Screening for congenital hearing impairment: time for a change.
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Child Health Services↗
Biomedical subjects
J Stevens
Publications and source records attributed to J Stevens.
Factors influencing elementary school teachers' ratings of ADHD and ODD behaviors.
Examined factors that influence teachers' ratings of children with either attention deficit hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD). 105 teachers watched 2 videotapes--1 depicting a normal child and the other a child with either ADHD or ODD--and rated each child using 2 different questionnaires. Results indicated that teachers accurately rated the child on the ADHD versus ODD tape as having significantly more inattention and hyperactivity but significantly less oppositionality. However, effect sizes indicated the presence of a unidirectional, negative halo effect of oppositional behaviors on ratings of hyperactivity and inattention. Teachers appeared less biased in their judgments when using a well-operationalized rating scale. Finally, knowledge, education, and experience with children with ADHD generally had no effect on the accuracy of teachers' ratings.
Adult↗
Portraits of menopause in the mass media.
This examination of menopause as presented by the popular print media was conducted in the context of furthering our understanding of the development of attitudes toward menopause. All articles indexed under "menopause" in the Reader's Guide in the years 1981, 1982, 1985, 1986, 1989, 1990, 1993, and 1994 were located and examined. The data revealed that, although there has been an increase in the frequency of articles on menopause in the last 15 years, the media's portrayal of menopause is problematic in several respects: (a) in spite of the increased attention, the information available on menopause through the popular media is minimal and insufficient; (b) there was little variability in terms of perspective, discipline, or focus; almost all were focused on menopause as a negative experience or disease and in need of medical treatment; (c) there was considerable contradiction and inconsistency among the articles with respect to descriptions of menopause and intervention advice for menopausal women; (d) aging, stress, life-style factors, race and ethnicity, exercise and diet were, with few exceptions, ignored or trivialized.
Adaptation, Psychological↗
When patient care gets too personal.
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Ethics, Nursing↗
A grounded theory approach towards understanding the self perceived effects of meditation on people being treated for cancer.
The activities undertaken by people suffering cancer and receiving oncology treatment are known to cause high levels of anxiety. In an oncology clinic in rural Australia, nurses and volunteers promoted the use of meditation to reduce the stress caused by the terminally associated illness and its treatments. The use and self-perceived effects of meditation by cancer sufferers and their partners was explored using a grounded theory approach. Data were gathered and analysed from a series of semi-structured interviews and the findings used to generate theory regarding the use of meditation within the oncology domain. A number of theories were generated by this data and they are discussed in relation to current nursing practice and future research.
Anxiety↗
Lower respiratory illness in infants and young children with cystic fibrosis: evaluation of treatment with intravenous hydrocortisone.
The purpose of our study was to assess the effect on pulmonary function of adding intravenous hydrocortisone to the standard treatment of infants with cystic fibrosis (CF) hospitalized for lower respiratory illnesses (LRI). Twenty CF infants were randomized and received 10 days of hydrocortisone (10 mg/kg/day) or placebo in addition to standard treatment with intravenous antibiotics, chest physiotherapy, and an aerosolized beta-agonist with cromolyn. Functional residual capacity (FRC) and forced expiratory flows (V'mak,FRC) were measured on admission, on Day 10 of hospitalization, and as outpatients 1-2 months following hospital discharge. Pulmonary function values were adjusted for differences in body length and expressed as Z-scores. Upon admission flows were decreased, and FRC was increased in both groups; there were no differences between the groups. The change in pulmonary function from admission to Day 10 of hospitalization was not different for the two groups. From admission to outpatient follow-up after hospitalization, there was a significant increase in flows for the steroid group, but not for the placebo group. In addition, the direction of change in FRC was significantly different for the two groups; the steroid group had a small decrease in FRC, while the placebo group had a small increase in FRC. These findings suggest that the addition of intravenous hydrocortisone to the standard treatment of CF infants hospitalized for a LRI may produce a greater or a more sustained improvement in lung function following hospitalization.
Anti-Inflammatory Agents↗
Comparison of attitudes and behaviors related to nutrition, body size, dieting, and hunger in Russian, black-American, and white-American adolescents.
Attitudes and behaviors related to nutrition are known to differ between white-American and black-American adolescents, however, little is known about teenagers from Russia. We hypothesized that, compared with white-American or black-American teenagers, Russian teenagers would prefer a larger body size, be less likely to diet, and be less concerned about being overweight. Self-administered questionnaires were completed by 196 students in Moscow, 326 white-American, and 239 black-American adolescents who attended school in North Carolina (mean age = 16). Ideal body mass index (BMI) was calculated from measured height and the response to the question, "What do you consider to be your ideal weight?" Mean ideal BMI was higher in black-American boys (25.1) and girls (21.4) than in white-American boys (22.1) and girls (19.2), and Russian boys (21.8) and girls (19.1). After controlling for BMI, black-American girls were less than half as likely to report dieting compared with white-American girls. There were no significant differences among white-American girls and Russian girls, and there were no ethnic differences between boys in the prevalence of dieting. White-American girls and black-American girls were much more likely to identify being overweight as an important nutritional concern than were Russian girls (odds ratios > 10), and there were no ethnic differences among boys. We conclude that preferences for body size, the prevalence of dieting, and concerns about being overweight were similar in Russian and white-American teens, with the exception of Russian teenaged girls who were less likely than American girls to identify being overweight as an important concern. Overall, weight-related attitudes and behaviors in Russian teenagers were more similar to those of white-American teenagers than those of black-American teenagers.
Adolescent↗
Prediction equations do not eliminate systematic error in self-reported body mass index.
Epidemiological studies of the risks of obesity often use body mass index (BMI) calculated from self-reported height and weight. The purpose of this study was to examine the pattern of reporting error associated with self-reported values of BMI and to evaluate the extent to which linear regression models predict measured BMI from self-reported data and whether these models could compensate for this reporting error. We examined measured and self-reported weight and height on 5079 adults aged 30 years to 64 years from the second National Health and Nutrition Examination Survey. Measured and self-reported BMI (kg/m2) was calculated, and multiple linear regression techniques were used to predict measured BMI from self-reported BMI. The error in self-reported BMI (self-reported BMI minus measured BMI) was not constant but varied systematically with BMI. The correlation between measured BMI and the error in self-reported BMI was -0.37 for men and -0.38 for women. The pattern of reporting error was only weakly associated with self-reported BMI, with the correlation being 0.05 for men and -0.001 for women. Error in predicted BMI (predicted BMI minus measured BMI) also varied systematically with measured BMI, but less consistently with self-reported BMI. More complex models only slightly improved the ability to predict measured BMI compared with self-reported BMI alone. None of the equations were able to eliminate the systematic reporting error in determining measured BMI values from self-reported data. The characteristic pattern of error associated with self-reported BMI is difficult or impossible to correct by the use of linear regression models.
Adult↗
Chick calretinin: purification, composition, and metal binding activity of native and recombinant forms.
Chick calretinin has been previously expressed in Escherichia coli and purified to homogeneity [Cheung, W-T., Richards, D.E., and Rogers, J.H. (1993) Eur. J. Biochem. 215, 401-410]. In the present study we have developed an improved purification procedure, involving a heat precipitation step followed by DEAE-cellulose chromatography with calcium-dependent elution. Native calretinin was purified from chick brainstem using the same method as for the recombinant protein but with an added affinity chromatography step. Typically 30 g of brainstem yielded 350 micrograms of protein. Several differences between the two forms imply that the native protein is acetylated at the N-terminus but otherwise unmodified. The calcium binding activities of both forms of calretinin were measured by equilibrium dialysis with 45Ca in Ca2+/EGTA buffers. The recombinant form bound 4.9 +/- 0.12 calcium ions with Kd = 0.38 +/- 0.02 microM and the native form was not significantly different. Recombinant calretinin was used to study its interaction with other cations present in cells and it was found that calcium binding was affected by Mg2+. Calretinin appears to bind 4.69 +/- 0.13 magnesium ions with Kd = 4.5 mM. Mg2+ increased the apparent dissociation constant for Ca2+. The shift is consistent with competitive binding of Ca2+ and Mg2+ to the same five sites, but Mg2+ binding is too weak to interfere significantly with Ca2+ binding under physiological conditions.
Amino Acids↗
What are the indications for a carotid duplex scan?
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Carotid Stenosis↗
Improved controlled ovarian hyperstimulation in poor responder in vitro fertilization patients with a microdose follicle-stimulating hormone flare, growth hormone protocol.
OBJECTIVE: To assess the efficacy of a novel protocol-microdose GnRH agonist (GnRH-a), FSH, and GH, for the stimulation of IVF patients who were canceled previously on a standard luteal GnRH-a, FSH, GH protocol. DESIGN: Prospective evaluation using the patient's previous IVF stimulation attempt as historic controls. SETTING: Private practice assisted reproductive technology center. PARTICIPANT(S): Thirty-two patients who had prior ovulation induction cycles canceled using luteal phase GnRH-a suppression followed by exogenous gonadotropins and GH. INTERVENTION(S): Precycle treatment with oral contraceptives followed by follicular phase administration of 40 micrograms leuprolide acetate every 12 hours beginning on cycle day 3 and FSH supplemented with GH beginning on cycle day 5. MAIN OUTCOME MEASURE(S): Paired analysis of E2 day 5, number of follicles, ampules of FSH required, and cancellation rate. The number of oocytes, embryos, embryo quality, implantation rate, and pregnancy rate (PR) were determined for completed cycles on the microdose GnRH-a, FSH, GH protocol. RESULT(S): Controlled ovarian hyperstimulation was superior during microdose GnRH-a, FSH, GH stimulation when compared with the prior luteal GnRH-a cycle. Specifically, there was a higher E2 response, more oocytes, fewer cycle cancellations, and no premature LH surge or luteinization. The microdose GnRH-a, FSH, GH protocol produced an average of 10 oocytes and a 50% ongoing PR. CONCLUSION(S): The microdose GnRH-a, FSH, GH protocol is superior to standard protocols for the treatment of patients with decreased ovarian reserve undergoing controlled ovarian hyperstimulation for IVF.
Adult↗
The evolution of ectoparasitism in the genus Lucilia (Diptera:Calliphoridae).
To consider the evolutionary origin of the ectoparasitic habit in the blowfly genus Lucilia (Diptera:Calliphoridae), phylogenetic analyses of mitochondrial DNA sequence data were performed for 10 species, including all the common Lucilia agents of myiasis, collected from Africa, Australasia, North America and Europe. Complementary genetic distance and parsimony analyses are used to consider inter and intraspecific relationships within the genus with reference to previous morphological work. The results support the hypothesis of independent multiple evolution of the ectoparasitic habit in Lucilia sericata, Lucilia cuprina and the Lucilia caesar/Lucilia illustris group and suggest that it has coevolved in relatively recent history along with the domestication and husbandry of sheep. The geographic differences in pathogenic importance of various species of Lucilia also suggest that there is a strong climatic influence determining which species has dominated. Lucilia cuprina has become the predominant pathogenic species in sub-tropical and warm temperate habitats (e.g., Australia and South Africa), L. sericata in cool temperate habitats (e.g., Europe and New Zealand) and L. caesar and L. illustris become more common in sheep myiasis in more northerly Palaearctic regions.
Africa↗
Health care access and utilization among pregnant adolescents.
PURPOSE: To assess access to and use of health care by adolescents prior to their becoming pregnant. METHODS: An interviewer-administered questionnaire was completed by all pregnant adolescents (n = 65) entering the Rochester Adolescent Maternity Program (RAMP) between January and June 1994. Questions addressed access and utilization issues including routine care and other services used, and existence of a regular source of care prior to pregnancy. RESULTS: Sixty-one adolescents (94%) completed questionnaires. Almost all (93%) had made a doctor or clinic visit, and 77% had had a checkup in the prior year. Most had Medicaid (85%) or private insurance (13%). The median number of visits to a regular source of care was 2.0 (range 0-10). Most frequently reported sources of regular care were hospital clinics (43%), community health centers (26%), and private physician offices (15%). Two-thirds (66%) reported having used multiple sources of care. Of those who used other sources in addition to a primary care source, 40% used reproductive health clinics. Adolescents whose primary care source was a traditional physician's office were more likely to also use reproductive health clinics than those who reported using more comprehensive primary care sources. CONCLUSIONS: Most pregnant adolescents in this sample had previously used routine primary care, usually in hospital clinics or health centers. Many of those adolescents also use multiple sources of care, most often for reproductive services. Access to reproductive health services does not seem to have been a problem for these adolescents prior to their pregnancies.
Adolescent↗
Repetitive and non-repetitive violent offending behaviour in male patients in a maximum security mental hospital--clinical and neuroimaging findings.
OBJECTIVE: To examine if different violent offending behaviours are associated with different clinical and neuroimaging profiles. METHOD: Thirty-nine schizophrenic and schizoaffective offenders from a maximum security mental hospital-20 repetitive violent offenders (RVOs) and 19 non-repetitive violent offenders (NRVOs)-were selected for clinical and neuroimaging assessments. RESULTS: Both groups had positive family history of mental illness and violence. Age, diagnosis, duration of illness, victim profiles and use of weapons at the time of the index offence were similar. RVOs had a higher prevalence of early parental separation, juvenile conduct problem, previous convictions of crimes not involving violence, impulsive suicide attempts, delusion of their lives being threatened at the time of the index offence and electroencephalographic (EEG) abnormalities localized to temporal lobes. NRVOs had a higher prevalence of sexual inexperience and command hallucinations to kill at the time of the index offence. Asymmetric gyral patterns at the temporo-parietal region were particularly common in RVOs and absent in NRVOs. Non-specific white matter changes in magnetic resonance imaging (MRI) and generalized cortical hypometabolism in positron emission tomography (PET) were present in both groups. CONCLUSIONS: Different structural and metabolic changes in the brain were associated with different violent offending behaviours. The complex interaction between violent behaviour, clinical features and neuroimaging findings in schizophrenia requires further studies.
Adult↗
Identification and assessment of ongoing stressors in adolescents with a chronic illness: an application of the behavior-analytic model.
Applied Goldfriend and D'Zurilla's (1969) Behavior-Analytic Model to the development of a context-specific measure of stressful situations for adolescents with a serious, chronic illness. In completing the situational analysis phase of the model, 45 adolescents with cystic fibrosis (CF), 20 parents of adolescents with CF, and 8 health care professionals completed structured interviews or daily diaries to obtain the widest range of problematic situations. The adolescent sample was recruited from two different medical centers, and stratified by sex and illness severity. A total of 1,174 problem situations were elicited across all participants and then content-analyzed into 164 nonredundant items in 10 domains (e.g., Medications and Treatment, and School). Few relations were found between demographic variables (e.g., age and illness severity) and the number or difficulty of problematic situations. Both adolescents and parents mentioned the greatest number of problematic situations in the domains of School, Medications and Treatment, and Parent-Teen Relationship. In terms of difficulty, all three respondents (i.e., teens, parents, and health care professionals) rated problems with Clinic and Hospital Visits as very difficult. For the adolescent sample, problems in the Parent-Teen Relationship and Health Concerns were also highly difficult. Significant associations were found between the problematic situations we identified and standardized measures of social and emotional functioning. Adolescents who rated their problems as more difficult also endorsed more symptoms of depression and lower perceptions of social competence. In a future study, the most salient items will be selected to create a role-play measure to elicit adolescents' coping strategies.
Adaptation, Psychological↗
HTLV-associated myelopathy in a cohort of HTLV-I and HTLV-II-infected blood donors. The REDS investigators.
OBJECTIVE: HTLV-I-associated myelopathy (HAM) is a slowly progressive spastic paraparesis caused by infection with human T-lymphotropic virus type I (HTLV-I). The prevalence of HAM among those infected with HTLV-I is poorly defined, and the association of a similar myelopathy with HTLV-II infection has not been confirmed. DESIGN: Cross-sectional examination of HTLV-I, HTLV-II, and control subjects from the baseline visit of a cohort study. SETTING/ SUBJECTS: Persons testing HTLV seropositive at the time of blood donation at five U.S. blood centers, their seropositive sex partners, and a matched control group of HTLV seronegative blood donors. MEASUREMENTS: HTLV-I and HTLV-II were differentiated by serology and/or polymerase chain reaction. All subjects received systematic neurologic screening examinations. RESULTS: A diagnosis of myelopathy was confirmed in four of 166 HTLV-I subjects (2.4%, 95% confidence interval 0.7%, 6.1%) and in one of 404 HTLV-II subjects (0.25%, 95% confidence interval 0.0%, 0.6%). None of the 798 controls had a similar myelopathy, although one had longstanding typical multiple sclerosis. CONCLUSIONS: Our data also suggest that HAM occurs more frequently among HTLV-I-infected subjects than reported by previous studies. The HTLV-II infected myelopathy patient identified in this cohort, together with three other case reports in the literature, implies a pathogenic role for this human retrovirus. The diagnosis of HTLV-associated myelopathy should be considered in cases of spastic paraparesis or neurogenic bladder when risk factors for HTLV-I or HTLV-II infection are present.
AIDS Serodiagnosis↗
A volumetric MRI study of Gilles de la Tourette's syndrome.
The neuroanatomic or neuropathologic basis of Gilles de la Tourette's syndrome (GTS) remains unknown. Recent studies have suggested abnormalities of cerebral asymmetry and basal ganglia volumes. We studied 17 patients with GTS and eight normal controls using volumetric MRI techniques for measuring the caudate nucleus, amygdala, and corpus callosum. One subject with GTS was subsequently excluded because he was left handed. No absolute differences in caudate nucleus volumes between patient and control groups were evident. There was an increase in corpus callosum (CC) cross-sectional area and a loss of the normal asymmetry of the caudate nucleus in the patient group. A loss of the normal correlation between cross-sectional area of the CC and whole brain index (WBI) in the patient group also was found. The amygdala measurements had a poor interrater reliability.
Adolescent↗
The challenge posed by endocrine-disrupting chemicals.
Rapid regulatory developments in the area of environmental endocrine disruption present a series of potential problems that are identified and illustrated with examples taken from the recent literature. A list of priorities is provided, including the need for additional epidemiological and wildlife studies, the derivation of a coordinated testing strategy, agreement on the toxicities expected of endocrine disrupting agents, and acceptance that whole animal assays will be uniquely critical in this area of toxicology. The intrinsic difficulty of attempting to simultaneously study all aspects of endocrine disruption indicates the need to reduce the scope of the problem, which can be achieved by first studying toxicities mediated by sex hormone receptors.
Androgen Receptor Antagonists↗