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At least 1,117 records · Page 62Linked to original sources

PubMed1996

The relation between neonatal thyroxine levels and neurodevelopmental outcome at age 5 and 9 years in a national cohort of very preterm and/or very low birth weight infants.

Transient neonatal hypothyroxinemia is very common in preterm infants. The literature on the effect of this hypothyroxinemia is, however, controversial, and large or long-term follow-up studies are not available. In a nationwide prospective follow-up study on very preterm and (or) very low birth weight infants (n = 717), we studied the relationship between thyroxine levels in the 1st wk of life and neurodevelopmental outcome at 5 y of age and school performance at 9 y of age. Thyroxine concentrations from filter paper eluates were determined in 717 infants: 32% had levels of more than 3 SD below the mean (< 60 nmol/L). The percentage of infants with such low levels increased with decreasing gestational age. At the age of 5 y, 96% of survivors (n = 640) were available for extensive neurodevelopmental examination: 85 (13.3%) had a disability and 92 (14.3%) a handicap. At the age of 9 y, 83% of survivors (n = 552) answered a questionnaire on school performance: 300 (54.3%) were in mainstream education in a grade appropriate for age, 151 (27%) were in mainstream education with grade retention, and 101 (18.3%) were in special education. Both neurologic dysfunction at age 5 y and school failure at age 9 y were significantly related to lower neonatal thyroxine levels even after adjustment for other perinatal factors (odds ratio, 1.3). Whether this relationship is causal should be investigated. If a causal relationship exists, substitution therapy may at least partially prevent neurologic dysfunction and learning disabilities, both common sequelae of very preterm birth.

Birth Weight↗

PubMed2004

Teaching, digression, and implicit curriculum.

BACKGROUND: Although medicine resides within contexts that have historical, cultural, and societal determinants, these are rarely addressed explicitly in current medical teaching. SUMMARY: The article describes a method of teaching in which mainstream biomedical learning is linked to digressions, which serve as the medium for considering the contexts of medicine, unmasking hidden messages, and broadening the scope of medical instruction. CONCLUSION: Teaching by digression encourages students to learn core clinical science while considering such otherwise neglected areas such as medical values, contexts, habits, and history. Integrating this consideration of the hidden assumptions of medical practice into mainstream medical learning allows students to understand modern biomedicine as a system that is historically, culturally, and socially conditioned.

Clinical Clerkship↗

PubMed2005

Information on telemedicine.

Although the practice of telemedicine is still not considered part of mainstream health care, there has been a steady growth in information about telemedicine since 1999. The increasing body of literature about telemedicine, the staying power of various telemedicine societies and Websites, and the growing number of well-attended conferences about telemedicine all attest that interest in and the practice of telemedicine worldwide are very much alive and well. Searching for information has also become easier with the advent of better and faster search engines, particularly Google. Nonetheless, many Websites are out of date and the semantic confusion between 'telemedicine' and other terms such as 'telehealth' means that considerable perseverance is required to sift the wheat from the chaff. There is a wide variety of both electronic and print resources that have proven to be reliable sources of information. These include: the Internet (Web), books and reports, journals and trade magazines, telemedicine societies and conferences. While telemedicine cannot yet be considered to be part of mainstream health care, it has become a more familiar part of health terminology worldwide.

Computer Communication Networks↗

PubMed1991

[Assessment of cadmium and lead released from cigarette smoke].

Cigarette smoke, which contains many harmful compounds, affects not only the smoker's health but also indoor air quality. To evaluate indoor air contamination by cadmium (Cd) and lead (Pb), we measured Cd and Pb contained in the mainstream and sidestream smoke exhaled by experimental smoking of Japanese cigarettes and also determined urinary and blood Cd and Pb levels in smokers and non-smokers and air Cd and Pb levels in smoky environments. 1. One cigarette of each of 7 Japanese brands contained about 1 microgram each of Cd and Pb, of which about 50 ng each was released to the mainstream and 250 ng of Cd and 50 ng of Pb to the sidestream by smoking. 2. The blood Cd level in the smokers was significantly higher than that in the non-smokers. The urinary Cd level in the smokers was slightly higher than that in the non-smokers. The blood Cd level was related to the number of cigarettes smoked daily. Blood and urinary Pb levels did not differ between the smokers and non-smokers, but the blood Pb level was also related to the number of cigarettes smoked daily. 3. The air Cd levels in smoky places such as the smoking car of the special express train, an office, and a pachinko parlor were markedly higher than that in outdoor air. The air Cd concentration was well correlated with the environmental tobacco smoke concentration. On the other hand, the air Pb level was slightly higher in the above smoky places than outdoors. The mean air Pb concentration was not correlated with the environmental tobacco smoke concentration but was higher at higher environmental tobacco smoke concentration in each place.

Adolescent↗

PubMed1986

Contribution of passive smoking to respiratory cancer.

This article reviews data from experimental and epidemiologic studies on passive smoking and makes 12 recommendations for further study. The physicochemical nature of passive smoke, the smoke inhaled by nonsmokers, differs significantly from the mainstream smoke inhaled by the active smoker. At present, measurement of urinary cotinine appears to be the best method of assessing exposures to passive smoking. Data indicate that the greater number of lung cancers in nonsmoking women is probably related to environmental tobacco smoke. Exposures in utero and very early in life to passive smoking may be important in relationship to the subsequent development of cancer and need further consideration. The short-term effects of environmental tobacco smoke on the cardiovascular system, especially among high-risk individuals, may be of greater concern than that of cancer and requires further study. Further study of increased risks of lung cancers in relation to environmental tobacco smoke exposure requires larger collaborative studies to identify lung cancer cases among nonsmokers, better delineation of pathology, and more careful selection of controls. In addition, studies of epithelial cells or specific cytology should be undertaken to determine evidence of cellular changes in relation to environmental tobacco smoke exposure. Animal inhalation studies with passive smoke should be initiated with respect to transplacental carcinogenesis, the relationship of sidestream smoke exposure with lung cancer, the induction of tumors in the respiratory tract and other organs, and the differences in the physicochemical natures of sidestream and mainstream smoke.

Air Pollutants↗

PubMed1996

The tar fraction of cigarette smoke does not promote arteriosclerotic plaque development.

In addition to being the single greatest known environmental cause of cancer, cigarette smoke (CS) is also a major contributor to heart disease. We reported previously that 1) inhalation of either mainstream or sidestream CS promotes aortic arteriosclerotic plaque development; 2) 1,3 butadiene, a vapor-phase component of CS, promotes plaque development at 20 ppm, which at the time was only 2 times higher than the threshold limit value; and 3) individual tar fraction carcinogens in CS, including polynuclear aromatic hydrocarbons (PAHs) and nitrosamines, either do not promote plaque development or do so only at high concentrations. These results suggested that the tar fraction is not the primary source of plaque-promoting agents in CS. We asked whether repeated exposure to the tar fraction of CS, collected in a cold trap (TAR), promotes plaque development in an avian model of arteriosclerosis. Acetone extracts of mainstream CS tar from burning, unfiltered reference cigarettes were solubilized in dimethyl sulfoxide (DMSO) and injected weekly into cockerels for 16 weeks (25 mg/kg/week). Positive controls were injected weekly with the synthetic PAH carcinogen, 7,12 dimethylbenz(a)anthracene (DMBA) dissolved in DMSO and negative controls were injected with DMSO. Plaque location and prevalence did not differ from group to group. Morphometric analysis of plaque cross-sectional areas showed that plaque sizes, which are log-normally distributed, were significantly larger in the DMBA cockerels compared to both the TAR and DMSO groups. There were no significant differences in plaque size between DMSO and TAR cockerels. The results reported here, combined with other recent findings, support the conclusion that the primary arteriosclerotic plaque-promoting components of CS are in the vapor phase.

9,10-Dimethyl-1,2-benzanthracene↗

PubMed1984

Misconceptions of homophobia.

Recent studies and analyses of social reactions to homosexuality are examined with the goal of linking them to general theories of deviance in the mainstream of sociology and social psychology. Homosexuality as an attitudinal object is classified as person, trait, and characteristic of collectivities and culture. The assumption of homosexuality as a "master status trait" is questioned. Foci of investigation are categorized as cognitive stereotypes, perceptions of threat to others and to valued aspects of society and culture, and the management of homosexuality. Ego-alien and phobic responses are distinguished. General problems of attitudinal research in the field are identified; chiefly, the overemphasis of cognitive elements and the neglect of affective and behavioral elements. The potential of this imbalance for the reification of homophobia among subjects and for the general public is noted. Other problems include the confounding of cognitive and affective dimensions and the assumption of stability of attitudes in different social settings. The need for concrete observations of responses to homosexuality in varying social settings and for the study of various types and phases of the disclosure process is specified. We call for grounded empirical observations of reactions to homosexuality within a model of the "social construction of reality" in order to place such studies within the mainstream of sociology and social psychology.

Attitude↗

PubMed1991

The gay voice in popular music: a social value model analysis of "Don't Leave Me This Way".

The gay voice in popular music and its potential to create positive social change regarding societal values about homosexuality is the focus of the present study. The historical development of the gay voice in popular music is reviewed as an introduction to a critical analysis of the Communards' music video "Don't Leave Me This Way." Using a modified version of the Social Value Model proposed by Rushing and Frentz, the video is analyzed on three levels: (a) narrative content, (b) use of symbols in the narrative, and (c) lyrical content. It is suggested that this video effected a dialectical synthesis of mainstream and homosexual values because it achieved mainstream commercial success while realistically expressing a gay perspective.

Conflict, Psychological↗

PubMed1996

The social marketing of project ARIES: overcoming challenges in recruiting gay and bisexual males for HIV prevention counseling.

This paper reports on the development, implementation, and evaluation of a social marketing campaign designed to recruit clients Project ARIES, and AIDS prevention study funded by the National Institute of Mental Health. Marketing channels employed for the campaign included advertising in the gay press, generating coverage in the mainstream press, distributing materials to HIV testing centers and other health and social service providers, and displaying posters in gay bars and baths. While these approaches all succeeded in eliciting inquiries from individuals engaging in high risk sexual behaviors, they differed in several respects, including their ability to reach specific subgroups that are often underserved by more traditional programs, such as men of color, younger men, and men who self-report as being closeted. Promotional materials displayed in gay bars and baths resulted in the highest percentage of callers who, after inquiring about the program, decided to participate in the counseling. Coverage in the mainstream press was the most successful in reaching closeted men, men who were less active in the gay community, and individuals who did not self-identify as gay. Display and classified ads in the gay press produced the highest number of initial inquiries. Finally, recruitment of participants via materials distributed to HIV test sites and other service providers was the most effective in reaching men who were HIV-positive.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Part 3: A community divided.

The task of those who seek to encourage and offer social support has become more difficult as the majority of social institutions, and the state have established, over time, stronger and more pervasive modes of communication. The intricacies of gay identity have been articulated largely by forces outside of the gay movement, with the inevitable result that GSOs and ASOs have occupied less space in the consciousness of gay men. Additionally, I hypothesize that men who are HIV-positive are engaging in fewer sexual contacts than men who are HIV-negative, and consequently lessening their attendance at venues where cruising is the main event. Financially and structurally, I shall demonstrate the disparity between GSOs and ASOs, and suggest that there is a natural intersection wherein the two SMOs could, and ought to cooperate, especially in the areas of fund-raising, joint program development, recruitment and political lobbying. However, their ideological bases appear to be sufficiently different to preclude such affiliations. These disparate ideologies are amplified by the mass media, and are consequently internalized by the members of the gay community. In the longer term, the divisiveness that manifests itself in the proliferation of numerous collectivities within the gay movement will contribute to the further isolation of gays from each other, and thwart any future attempts at coalition building, which could obviate the continued existence of a gay movement. Some writers suggest that the gay movement is going through a phase in an inevitable process of paradigm shifting, and in the end, the community will come back together-stronger and more unified than it was previously. However, if this is a phase it is clear that the gay movement is in the 'dark before the dawn' initial phase of this paradigmatic shift, and subsequent phases are by no means guaranteed. As AIDS spreads beyond marginalized groups, and infiltrates the social majority, it is possible that much of the discrimination that has positioned gay men as 'other' will be abandoned in favour of a more enlightened, pluralistic conviction of the humanity of gays as full-fledged members of a mosaic-type community structure. On the other hand, it is also possible that as AIDS spreads into mainstream Western communities, gays will be further vilified and scapegoated as the perpetrators of this deadly disease. Preventative action is required to offset this possibility-preventative action can be affected by building a strong and unified gay community ready to withstand the onslaught of the mainstream enmity. This action would frame AIDS and gayness such that this type of situation would not come about. What is required is a new mode of co-operation among ASOs and GSOs, a model which firstly puts the gay house in order, and is then suitably structured to be more inclusive of all gay men's needs, and positioned to assist in the second wave of HIV infection-the general public.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Creating change agents: a national substance abuse education project.

OBJECTIVE: This study evaluated the effects of a national interdisciplinary faculty development program, Project MAINSTREAM, on creating curriculum enhancement in health professional education. METHOD: Thirty-nine faculty completed a two-year, part-time fellowship program featuring interdisciplinary collaboration, mentoring, training meetings, and Internet-based instructional materials. The main vehicle for curricular change was a required collaborative education project to develop trainees' core competencies in substance abuse prevention services. RESULTS: Fellows used a variety of approaches to implement 123 curricula and provide 66,995 hours of training to 10,170 trainees. Ninety percent of the training hours occurred in required courses, a potential indication of sustainability. Fellows indicated that a majority of the offerings would be sustained beyond the fellowship. CONCLUSION: Project MAINSTREAM shows promise as a model for achieving durable curriculum change in response to the public health crisis associated with a workforce untrained to deliver substance abuse services.

Clinical Competence↗

PubMed2005

Interdisciplinary service-learning substance abuse projects: processes and outcomes.

The purpose of this paper is to describe the development and implementation of community-based, service-learning field projects by 30 health professional faculty fellows of Project MAINSTREAM, a faculty development program on substance abuse. The fellows worked together for two years in 10 Interdisciplinary Faculty Learning Groups (IFLGs), which consisted of three academics of different disciplines. The ten projects are viewed within the context of service- learning and are based on a balance between the provision of services to the community and furthering the learning objectives of Project MAINSTREAM.

Adolescent↗

PubMed2000

The behaviour and self-esteem of children with specific speech and language difficulties.

BACKGROUND: Children with specific speech and language difficulties (SSLD) may have associated difficulties that impair their access to the curriculum, and their social relationships at home and in school. AIMS: (i) To identify the range of additional problems experienced by children with SSLD in different educational contexts; (ii) to consider the relationship between these problems and the child's current language status and (iii) to consider the child's self-esteem and the extent to which self-esteem is associated with the primary language problem or other associated difficulties. SAMPLE: Sixty-nine children (17 girls, 52 boys) aged 7-8 years (Year 3) who had been identified as having SSLD, 59 from two local education authorities and 10 from regional special schools for children with severe speech and language difficulties. METHOD: The children were assessed on a range of cognitive, language and educational measures; children and teachers completed a measure of the children's self-esteem (Pictorial Scale of Perceived Competence and Social Acceptance); teachers and parents completed a behavioural questionnaire (Strengths and Difficulties Questionnaire (SDQ); teachers also completed a further rating scale which included a behaviour subscale (Junior Rating Scale: JRS). RESULTS: The children's behaviour was rated as significantly different from the norm on both the SDQ and JRS, with the parents more likely to rate the child as having problems, but also as having prosocial behaviour. Both teachers and parents tended to rate the boys as having more problems than girls on the SDQ, with significant differences for the parents' ratings occurring on the total score and the hyperactivity and conduct problems scales. The children had positive self perceptions, which were comparable to the standardisation sample, and generally significantly higher than those of the teachers. The language and educational attainment scores of the children in special and mainstream schools were generally not significantly different, but parents rated the latter group as having more behaviour difficulties. Multiple regression analyses identified language comprehension and reading comprehension as the only predictors of the parents' rating of behaviour (on the SDQ). No relationship was found with the teachers' ratings. CONCLUSIONS: Behavioural difficulties, but not low self-esteem, are common in children of 7-8 years with SSLD, but the differences in patterns of relationship between parents and teachers, and with respect to children attending mainstream and special schools, challenge simple interpretations of comorbidity.

Child↗

PubMedDate not supplied

How physical education teacher education majors should be prepared to teach students with hearing loss: a national needs assessment.

A national needs assessment survey is described that gathered information on current practices in physical education in both center-based schools for the deaf and mainstream programs serving deaf and hard of hearing students, grades K-12. The manner in which deaf and hard of hearing students are being served in physical education programs, the depth and breadth of curricula, and the credentials needed to teach are described. The study compares similarities and differences among physical education programs in center-based deaf institutions and mainstream schools. In summary, the study identifies areas of concentration needed in curriculum, and methods of teaching appropriate for student teacher candidates. This information has value for physical education programs that are considering revising their curricula to prepare teacher candidates who wish to work with deaf students.

Child↗

PubMed2002

Acceptance of deaf students by hearing students in regular classrooms.

Peer relations are of great importance during adolescence. Belonging to a group and feelings of acceptance or rejection by other members are paramount. The article explores the attitudes of 792 hearing students from 10 to 20 years of age in 22 different schools in Spain toward the classroom mainstreaming of deaf students. In general terms, the results, obtained from a scale similar to the Likert and consisting of 19 questions, show that the deaf student is well received socially by hearing classmates. Hearing students in general felt that deaf students might be better looked after at a special school and that deaf students did not work as hard as hearing students. Young female hearing students reported the strongest support for mainstreaming of deaf students. Teachers were perceived as dedicated and patient.

Adolescent↗

PubMed2005

Evidence-based alternative medicine?

The validity of evidence-based medicine (EBM) is the subject of ongoing controversy. The EBM movement has proposed a "hierarchy of evidence," according to which randomized controlled trials (RCTs) and meta-analyses of RCTs provide the most reliable evidence concerning the efficacy of medical interventions. The evaluation of alternative medicine therapies highlights problems with the EBM hierarchy. Alternative medical researchers-like those in mainstream medicine-wish to evaluate their therapies using methods that are rigorous and that are consistent with their philosophies of medicine and healing. These investigators have three ways to relate their work to EBM. They can accept the EBM hierarchy and carry out RCTs when possible; they can accept the EBM standards but argue that the special characteristics of alternative medicine warrant the acceptance of "lower" forms of evidence; or they can challenge the EBM approach and work to develop new research designs and new standards of evidence that reflect their approach to medical care. For several reasons, this last option is preferable. First, it will best meet the needs of alternative medicine practitioners. Moreover, because similar problems beset the evaluation of mainstream medical therapies, reevaluation of standards of evidence will benefit everyone in the medical community--including, most importantly, patients.

Biomedical Research↗

PubMed1996

[Measuring pulmonary CO2 elimination--studies with the lung model using various mixed gases].

One way of determining pulmonary CO2 elimination during anaesthesia is the breath-by-breath method. With this technique, CO2 analysis is carried out using either the mainstream method (MSM), that is, directly in the expired air flow, or in samples of expired air. A disadvantage of MSM is the lack of sensor signal correction for changes in the composition of the gas mixture and barometric pressure. Sidestream systems (SSM) measure respiratory gas flow and gas concentration with adequate accuracy, and also correct the measured values for gas composition and ambient parameters. Disadvantages of breath-by-breath analysis are the SSM-system-related delay and distortion of the CO2 curves. In the present study, a computer-assisted comparative analysis of CO2 elimination measurement by the sidestream and mainstream methods was carried out using different mixtures of gases in a lung model. Under the selected conditions simulated in the lung model, evaluation of CO2 elimination using SSM and MSM is possible with an error of between 0 and 10% versus reference systems. Measuring accuracy of the MSM system in particular is found to depend directly on the composition of the gas mixture. Using the method described here, the measuring error of an SSM system in terms of delay and response time can be compensated with adequate accuracy.

Carbon Monoxide↗

PubMed1999

Complementary and alternative medicine use among women with breast cancer.

The legacy of 19th-century social theories applied to the study of non-mainstream treatment use continues to affect contemporary research into complementary and alternative medicine (CAM). Quantitatively based studies of CAM use have been hindered by the lack of an adequate lexicon, inaccurate characterizations of the people who use CAM, and underestimates of the prevalence of usage. Results from a qualitative prospective cohort study challenge previous stereotypes by indicating that CAM usage does not increase dramatically with the initial diagnosis of cancer and that younger women are more likely to use CAM than older women. Qualitative research methods are uniquely appropriate for obtaining accurate information about health practices that, despite growing acceptance in some areas of society, are still viewed as outside of the mainstream.

Adult↗