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Biomedical subjects

S Sussman

Publications and source records attributed to S Sussman.

At least 37 records · Page 2Linked to original sources

Experience with segmental reconstruction of the radiated mandible with alloplastic prostheses.

Reconstruction of the mandible after radiation therapy and segmental resection is often complicated by wound breakdown, osteoradionecrosis, and crippling of the oral cavity. These complications make patient salvage after radiated oral carcinoma a high-risk endeavor. Although head and neck surgeons have improved the reliability of mandibular reconstruction with microvascular free tissue transfer, medical and oncologic issues may prohibit their application. This report presents 12 selected cases undergoing alloplastic reconstruction of the mandible and soft tissue reconstruction of the oral cavity. Although not as reliable as some reports of free tissue transfers, the results were reproducible and satisfactory in these cases, with time-efficient hospitalization and functional rehabilitation. Ten of 12 prosthetic reconstructions have been durable in this study population for as long as 36 months.

Aged↗

Implementation and process evaluation of a student "school-as-community" group. A component of a school-based drug abuse prevention program.

Little documentation exists regarding the functioning of formalized adolescent groups as drug abuse prevention agents. Two studies are described that were conducted at high schools whose students are at high risk for drug abuse. Twenty-one schools were randomly assigned to one of three conditions: (a) standard care, (b) classroom drug abuse education only, or (c) classroom plus school-as-community. Results of the first study indicated that the school-as-community component--which involved weekly meetings and periodic events at seven schools--was implemented as planned, drug abused focused, and perceived as productive in discouraging drug abuse. In the second study, staff in the classroom plus school-as-community condition self-reported involvement in the greatest number of community activities across the school year, compared with staff from the other two conditions. These two studies support the feasibility of formalized groups of high-risk youth to promote drug-free events.

Adolescent↗

School-as-community activity selection at continuation high schools.

This paper describes two studies which together provide an example of an empirically based "school-as-community" development process used in a large-scale school-based drug prevention trial among youth at continuation high schools in California. First, we generated a list of schools' current community involvement from 96 school personnel and 144 students from 20 continuation high schools. Second, we reduced the number of activities indicated, with some discussion, to a list of 12 populars. Then, we administered this list to a total of 388 students from six continuation high schools who provided perceived quality ratings. We generated six categories of activities from the results of these two studies. These studies reveal a means to determine activities likely to be completed by this school system and a means to limit the variability of activities which could be manipulated in an experimental trial involving a school-as-community component.

Adolescent↗

Immediate impact of thirty-two drug use prevention activities among students at continuation high schools.

Those teenagers who are unable to remain in the regular school system for reasons including substance use are transferred to a continuation high school. Generic comprehensive social-influence-drug-use-prevention-activities are less likely to be effective for use with these at risk youth. Thus, both classroom and self-instruction (main mode of instruction at continuation high schools) versions of 16 activities derived from different theoretical sources were tested and ranked on immediate outcome variables. 388 students from six continuation high schools were provided with a pretest-activity-posttest "component study" protocol. The scores on perceived quality ratings were standardized and averaged to permit easy comparisons across lessons. While yielding similar knowledge changes, students who received the health educator led activity consistently reported higher scores on perceived quality. Social influence-oriented lessons, in general, were rated of relatively low perceived quality. The present approach assisted in selection of the lessons with the greatest overall immediate impact.

Adolescent↗

The conflict between least harm and no-use tobacco policy for youth: ethical and policy implications.

This paper examines policy and ethical implementation issues associated with local drug policies that are aimed at producing a "least harm" approach toward youth, with particular application to tobacco policy as an example of a legal, but addictive drug. Research is reviewed which shows the inconsistencies between federally mandated enforcement of zero tobacco use, the Synar Amendment and local community and school policies which appear to relax enforcement of no-use policies for the purpose of retaining youth in school. The inconsistencies are described from the perspective of a "least harm" approach, in that tobacco use may be considered less harmful than absence from school, or use of other substances. The conflict between law and intent to reduce harm is examined with implications for long-term enforcement of federal policy, and for effectiveness of tobacco and other drug abuse prevention programs and other drug policies. Several strategies for reducing the conflict are recommended. These include provision of support-orientated smoking cessation programs for youth on school campuses and in community organizations, and promoting consistent no-use norms across all drugs and across multiple channels that affect youth-mass media, school, point-of-purchase settings and public settings and events.

Adolescent↗

Vulnerability to victimization, concurrent problem behaviors, and peer influence as predictors of in-school weapon carrying among high school students.

Previous research has indicated the potential relevance of three constructs in the prediction of adolescent weapon carrying, (a) general delinquency, (b) self-protection, and (c) social influence. The current study tests the independent associations between in-school weapon carrying and these three constructs. The sample consisted of 504 students from seven southern California high schools. Overall, 25% of the sample carried a weapon to school in the last year. Self-defense was the most commonly reported reason for in-school weapon carrying. The results from a simultaneous logistic regression analysis indicated increased risk of in-school weapon carrying among students who are male, who are affiliated with gangs or tagging crews, who are exposed to peers who carry weapons to school, and who feel vulnerable to being victimized. Prevention programs targeted at reducing in-school weapon carrying may benefit from a comprehensive focus that includes efforts to reduce involvement in other problem behaviors, influence norms regarding weapon carrying, and reduce actual and perceived vulnerability to victimization.

Adolescent↗

The correlates of addiction concern among adolescents at high risk for drug abuse.

A teenager's awareness that he or she is becoming a drug addict or alcoholic is likely to lead that youth to try to get treatment. This report examined correlates of addiction concern among a sample of youth at high risk for drug abuse. Approximately 36% of a sample of 274 students at two southern California continuation high schools perceived themselves at risk for drug or alcohol addiction. Whereas 15 of 25 demographic, drug use, social psychological, or health orientation related variables were associated with an addiction concern measure in bivariate analyses, after partialing out covariation among its correlates, three drug use indices, two items that measured the importance of health as a value, and an assertiveness measure remained significant nonredundant correlates of addiction concern. These results suggest a potential importance of both manipulation of health motivation and social skills instruction in facilitating the prevention of adolescent drug abuse.

Adolescent↗

Predictors of misreporting cigarette smoking initiation among adolescents.

This study examines the prevalence of invalid reports of cigarette smoking initiation among adolescents (i.e., reporting cigarette smoking at one time point and denying ever trying cigarettes at a subsequent time point) and the association of misreports with scores on other problem-prone variables. Misreports did not vary as a function of item complexity and did not reflect careless responding. In the seventh grade, misreporters' scores on the problem-prone variables were higher than those of nonsmokers and lower than those of smokers. In contrast, when measured in the eighth grade, misreporters' scores did not differ from those of nonsmokers. Misreporters did show a greater decrease in intentions to smoke, alcohol use, and number of friends who smoke compared to nonsmokers and consistent smokers. Explanations for these findings are discussed.

Adolescent↗

The relations of school staff smokers' attitudes about modeling smoking behavior in students and their receptivity to no-smoking policy.

This study examined school personnel smokers' reports regarding how they would feel if a no-smoking ban was instituted on school premises. Demographics, smoking history, interest in quitting, and perception of school staff as role models for student smoking behaviors were examined as concurrent predictors of personnel attitudes toward a school-wide no-smoking policy. Generally, the fifty-nine respondents, sampled from fourteen schools, were interested in quitting smoking, but they did not favor a policy prohibiting smoking on campus. A staff role model index was a significant predictor of support for a no-smoking policy; the stronger the belief that staff influence their students' smoking, the greater the desire for a smoking ban at school. Compliance by school staff to future regulations that schools become smokefree environments may be improved if staff believe or are taught that they can directly affect students' smoking behaviors.

Adolescent↗

Use of the "theme study" as means of curriculum development in continuation high schools.

This article presents the evaluation of written paragraphs which described twenty-one drug abuse prevention "themes" contained in thirty-five separate activities, as part of the process of curriculum development targeting Continuation High School students. The goal was to determine which activities were most preferred by these youth. The paragraphs consisted of descriptions of traditional drug abuse prevention program activities, alternative activities using the themes underlying traditional activities, and novel activities generated from newly developed themes. The study was conducted with seven Continuation High Schools. Three hundred and fifteen students participated in this study. Each student rated detailed written descriptions of five activities. Classrooms were randomly assigned to different combinations of paragraphs. An analysis of variance indicated that there were significant differences in preferences among activities, with a marked preference for the alternative and novel activity presentations. Females, Latinos, older students, and non-marijuana users rated the activities higher overall. There were no significant interactions between demographic variables and order of activity preference. If there is a limit in amount of allotted time and resources, the theme study is an appropriate and cost-effective tool for gaining important information for health curricula development.

Adolescent↗

The television, school, and family smoking prevention and cessation project. VIII. Student outcomes and mediating variables.

BACKGROUND: This paper presents the student outcomes of a large-scale, social-influences-based, school and media-based tobacco use prevention and cessation project in Southern California. METHODS: The study provided an experimental comparison of classroom delivery with television delivery and the combination of the two in a 2 x 2 plus 1 design. Schools were randomly assigned to conditions. Control groups included "treatment as usual" and an "attention control" with the same outcome expectancies as the treatment conditions. Students were surveyed twice in grade 7 and once in each of grades 8 and 9. The interventions occurred during grade 7. RESULTS: We observed significant effects on mediating variables such as knowledge and prevalence estimates, and coping effort. The knowledge and prevalence estimates effects decayed partially but remained significant up to a 2-year follow-up. The coping effort effect did not persist at follow-ups. There were significant main effects of both classroom training and TV programming on knowledge and prevalence estimates and significant interactions of classroom and TV programming on knowledge (negative), disapproval of parental smoking, and coping effort. There were no consistent program effects on refusal/self-efficacy, smoking intentions, or behavior. CONCLUSIONS: Previous reports demonstrated successful development and pilot testing of program components and measures and high acceptance of the program by students and parents. The lack of behavioral effects may have been the result of imperfect program implementation or low base rates of intentions and behavior.

Child↗

Two-year behavior outcomes of project towards no tobacco use.

The article presents 2-year follow-up data from a school-based tobacco use prevention project designed to test the effectiveness of 3 primary components in social influence programs. The components either teach refusal skills, awareness of social value misperceptions, or physical consequences. Curricula were tested with a randomized experiment involving 48 junior high schools. These data suggested that (a) a physical-consequences curriculum is successful at attenuating increases in adolescent smokeless tobacco use, (b) cigarette experimentation may be attenuated by various approaches, and (c) a comprehensive program with all 3 components was necessary to attenuate increases in weekly use of both forms of tobacco. These results also indicate that school-based tobacco use interventions can be effective at least 2 years postprogram, after students make their transition to high school.

Adolescent↗

Psychosocial predictors of health risk factors in adolescents.

Previous research has confirmed the role of problem-behavior theory constructs as predictors of nonconventional behaviors such as adolescent drug abuse. No prospective study, however, has examined this theory's relevance to less extreme nonconventional adolescent behaviors, such as poor health practices. In the present study, an attempt was made to predict an index composed of seven health risk factor items measured in 8th grade from numerous variables measured in 7th grade selected to reflect personality, perceived environment, and behavior systems of problem-behavior theory. In addition, problem-behavior theory was compared in predictive efficacy to a wellness notion. Factor analysis did not support the construct validity of the three systems as measured herein. Instead, resulting empirically derived factors reflected domains labeled "wellness," "subjective distress," and "problem behavior." In addition, linear regression results indicated that constituents of wellness, subjective distress, and problem-behavior domains, as well as the demographic variable of lower socioeconomic status, and taking less care of one's own physical health in 7th grade, were predictors of taking less care of one's physical health the next year. One interpretation of these results is that lack of a sense of wellness may lead one to yield to problem behavior-related social environment influences including participation in poor health practices.

Adolescent↗

Continuation high schools: youth at risk for drug abuse.

Students at alternative high schools may be at substantial risk for drug abuse. The present article provides a general overview of the drug use-related context of continuation high schools in southern California. A total of 144 students and ninety-six staff were interviewed from twenty continuation high schools. The interview data revealed that continuation school students show high levels of substance use. However, only 20 percent of the students report that they received any drug abuse prevention programming. Also, students at continuation high schools aspired to a productive life after high school including continued education. Thus, these youth may still be amenable to preventive educational interventions which deter them from drug use and help them to fulfill their future goals.

Adolescent↗

Empirical development of brief smoking prevention videotapes which target African-American adolescents.

Two studies are described which provide evaluations for two brief videotapes developed as supplemental materials in the prevention of tobacco use among African-American adolescents. One videotape (the "soap opera") provides a more general audience-oriented presentation of prevention material and it was filmed primarily at a shopping mall, whereas the other videotape (the "rap") provides a "hip-hop generation" presentation, and it was filmed primarily at an outdoor hangout. The first study compared the two videotapes against each other. The second study compared the two videotapes combined in the same presentation, controlling for order of presentation, against a discussion group control. The results of the two studies indicated few differences in receptivity to the two videotapes among primarily African-American and Latino young adolescents. The rap videotape was rated as more accurate in its depiction of the African-American lifestyle, although both videotapes were equally liked. When shown together, the videotapes were not found to be superior in decreasing behavioral intention to smoke compared to a discussion group control. No change in trial of smoking was observed within or across conditions measured over a pre-post summer interval. These data suggest that "culturally sensitive" videotapes have no more of a short-term effect on youth than do other types of brief interventions which involve minority implementers.

Adolescent↗

For whom does Alcoholics Anonymous work?

A brief summary of the literature to evaluate for whom Alcoholics Anonymous (A.A.) is or is not likely to be effective is provided. A description of A.A. is presented. Next, support and criticisms of A.A., details of who A.A. seems to help and does not seem to help, and alternatives to A.A. are discussed. Finally, recommendations regarding matching clients to supportive treatments are made.

Alcoholics Anonymous↗

Group self-identification and adolescent cigarette smoking: a 1-year prospective study.

As an extension of previous work, we analyzed the longitudinal relations between group self-identification and adolescent cigarette smoking. The predictive precedence of cigarette smoking and identification with 6 different types of peer groups was examined. Results indicated that 7th-grade group self-identification predicted 8th-grade cigarette smoking, whereas 7th-grade cigarette smoking did not predict 8th-grade group self-identification. Group self-identification also was compared with 7 other psychosocial variables as predictors of smoking 1 year later. The pattern of results suggests that group self-identification is about as good a predictor of smoking as other psychosocial variables, and that group self-identification is more than a mere proxy of other psychosocial variables.

Adolescent↗