Search PubMed⌕ Search

Biomedical subjects

C S Alexander

Publications and source records attributed to C S Alexander.

86 records · Page 5Linked to original sources
PubMedDate not supplied

The social context of smoking among African-American and white adolescents in Baltimore City.

OBJECTIVE: To describe and understand variations in social influences on smoking behavior among African-American and white male and female adolescents in Baltimore City, USA. DESIGN: A qualitative study where adolescents, both smokers and non-smokers, were interviewed individually (n = 21) and participated in focus groups (n = 18 focus groups, 3-10 participants per group). RESULTS: Social contexts emerged as most relevant and salient themes related to smoking behavior. White females perceived the most permissive parental messages around smoking, while males, especially African-American males, reported receiving the strictest parental sanctions. Females' need to fit in with peers contrasted with males' being coerced to smoke. Possible reasons for African-Americans' non-use of cigarettes include a desire not to disrespect parents and being turned off by parental addiction to nicotine. All adolescents cited the school's lax anti-smoking policy as a reason teens smoke at school. CONCLUSION: Interventions targeted at schools and families offer promise for reducing adolescent cigarette use.

Adolescent↗
PubMedDate not supplied

Employment patterns among newly hired hospital staff nurses; comparison of nursing graduates and experienced nurses.

Comparison of newly hired nursing graduates in their first hospital staff nurse positions and newly hired experienced nurses employed in the same hospitals revealed that the two groups were indistinguishable with respect to turnover patterns and rates, job hunting behavior, and job satisfaction levels. Type of basic nursing education did not alter results. Differences between the two groups were in the opposite direction from that expected based on the literature which emphasizes problems associated with role transition among new graduates. These findings imply that the process of job acclimation is fundamentally the same for the two groups. Implications for hospital and nursing administrators are discussed.

Employment↗
PubMedDate not supplied

Lowering of blood acetaldehyde levels-a possible approach to prevention of alcoholic cardiomyopathy.

Based on the assumption that circulating acetaldehyde (AcH) is cardiotoxic, D-penicillamine was administered to dogs given alcohol orally, or given AcH intravenously. Paralleling the increase in plamsa norepinephrine (NE) and epinephrine (E) induced by AcH infusion, hemodynamic measurements showed a positive inotropic response with increase in pulse, blood pressure, left ventricular contractility, and cardiac output. Infusion of D-penicillamine abruptly lowered circulating levels of AcH and catecholamines, which was accompanied by an appropriate hemodynamic response.

Acetaldehyde↗
PubMedDate not supplied

Situational and financial barriers to prenatal care in a sample of low-income, inner-city women.

The relationship between the use of prenatal care and factors that may impede access to care was examined in a sample of low-income, inner-city women. Situational and financial barriers to care were not important correlates of utilization. In unadjusted analyses, only insurance status and employment status were associated with utilization. Of the sociodemographic characteristics studied, only parity was strongly associated with the use of prenatal care. When the apparent associations between utilization and insurance status and utilization and employment were analyzed controlling for parity, the estimated strength and statistical significance of these relationships diminished considerably. Multiparous women who were more likely than primiparous women to be underutilizers were also more likely to be on medical assistance and to be unemployed. These findings suggest that situational and financial barriers are not important correlates of utilization for low-income, adult women living in urban areas where there are accessible clinic facilities and public transportation. Efforts to identify and surmount other kinds of barriers may prove to be a more effective approach to prenatal outreach for women in these circumstances.

Adult↗
PubMedDate not supplied

Early sexual activity among adolescents in small towns and rural areas: race and gender patterns.

A 1987 survey of 758 eighth-grade students from three rural counties in Maryland revealed that 61 percent of males and 47 percent of females have engaged in sexual intercourse, and that 77 percent of black students and 40 percent of whites have ever had intercourse. A logistic regression analyzing the effects of race and gender shows that the odds that young black teenagers would have had intercourse are over five times those for whites, and that the odds for males are about twice those for females. The introduction of developmental, individual, academic and behavioral factors into the regression model has little effect on these odds ratios. Separate logistic analyses of four subgroups--white males, white females, black males and black females--reveal no consistent associations between sexual activity and the factors examined. For example, such types of problem behavior as cigarette smoking and use of alcohol or certain other drugs are associated with the likelihood of sexual activity, but the specific type of behavior involved differs by subgroup: Cigarette smoking is related to an increased likelihood of sexual activity just among white females, while alcohol consumption is associated with sexual experience among black females and white males only. Use of drugs other than marijuana or alcohol is linked to a 5-9 times greater risk of sexual activity among whites, but not to any significantly increased risk among blacks, whereas living in a town (rather than in the country) is significantly associated with the likelihood of sexual intercourse among both white and black males, but not among females of either race.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Curtailment of well child services by a local health department: impact on rural 2-year-olds.

The impact of changes in the delivery of well child health services by a rural health department on the reported health status, immunization status, and patterns of health care use is evaluated for poor children born in 1981, when well child clinic services were reduced. Using birth certificate records, all 1981 resident births were enumerated for the case county in Maryland and for a demographically similar comparison county that had continued to operate health department well child clinics. Trained local interviewers tracked and interviewed mothers or guardians of the 1981 cohort. Data were obtained on 567 of 589 eligible children, reflecting a 96 percent response rate. Children in each county were defined as poor if their mothers reported receiving AFDC (Aid to Families with Dependent Children), food stamps, or medical assistance or reported annual household incomes of below +5,000. This poverty status indicator was significantly correlated with health department use in the comparison county. Findings indicate that mothers of poor children in both counties were as likely as mothers of nonpoor children to assess their 2-year-old's health status as good, to identify a regular source of preventive care, and to report complete immunizations for their toddler. Although many private physicians in the case county appear to be seeing poor children in their offices, the distribution of study children among physicians was highly skewed. Out of 19 physicians or health facilities in the case county, one pediatrician was reported as the primary source of pediatric care for 52 percent of the 2-year-olds, one-third of whom were poor. In contrast, no one physician or facility was reported as providing pediatric care for more than 10 percent of 2-year-olds in the comparison county. Findings are discussed in light of these differences in physician supply and practice patterns.

Child Health Services↗
PubMedDate not supplied

Drug use and illnesses among eighth grade students in rural schools.

We examined the relationship between drug use by young adolescents and two indicators of illness, frequency of illness and numbers of days absent from school owing to illness. Data were from a general health survey of all eighth grade students enrolled in public schools in two rural Maryland counties. A total of 745 students completed a self-administered questionnaire during school hours in January 1984. Information was obtained on a variety of sociodemographic characteristics and on the students' use of tobacco, alcohol, and marijuana. Correlational analyses were used to examine the relationships among cigarette smoking, beer or wine drinking, whiskey or hard liquor drinking, and marijuana use. Logistic regression was used to model the effects of drug use behaviors on the likelihood of being absent from school 3 or more days, adjusting for the student's age, sex, race, parents' education, illness frequency, and concerns about learning problems in school. We found substantial covariation among the use of cigarettes, alcohol, and marijuana. After adjusting for the background variables of illness, frequency, and learning problems, we found that students who are frequent cigarette smokers experienced a 2.6 risk of school absenteeism. Other drug use behaviors were not associated significantly with increased risk of missing school. Findings are discussed within the context of health-related consequences of drug use.

Absenteeism↗
PubMedDate not supplied

Determinants of staff nurses' perceptions of autonomy within different clinical contexts.

Studies of nurses and other health professionals indicate that autonomy is an important determinant of job satisfaction and turnover. This study analyzed selected characteristics of hospital nursing units to identify those features of the work setting that influence staff nurses' perceptions of autonomy: comparisons among nurses who work in different clinical areas were made. Data were collected by interviewing 789 nonsupervisory registered nurses who were employed full time at one large university-affiliated hospital. Personal and job-related information was obtained for each nurse. Structural features of units, such as workload, were gathered from head nurse reports and hospital records. Findings indicated that nurses' perceptions of autonomy are influenced by both personal characteristics of the nurse and structural features of the units. The nurse's sense of personal efficacy and the relationship she has with her head nurse are two important determinants of autonomy across all units. Workload, primary nursing, and staffing patterns are influential factors in predicting autonomy for nurses who work in critical care areas. Implications of these findings for nursing administrators are discussed.

Efficiency↗