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Biomedical subjects

R S Gold

Publications and source records attributed to R S Gold.

At least 19 recordsLinked to original sources

Situational factors and thought processes associated with unprotected intercourse in heterosexual students.

Heterosexual students were asked to recall two sexual encounters from the preceding six months: one in which they had unprotected intercourse ('unsafe' encounter) and one in which they resisted a strong temptation to have unprotected intercourse ('safe' encounter). The aims were to record justifications for unprotected intercourse that respondents had given themselves during the unsafe encounter and to identify factors that distinguished between the encounters. In respondents recalling an unsafe encounter (n = 284), the most common self-justification reported was that there was no need for concern since measures to avoid pregnancy had been taken. The first factor that emerged from a Factor Analysis of the self-justification data involved using perceptible characteristics to infer that the partner was unlikely to be infected. Among respondents recalling both encounters (n = 173), there was a trend for type of partner to distinguish between the encounters. With this variable controlled (n = 115), desires, knowledge of condom availability, communication about condom use, degree of boredom, and level of intoxication differentiated between the encounters. The results are discussed in relation to those obtained in our earlier study of gay men.

Adolescent

Situational factors and thought processes associated with unprotected intercourse in young gay men.

OBJECTIVES: To investigate (1) the types of justifications, if any, that young gay men give themselves at the time they make the decision to have unprotected anal intercourse and (2) the types of occasion on which they are most at risk of having unprotected intercourse. DESIGN AND METHODS: In structured interviews, gay men aged 15-21 years were asked to recall two sexual encounters from the preceding 6 months: one in which they had had unprotected anal intercourse ('unsafe' encounter) and one in which they had resisted a strong temptation to have unprotected intercourse ('safe' encounter). We studied both types of encounter to enable identification of situational variables distinguishing between them. RESULTS: The first two factors that emerged from a Factor Analysis of the self-justification data ('unsafe' encounter, n = 219) involved, respectively, high-risk behaviour in response to a negative mood state and inferring from perceptible characteristics that the partner was unlikely to be infected. The most commonly reported self-justification was of this latter type. In respondents recalling both encounters (n = 115), sexual desires, mood, communication, and use of 'dirty talk' distinguished between the encounters. In contrast, type of partner, consumption of alcohol or drugs, desire for excitement, and use of pornography did not. CONCLUSIONS: Results are discussed in relation to those obtained in our earlier study of older gay men. Young gay men appear to be more single-minded about what they want to do sexually, and more likely to infer from perceptible characteristics that their partner is unlikely to be infected. In young gay men, a negative mood state is associated with unsafe sex, an opposite finding to that obtained with older gay men. The results also suggest the possible importance of failure to communicate about desires concerning safe sex and the use of 'dirty talk'; these may help to facilitate the occurrence of unsafe sex.

Adolescent

Gender and ethnic differences in adolescents' attitudes toward condom use.

This secondary analysis from the National Adolescent Student Health Survey (NASHS) examined relationships between adolescents' personal and perceived peer attitudes toward condom use with gender and self-reported ethnic background. Descriptive results revealed general personal support and perceived peer support for condom use. Results from multivariate analysis of variance (MANOVAs) demonstrated significant interaction effects for the eighth grade sample [F = (4, 2383228) = 3530.01 p = .000], and the 10th grade sample [F = (4, 2636878) = 2594.41073, p = .000]. Contrasts revealed significant differences among all ethnic groups for both belief variables for the entire sample, eighth grade students, and 10th grade students. Though general support exists for condom use among U.S. eighth and 10th grade students, conviction varies among groups perhaps indicating a need for tailored messages about condom use, especially for Hispanic students. Implications for health education include the need for cultural-sensitive and gender-sensitive STD education.

Acquired Immunodeficiency Syndrome

The World Health Organization: school health initiatives.

The United Nations and its family of operational agencies have existed for almost five decades. For school health personnel, to understand how these agencies operate--in particular, the World Health Organization (WHO)--is worthwhile. To understand how WHO influenced the practice of health education for school-aged youth, some critical events that have occurred during the past five decades are reviewed and several current and future activities are identified and described.

Child

The potential contribution of computerized school-based record systems to the monitoring of the disease prevention and health promotion objectives for the nation.

This article discusses the potential contribution of computerized school-based record systems to help monitor the 1990 and future health objectives for the nation, to provide a continuing health data base on nearly 50 million Americans, and to improve current school health record-keeping practices. Limitations of paper-based health record systems and the state-of-the-art and future potential of computerized record systems are described. Several key obstacles to computerization of school health records are considered, including technological problems, difficulties in appreciating and evaluating the benefits of computerization, costs, acceptability to individuals and organizational users, standardization problems, and concerns about confidentiality. Implementation steps involving research and surveillance measures for attaining the 1990 objectives that may be facilitated by improved school health records and information systems are specified. As school health education and school health services increasingly become vehicles for achieving national public health objectives, including those set for 1990, it will be desirable to establish data systems that link information collected in individual schools with research and surveillance activities at the state and national level. Moreover, it will be desirable for school's health records and information systems to contain data describing students' health-related knowledge, attitudes, behaviors, and physiological risk factors, in addition to the data traditionally maintained in such records.

Attitude to Computers

Asystole due to the oculocardiac reflex during strabismus surgery: a report of two cases.

The oculocardiac reflex is a well-known entity which may result in vagal depression of the heart when pressure is placed on the eyeball or when traction is applied to the extraocular muscles. Bradycardia is, by far, the most common cardiac response to these stimuli. We report two cases of ten-second episodes of asystole during traction on the medial rectus muscle as a reminder to ophthalmologists and anesthesiologists alike that this complication can and does occur during strabismus surgery.

Adolescent

School health education: a foundation for school health programs.

This article describes the present status of health instruction--one of the original three components of the school health program--and suggests ways to improve its effectiveness as one of the eight components of a comprehensive school health promotion program. The article also demonstrates the complexity of the theory base, content, methodology, and outcome expectations of health instruction; a complexity that demands the subject be taught by teachers who are thoroughly prepared and committed to teaching health.

Child

Relationship of lumbosacral nevocytic nevi to sun exposure in dysplastic nevus syndrome.

In 104 consecutive Caucasian patients who had histologically proved dysplastic nevi, the number and diameter of nevocytic nevi were determined in two equally sized contiguous rectangles in the lumbosacral region. The cephalad (superior) rectangle was in a relatively sun-exposed site, whereas the caudad (inferior) rectangle was in a relatively sun-protected site. Many of the nevocytic nevi identified in these rectangles had the clinical features of dysplastic nevi. Significantly, more nevi were found in the cephalad rectangle compared with the caudad rectangle. Men greater than or equal to 40 years of age had significantly larger nevi in the cephalad rectangle compared with the caudad rectangle. These data are consistent with the hypothesis that sunlight promotes development of more and larger nevocytic nevi in individuals afflicted with dysplastic nevus syndrome.

Adolescent

The validity of reliability assessments.

This paper focuses on reliability and evaluation of health education programs in school settings. Reliability is a concept that guides researchers in selecting or developing instruments, and is used as a standard, with validity and acceptability, for judging the credibility of research findings and inferences. Reliability is defined within the context of research design, and methods for estimating the reliability of cognitive measures are reviewed. Using data gathered in a school health education curriculum evaluation as an example, possible errors in hypotheses testing that may occur when estimating internal consistency of cognitive test scores obtained in quasi-experimental designs are examined. The appropriateness of internal consistency as a measure of reliability of cognitive measures is discussed and suggestions for reliability assessment and related issues such as power analysis are presented.

Attitude to Health

Use of statistics in the Journal of School Health 1979-1983: a content analysis.

A content analysis of the statistical methods employed in the research/evaluation articles published in Volumes 49-53 of the Journal of School Health (JOSH) was performed. Questions addressed included: To what extent does JOSH publish articles having a research/evaluation theme? Does knowledge of a few basic statistical techniques provide access to the statistical components of a high percentage of the research/evaluation reports published in JOSH? Which additional, but more complex techniques are used most often by authors? Results indicated that, to have access to the statistical content of about three-fourths of the research/evaluation reports published in JOSH, a reader would have to have learned descriptive statistics, analysis of contingency tables, analysis of variance, t-tests, and multiple comparison tests. Knowledge of these and other statistical procedures might assist school health practitioners read research/evaluation reports, and adapt the findings to their respective work settings. Moreover, content analyses can be tools for assessing the state-of-the-art of a profession, as well as helping to plan for practitioners' continuing education needs.

Periodicals as Topic

Avoiding type III errors in health education program evaluations: a case study.

Monitoring the implementation of a program being evaluated can improve the interpretability of data collected and help evaluators to avoid committing a Type III error: evaluating a program that has not been adequately implemented. This article describes an evaluation that analyzed the implementation of a school health education curriculum, assessed cognitive learning outcomes attributable to the curriculum, and examined the relationship between classroom implementation and changes in students' knowledge. Five fifth-grade classes (n = 101) participated in the curriculum, and five classes (n = 84) served as a comparison group. Data collection procedures involved a pretest and posttest of all students' health-related knowledge, daily monitoring of classroom implementation by the five teachers participating, and questionnaires completed by principals and teachers. Analysis methods included descriptive statistics, parametric and nonparametric tests of significance, and qualitative assessment procedures. Results indicated that the curriculum had a positive effect on learning in students; curriculum implementation varied considerably among the five classes participating; teaching/learning activities that were most and least likely to be implemented could be identified and described; both teachers and principals perceived the program favorably; some health instruction was occurring in the comparison classes, so it was not appropriate to consider them as pure controls; and no statistically significant relationship between curriculum implementation and cognitive outcomes was observed. This study provides evidence of the need for and value of measuring implementation of programs being evaluated. Implications for developing implementation measures and the role of formative evaluation in health education practice are considered.

Curriculum

Oral sarcoidosis: review of the literature.

Patients with symptoms consistent with sarcoidosis who are seen by a dentist are not common. Generally, the disease is documented in a patient before the expression of oral symptoms. The most common oral or para-oral symptom appears to be an asymptomatic swelling--usually of the parotid glands or cervical nodes. Often these lesions are first brought to the attention of our medical colleagues. However, in four instances reported in the literature, systemic sarcoidosis was discovered because of the initial oral symptoms. There are often changes in the minor salivary glands under clinically normal-appearing mucosa in patients with systemic sarcoidosis. We have reviewed the concepts of etiology, criteria for diagnosis, and rationale of treatment, along with a review of the dental literature of sarcoidosis. An illustrative case report of a sarcoid lesion on the buccal mucosa is presented.

Adult

Unique case of mesenteric fibrosis in multiple polyposis.

A massive mesenteric fibroma in a patient who had had subtotal colectomy for familial polyposis necessitated resection of all but the proximal 3 to 4 feet of small bowel. The patient is alive and well with few stigmata of short bowel syndrome. Acknowledgment: We wish to thank CAPT Malcolm L. Cowen, USN, MC, Chief of the Department of Pathology, for histopathologic photomicrographic study and extensive laboratory data.

Colonic Neoplasms