietary methodology, field data collection, and data processing and analysis. A brief review of existing national nutrition surveys and studies of infants and toddlers, and available study designs and dietary methods, is also included. SUBJECTS/SETTING: Most national studies have been cross-sectional and assessed breastfeeding rates, dietary intake, and nutritional status among general and high-risk populations. Other specialized studies have been longitudinal and tracked dietary intake and nutritional status from infancy to the preschool years, or focused on studying a specific research topic, such as the relationship between fluoride intake and dental caries. CONCLUSIONS: The 2002 Feeding Infants and Toddlers Study has advanced the knowledge base on infant and toddler nutrition by using state-of-the-art methodology and by providing researchers with updated information to develop further research questions. Our findings can be used by child health and nutrition organizations to develop dietary recommendations and improved nutrition education materials. Clinicians and practitioners in the fields of public health and wellness can use the information to provide practical advice to parents in a variety of settings to help give children a more healthful start.

Breast Feeding↗

The World Fertility Survey: charting global childbearing.

Interviewing some 350,000 women in 42 developing countries and 20 developed countries representing nearly 40% of the world's population, the World Fertility Survey (WFS) is in a unique position to document the historic 1970s slowdown in global population growth. This Bulletin describes efforts begun in 1972 to ensure high quality, internationally comparable, accessible data, the data's importance for policymakers, planners and researchers, and major findings available by early 1982 from directly assisted WFS surveys in 29 developing countries and contraceptive use data from WFS-type surveys in 16 developed countries. Marital fertility has declined in all developing regions except Africa but still averages from 4.6 children/woman in Latin America to 6.7 in Africa, while preferred family size ranges from 3.0 children in Turkey to 8.9 in Senegal--far above the average 2.2-2.5 children/woman needed to end developing countries' population growth in the long run. However, women ages 15-19 prefer nearly 2 children fewer than the oldest women ages 45-49; 3.8 vs. 5.7 on the average. Nearly 1/2 (48%) of married women surveyed in 27 countreis said they wanted no more children. Preventing all unwanted births would reduce birth rates up to 15 births/1000 population in these countries. Overall, 32% of married, fecund women in developing countries are using contraception compared to an average 72% in 16 developed countries. Education, literacy, and more available family planning services increase contraceptive use. Age at marriage is rising in Asia, but this factor alone has little effect on fertility. Infant mortality is higher in many developing countries than previously thought. Breastfeeding is an important restraint on fertility in most developing countries but is declining among more educated, employed, and urban women which could raise fertility if not compensated for by gains in contraceptive use.

Africa↗

Creating the most frightening company on earth. An interview with Andy Law of St. Luke's. Interview by Diane L. Coutu.

Though only five years old, employee-owned St. Luke's Communications has become one of the most talked about advertising agencies in the United Kingdom, winning numerous awards--though it doesn't enter contests--and increasing its profits eightfold. Chairman and cofounder Andy Law attributes the firm's success to its determination to continuously reinvent itself in a world populated by dot-coms and mega-ad agencies. St Luke's intends to revolutionize the way business is done and provide a credible alternative to the capitalism of both the old economy and the new. To that end, it pushes its people to take enormous risks. As Law says in this candid interview, "We're fundamentally convinced that there is a connection between co-ownership, creativity, collaboration, and competitive advantage." In this interview, Law comments on topics ranging from dot-coms--he calls them old-fashioned--to the hazards of St. Luke's environment. "When I see ... paranoia," he says, "it's a sign there's been too much change." Along the way, he provides concrete examples of how St. Luke's fosters its brand of "confrontative, angry creativity" and manages an organization that is run "like a radical democracy." Safety and fear play key roles. No one has ever been fired for poor performance, so employees can feel secure about their jobs, but the firm requires people "to peel away all the levels of their personalities.... That's truly frightening." Self-knowledge, Law says, "is the DNA of a creative company in the creative age."

Advertising↗

Comparing nutrition programs conducted by public health and Cooperative Extension personnel.

We surveyed 218 county extension agents, 75 state extension specialists, 163 public health nutritionists, and 87 public health administrators in 16 states to compare the nutrition program characteristics of extension personnel with public health personnel. Public health personnel were most strongly influenced by funding regulations--more than 80% of public health nutritionists cited infant/preschool nutrition and nutrition for pregnant/lactating women as program topics. About half of the extension agents listed food preservation and preparation as the dominant topics provided. Public health personnel most frequently designed programs for pregnant and lactating women and low-income clientele; 91% of the nutritionists ranked one-to-one counseling as one of their three most important delivery methods. Extension personnel designed programs more often for homemakers/adults and youth and ranked a combination of group and media delivery methods as most important. Public health personnel use anthropometric measures and food intake records to evaluate their programs; extension personnel use written questionnaires and program records. More than 50% of the nutritionists ranked improving the health of their clients as one of the three most important impacts of their programs; more than 50% of the extension agents ranked increasing knowledge and improving skills as their most important impacts.

Dietary Services↗