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A YRBS survey of youth risk behaviors at alternative high schools and mainstream high schools in Hong Kong.

In Hong Kong, prevocational schools serve as an alternative to mainstream schools to provide education with more emphasis on practical and technical subjects. In this paper, health-risk behaviors of prevocational school (PVS) students were identified, and comparisons of health-risk behaviors with or without adjusting the demographic factors from prevocational schools and mainstream schools were made. The PVS students were at higher risk for most categories of health-risk behaviors such as unintentional and intentional injuries, smoking, alcohol drinking, glue sniffing, inadequate physical activity, insufficient consumption of fresh fruits and vegetables, and early sexual activity with multiple partners. Female students of PVS reported higher prevalence of emotional problems and substance abuse. Findings suggest that the school environment is an influential factor on the lifestyle behavior of students. Comprehensive health education and intervention programs are needed for youth in Hong Kong prevocational schools.

Adolescent↗

Beyond the mainstream: the special needs of the chronic child patient.

Born of civil rights legislation and promoted by a desire for simple, rapid means of modifying behavior, Public Law 90-142 represents an effort at normalizing behaviorally disturbed children through "mainstreaming." This paper argues that a simplistic insistence on equality through mainstreaming violates the rights and needs of some behaviorally disturbed children to be different.

Adolescent↗

Neurological soft signs in mainstream pupils.

AIMS: (1) To examine the relation between neurological soft signs and measures of cognition, coordination, and behaviour in mainstream schoolchildren. (2) To determine whether high soft sign scores may predict children with significant problems in other areas. METHODS: A total of 169 children aged between 8 and 13 years from mainstream schools were assessed. They form part of a larger study into the outcome of meningococcal disease in childhood. Half had previous meningococcal disease and half were controls. Assessment involved measurement of six soft signs followed by assessment of motor skills (movement ABC), cognitive function (WISC-III), and behaviour (Conners' Rating Scales). RESULTS: Children having an age corrected soft sign score above the 90th centile were considered to have an excess of soft signs. When compared to the other children they had significantly worse scores on the other three measures. Median movement ABC score was 15.3 v 7. Mean total IQ scores were lower by 10.3 points. Median behaviour scores were significantly higher on both parental and teacher questionnaires. A soft sign score above the 90th centile had a sensitivity of 38% for detecting cognitive impairment, 42% for detecting coordination problems, and 25% for detecting possible attention deficit hyperactivity disorder. CONCLUSION: In this group of children higher scores on the soft sign battery were related to significantly worse performance on measures of cognition, coordination, and behaviour. However, although soft sign assessment may be of interest it cannot accurately predict which children are likely to have impairment in other areas.

Adolescent↗

Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke.

BACKGROUND: Exposure to secondhand smoke causes lung cancer; however, there are little data in the open literature on the in vivo toxicology of fresh sidestream cigarette smoke to guide the debate about smoke-free workplaces and public places. OBJECTIVE: To investigate the unpublished in vivo research on sidestream cigarette smoke done by Philip Morris Tobacco Company during the 1980s at its Institut für Biologische Forschung (INBIFO). METHODS: Analysis of internal tobacco industry documents now available at the University of California San Francisco Legacy Tobacco Documents Library and other websites. RESULTS: Inhaled fresh sidestream cigarette smoke is approximately four times more toxic per gram total particulate matter (TPM) than mainstream cigarette smoke. Sidestream condensate is approximately three times more toxic per gram and two to six times more tumourigenic per gram than mainstream condensate by dermal application. The gas/vapour phase of sidestream smoke is responsible for most of the sensory irritation and respiratory tract epithelium damage. Fresh sidestream smoke inhibits normal weight gain in developing animals. In a 21 day exposure, fresh sidestream smoke can cause damage to the respiratory epithelium at concentrations of 2 microg/l TPM. Damage to the respiratory epithelium increases with longer exposures. The toxicity of whole sidestream smoke is higher than the sum of the toxicities of its major constituents. CONCLUSION: Fresh sidestream smoke at concentrations commonly encountered indoors is well above a 2 microg/m3 reference concentration (the level at which acute effects are unlikely to occur), calculated from the results of the INBIFO studies, that defines acute toxicity to humans. Smoke-free public places and workplaces are the only practical way to protect the public health from the toxins in sidestream smoke.

Air Pollutants↗

[Mainstream medicine versus complementary medicine (homeopathic) intervention: a critical methodology study of care in pregnancy].

This meticulously evaluated study investigated two fundamental questions. The first dealt with the usefulness and adequacy of the instruments (questionnaires and case report forms) presently available in mainstream clinical research when trying to evaluate two dissimilar therapeutic systems such as main stream medicine and homeopathy. The second question dealt with the comparability of the two populations of patients in terms of individual personality characteristics as well as regarding the progress of the pregnancies and the course of the deliveries under the two systems of care and control. It turned out that a study of that kind is feasible in principle but is very demanding and time consuming. In addition the study showed clearly that the instruments presently available in mainstream medicine do not cover essential aspects of homeopathy and, therefore, impede a comparison of the two therapeutic systems. In the homeopathic group the frequency of situations requiring a Cesarean was remarkably low. However, the number of cases is too small to draw qualifying conclusions.

Cesarean Section↗

Analysis of volatile N-nitrosamines in mainstream and sidestream smoke from cigarettes by GLC-TEA.

Volatile N-nitrosamines were quantitatively determined in mainstream and sidestream smoke of commercial cigarettes using gas chromatography-thermal energy analysis (GLC-TEA). The smoke was trapped in ascorbic acid solution buffered at pH 4.5 and then extracted with dichloromethane; the organic phase was chromatographed on basic alumina and analyzed by GLC-TEA. The mainstream smoke of 22 different commercial cigarettes from Germany and Switzerland contained between 0.1 and 27 ng dimethylnitrosamine (DMN), 1.5 and 29 ng nitrosopyrrolidine (NPY) and traces of methylethylnitrosamine (MEN). The sidestream smoke of these cigarettes contained between 143 and 415 ng DMN, 3.1 and 27 ng MEN and 28 and 150 ng NPY. In a final experiment we measured the DMN concentration in a sealed experimental chamber as a function of the number of cigarettes smoked and recovered 68-87% of the DMN values found when using the sidestream collection device applied in the other experiments.

Chromatography, Gas↗

"Out-of-the-mainstream" youth as partners in collaborative research: exploring the benefits and challenges.

Forming collaborations between university-based researchers and community-based organizations (CBOs) serves to improve health promotion research and service. Unfortunately, members of the targeted populations are typically not included in such collaborations. This article describes the development and maintenance of a successful university-CBO collaboration that was formed to explore HIV-related risk rates and prevention strategies for suburban street youth and discusses the benefits and challenges of including out-of-the-mainstream youth as full collaborative partners in the research. Specific benefits included population-specific modifications of the research methods and instruments, recruitment of hard-to-reach youth, greater ease in tracking participants, and increased project acceptability and credibility. Among the challenges were issues related to boundaries, confidentiality, commitment, and burnout. Although such collaborations require increased time and commitment, the synergistic knowledge and experience of university researchers, community-based service providers, and out-of-the-mainstream youth can result in the development of unique and informative research and service programs.

Adolescent↗

Reading, language and memory skills: a comparative longitudinal study of children with Down syndrome and their mainstream peers.

BACKGROUND: Many of today's young adults with Down syndrome never had the opportunity to learn to read. However, an increasing number of children with Down syndrome are currently attending mainstream schools and being taught to read. As a consequence, it is now possible to systematically study reading development in children with Down syndrome. AIMS: The aim of this study was to chart the development of reading, language, and memory skills in children with Down syndrome and to investigate the relationships between these abilities. SAMPLE: Twenty-four children with Down syndrome aged between 4 and 12 were followed over two years and compared to 31 children matched for reading age, and 42 children of average reading ability, selected from the same mainstream classes as the children with Down syndrome. METHOD: Standardised assessments were administered annually to obtain measures of reading, spelling, language, memory, and general intelligence. RESULTS: The children with Down syndrome had relatively advanced single word reading ability compared to their other cognitive skills. The reading progress of the children with Down syndrome did not differ significantly from that of the reading matched group even after two years. Different cognitive abilities were highly correlated with one another in all groups. However, after controlling for age, many of the partial correlations between reading and the other measures were reduced to non-significant levels. CONCLUSIONS: Most children with Down syndrome are capable of learning to read single words. However, there was no evidence over this two-year period to support the hypothesis that learning to read will help to enhance language and memory development in children with Down syndrome.

Analysis of Variance↗

Behavioral and emotional adjustment of teenagers in mainstream school who were born before 29 weeks' gestation.

OBJECTIVES: To investigate behavioral and emotional problems and positive adjustment of 15-to 16-year-olds who were born at extremely low gestational age (ELGA), from the perspective of parents, teachers, and teenagers. METHODS: Prospective follow-up was conducted of birth cohorts, with classroom control subjects. All infants who were born before 29 weeks in 1983-1984 (mean gestational age: 27 weeks) to mothers who resided in 3 regions of the United Kingdom were studied. A total of 82% (179 of 218) of survivors were traced at age 15 to 16. The 150 in mainstream school were compared with age- and gender-matched classroom control subjects (n = 108). Behavioral and emotional problems, delinquency, peer relations, self-esteem, and hobbies, were assessed by standardized, well-validated instruments, including the Strengths and Difficulties Questionnaire, administered by mail to parents, teenagers, and teachers. RESULTS: Parents were more likely to rate ELGA teenagers than control subjects as in the "abnormal" range for hyperactivity (8% vs 1%; difference: 7%; (95% confidence interval [CI]: 2-12), peer relationship problems (19% vs 5%; difference: 14%; 95% CI: 6-21), and emotional problems (18% vs 7%; difference: 11%; 95% CI: 3-19), but not conduct problems (10% vs 5%; difference: 5%; 95% CI: -1 to 12)). Teachers reported a similar pattern. In contrast, compared with control subjects, ELGA teenagers did not rate themselves as having more problems with peers, hyperactivity, conduct, depression, or low self-esteem. They reported more emotional problems but less delinquency, alcohol, cannabis, and other drug use. CONCLUSIONS: Compared with mainstream classmates, children who are born extremely early continue to have higher levels of parent- and teacher-reported emotional, attentional, and peer problems well into their teens. However, despite these problems, they do not show signs of more serious conduct disorders, delinquency, drug use, or depression.

Adolescent↗

Nestle and breast vs. bottle feeding: mainstream and Marxist perspectives.

The breast vs. bottle feeding issue has sparked a controversial debate. Mainstream analysis of the problem shows that arguments made by the business community, as represented by the Nestle Corporation, do not withstand examination of the evidence. For example, it cannot be substantiated that women begin formula feeding because they have entered the labor force. Mainstream studies of cost effectiveness further indicate that bottle feeding is a drain on the incomes of impoverished Third World families and nations. Marxist analysis gives a very different perspective. Nestle represents 19th century capitalist development and the Industrial Revolution, and 20th century imperialism, neocolonialism and monopoly capitalism. Its motive has been capital accumulation and expansion. To increase surplus value appropriation, capitalism must devalue the household (subsistence) economy in which women enjoyed considerable status. Women also produce the most fundamental commodity for capitalism-laborers; therefore, the biological connection must be masked and controlled for the benefit of capital. Thus, as the capitalist mode of production has developed, women have been removed from important roles in production and reproduction. Coupled with the ascendancy of science, expertism and public health imperialism, breast feeding in any market economy becomes nearly impossible. As women internalize the values of capitalist ideology, they elevate "man-made" marketed commodities over subsistence goods such as breast milk.

Bottle Feeding↗

Substance use as a measure of social integration for women of different ethnocultural groups into mainstream culture in a pluralist society: the example of Canada.

Analysis of Canadian data from the 1989 National Alcohol and Drugs Survey was used to identify profiles of alcohol and other drug-using behaviors among Canadian women of different ethnic or cultural groups. The profile considered 110 different substance use variables including alcohol or drug type used, quantity, frequency, drinking or drug-taking circumstances, beverage preference, reasons for drinking or not drinking, and opinions regarding appropriate drinking or drug-taking behavior of Canadian women who described themselves as belonging to the "Canadian," French, English, German/Dutch, Irish, Scottish, Ukrainian/Polish, Italian/Portuguese, and "Other" (Chinese, Jewish, and "Other") ethnic or cultural groups. Alcohol, tobacco, and drug use behavior was found to differ by ethnocultural group. Further, each ethnocultural group was found to differ from the national average. The amount of difference between the national average and each ethnocultural group was related to the period of arrival and the length of time that an ethnocultural group has been present in Canada. The degree of similarity or difference between each ethnocultural group and the mainstream national average for alcohol, tobacco, and drug use and drug-use behavior may be used to measure the degree of social integration of each ethnocultural group and the degree of acculturation of women of specific ethnocultural groups into mainstream Canadian society.

Acculturation↗

Chiropractic: a profession at the crossroads of mainstream and alternative medicine.

Chiropractic is a large and well-established health care profession in the United States. In this overview, we briefly examine the development of chiropractic from humble and contentious beginnings to its current state at the crossroads of alternative and mainstream medicine. Chiropractic has taken on many of the attributes of an established profession, improving its educational and licensing systems and substantially increasing its market share in the past two decades. The public increasingly uses chiropractic largely for spinal pain syndromes and appears to be highly satisfied with the results. Of all the so-called alternative professions, chiropractic has made the largest inroads into private and public health care financing systems and is increasingly viewed as an effective specialty by many in the medical profession. Much of the positive evolution of chiropractic can be ascribed to a quarter century-long research effort focused on the core chiropractic procedure of spinal manipulation. This effort has helped bring spinal manipulation out of the investigational category to become one of the most studied forms of conservative treatment for spinal pain. Chiropractic theory is still controversial, but recent expansion in federal support of chiropractic research bodes well for further scientific development. The medical establishment has not yet fully accepted chiropractic as a mainstream form of care. The next decade should determine whether chiropractic maintains the trappings of an alternative health care profession or becomes fully integrated into all health care systems.

Chiropractic↗

Benefits of a mainstreamed summer camp experience for teens with ESRD.

This is a report on a pilot project integrating children with end stage renal disease (ESRD) with well children for a summer camp experience. As the teen with ESRD prepares to enter the work force and college, he/she will have to adapt to a variety of situations that will not adapt to his/her unique medical condition. These issues motivated a pilot project in which 9 ESRD children were mainstreamed into a 2 week, YMCA summer camp experience. Pre and post questionnaires were developed and distributed to the camper, family, and the cabin counselor along with interviews to assess the value of the experience. All the children left camp more independent and knowledgeable about their self-care. The results of this pilot project indicate that children with ESRD can adapt to their environment and increase independence, self-care and self-esteem through supervised mainstreamed experiences.

Adolescent↗

[A study of children with special needs in mainstream schools and the role of nursing teachers].

OBJECTIVE: Principals of elementary schools and classroom teachers of classes for children with special needs were surveyed by questionnaire to identify the features of children with special needs in mainstream schools and the role of nursing teachers. METHODS: Subjects in Y prefecture were asked to consider several items including the following: 1) presence in class of children with special needs; 2) presence of a child with special needs who was a target of a class or a school for children with special needs; 3) presence of education for special needs experience; 4) obstacles that such children face; 5) the relation with a nursing teacher from June to August in 1998. RESULTS: 1. There was no class for children with special needs in 87 among 135 schools. Children with special needs were present in 27 out of 87 schools, and the frequency of children with special needs was about 0.3% in mainsteam classes. 2. The total number of children in classes for special needs was 177 including 142 (79.8%) with intellectual disabilities, 77 (43.3%) with complex disabilities and 61 (34.3%) requiring medical care. 3. Ninety percent of teachers of special needs classes asked a school nurse about health care for special needs and how to cope with matters relating to disabilities. 4. Ninety percent of teachers of special needs classes were concerned about matters such as the method of teaching and coping with matters relating to disabilities. CONCLUSION: The survey found that there are children with special needs in mainstream classes. The situation with the disabilities is an appreciable number of complex, so teachers of special needs classes had many concerns. Those teachers are inclined to be isolated in school. To achieve good educational outcomes for children with special needs it is important to develop a systematic network between school and experts such as medical doctors and educational professionals. Nursing teachers could play an important role in their relation, with medical specialists.

Child↗

Educational mainstreaming of physically handicapped children.

The therapeutic and educational needs of 31 children who, after attending a private pre-school for the physically handicapped, were mainstrained in public schools are described in this paper. Their adjustment was followed for one to three years. Information was gathered through questionnaires and interviews with parents, children, and classroom teachers on how successful and to what extent the children had been mainstreamed, as well as what physical, academic, and social problems were encountered. Patterns and trends of relative educational abilities and disabilities of children with spina bifida and cerebral palsy are discussed in view of the literature and the problems encountered by this population. Questions that teachers frequently asked of health professionals who are experienced in dealing with the effects of handicapping conditions as well as a procedure for providing this information are also discussed. Successful mainstreaming depends on cooperative work and mutual advocacy among health professionals, parents, and educational personnel.

Adaptation, Psychological↗

[Determination of benzo(a)pyrene in cigarette mainstream smoke by second-order-derivative synchronous fluorescence].

The synchronous fluorescence, first-order and second-order-derivative synchronous fluorescence spectra of BaP in cigarette mainstream smoke were studied. It was indicated that the second-order-derivative synchronous fluorescence spectrum could decrease the disturbances of BaP homologous compounds and background of sample. Hereby the present paper introduces a new method to determine BaP in cigarette mainstream smoke by solid-phase-extraction second-order-derivative synchronous fluorescence. The detection limit is 0.2 ng x mL(-1), the average recoveries of BaP are 80.2%-86.2%, and the RSD is 2.64%-3.02%.

Benzo(a)pyrene↗

The challengers, interactors and mainstreamers: second step education and nursing roles.

What impact have post-licensure or "Second Step" programs for nurses had been upon experienced nurses? How successful have they been in developing more professional orientations among nurses trained for a technical role? A factor analysis of longitudinal data from 236 nursing students in six Second Step programs revealed that students entering these programs varied greatly in professional attitudes. Three types of students--the challengers, the interactors, and the mainstreamers were differentiated, by their contrasting nursing styles as well as by diverse sociopolitical views and personality characteristics. Data indicated that, at graduation, students in all three groups perceived themselves as more professionally involved, committed, and competent, but they did not change similarly in other areas of life. The challengers and the interactors made significant changes in their sociopolitical views and in some personality characteristics, while the mainstreamers made fewer changes and maintained greater consistency from entry to graduation. Second Step education promoted professional development, but its impact upon other areas of life varied, depending upon the students' receptivity and readiness for change.

Adult↗

Intergroup contact and social outcomes for mainstreamed EMR adolescents.

The prediction of the contact hypothesis, that contact between nonretarded and EMR adolescents would result in the EMR adolescents being viewed as more competent, likeable, and socially acceptable, was examined. Subjects were 26 mainstreamed EMR adolescents. Likeability, competency, and acceptability scores were computed for each subject on the basis of responses by nonretarded (n = 382) and EMR classmates (n = 56) to a survey questionnaire. Intergroup contact did not significantly modify the attitudes of nonretarded classmates toward the EMR subjects, who were viewed as significantly more competent, likeable, and socially acceptable by EMR classmates in the special class than by nonretarded classmates in the mainstream class.

Adolescent↗