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Biomedical subjects

A Handler

Publications and source records attributed to A Handler.

48 records · Page 3Linked to original sources

Changes in discrimination learning and brain activity (ERP's) due to combined exposure to NO and CO in rats.

Carbon monoxide (CO) and nitric oxide (NO) are air pollutants frequently appearing in combination. Information available on the mechanisms of NO intoxication suggests that in mixtures with CO additive effects should be assumed. In this study CO and NO-induced changes and their interaction were investigated at different levels of integration: carboxyhemoglobin (COHb) and methemoglobin (met-Hb) formation as well as centrally mediated effects were analyzed using evoked potential techniques and behavioral data from a complex discrimination learning experiment. Slight enhancements of COHb and met-Hb concentrations were seen for the combined CO + NO exposure conditions at low and high exposure levels when compared to isolated exposure conditions. The performance decrease was clearly higher under NO exposure than under CO exposure. Decrements were overadditive when simultaneous CO + NO exposure was used in higher concentration. Both gases affected early evoked potential components (P10, N30) in the same way: latencies were prolonged and amplitudes increased. Later potential components were differently influenced by CO and NO. Mainly the N150 amplitude was decreased in NO exposure and increased in CO conditions. N150 amplitude was also decreased after combined CO + NO exposure. At high levels this effect was overadditive indicating a dominant role of NO in the CO + NO combinations used in this experiment.

Animals↗

Perinatal screening for illicit drugs: policies in hospitals in a large metropolitan area.

More data are needed regarding the screening policies of perinatal units for illicit drugs, especially in states where positive drug test results are linked with child neglect. The process by which pregnant women and infants are selected for illicit drug testing has caused concern because it may lead to bias and overrepresentation of certain populations in the drug-using groups. To examine hospital policies for screening women and newborn infants in prenatal, labor, and newborn hospital units, we conducted a telephone and follow-up mail survey of 49 Chicago-area hospitals. Nurse administrators or clinical specialists were questioned about the criteria used to select mothers and infants for testing, the extent to which written informed or oral consent was obtained for drug tests, and the actions taken by hospitals in response to positive drug test results in infants. Variations in policy among hospitals and hospital units were evident. The most frequently cited criteria for testing mothers and infants for drug use were verbal admission of drug use, the health provider's suspicion of drug use, a positive diagnosis of human immunodeficiency virus or a sexually transmitted disease in the mother, or a combination of these criteria. Universal drug screening may be a viable option when sanctions are the consequence of perinatal drug testing. The removal of sanctions, however, and a return to disclosure within a supportive client-caregiver relationship are the preferred options.

Chicago↗

A longitudinal comparison of the AIDS-related attitudes and knowledge of parents and their children.

As part of an evaluation of an experimental school-based AIDS risk-reduction program, data from 2,392 middle-school students in 15 high-risk school districts and from 1,627 of their parents were compared to examine how young adolescents and their parents differ with respect to AIDs-related knowledge and attitudes. At the time of the seventh-grade pretest, parents knew significantly more about AIDS than their children did. At the eighth-grade posttest, students who participated in the program knew either more than or at least as much as their parents in several subject areas, while among those not exposed to the program, parents still knew more than their children in most areas. The intervention had a positive impact on students' attitudes toward people with AIDS and on their degree of comfort about discussing with their parents such issues as drug use and sexuality.

Acquired Immunodeficiency Syndrome↗

Local health department effectiveness in addressing the core functions of public health.

Objective 8.14 of the Year 2000 National Health Objectives calls for 90 percent of the population to be served by a local health department effectively carrying out the three core functions of public health--assessment, policy development, and assurance. To provide a benchmark of local health department effectiveness in addressing the core functions and to assess implications for achieving the year 2000 target, a random national sample (stratified by jurisdiction and population base) of local health departments was surveyed to determine self-reported compliance with 10 public health practice performance measures that operationalize the core functions. Overall compliance with the 10 performance measures was 50 percent, based on weighted responses of 208 responding health departments. Compliance was highest for the practices related to the assurance function and least for practices related to the policy development function. Compliance was also high for departments serving a population of 50,000 or more and those smaller departments organized at the city and city-county levels. Using two different definitions developed by the investigators, 19 and 31 percent of the health departments were judged to be effective in addressing the core functions of public health. These data suggest that less than 40 percent of the U.S. population was served by a health department effectively addressing the core functions of public health in 1993. It appears that considerable capacity building within the public health system will be needed to achieve the year 2000 target of 90 percent.

Community Health Services↗

Implementing and assessing organizational practices in local health departments.

One of the most difficult forms of public health practice to characterize involves governmental public health agencies, especially at the local level. A lack of consensus within the public health community as to the purpose and content of organizational public health practice inhibits efforts to increase the capability of public health to address effectively its core functions of assessment, policy development, and assurance. Meaningful capacity building efforts must establish both benchmarks and expectations for the organizational practice of public health. Those markers must be established so that the impact of practice on outcomes and health status can be examined. A model identifying 10 organizational practices was established through the work of the Centers for Disease Control and Prevention (CDC) in collaboration with national practice organizations. Early applications of the model to public health capacity building activities have been effective. Among the applications have been approaches to surveillance of health department practice, certification of local health departments using practice guidelines, and development of leadership within the public health enterprise. Although results are promising, use of the model requires additional external examination and validation, as well as acceptance and consensus within the public health community. The development of organizational practice guidelines for public health agencies may be useful in further efforts to characterize and measure public health practice and its impact on the public's health.

Government Agencies↗