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At least 199 records · Page 11Linked to original sources
PubMed1995

Computer integrated drug prevention: a new approach to teach lower socioeconomic 5th and 6th grade Israeli children to say no to drugs.

Drug prevention education provides an important first line of defense against future drug use. Many drug prevention strategies have been developed which teach youngsters of all ages how to say no to drugs. Nevertheless, the problem of drug use and abuse continues to escalate, and younger children, particularly those undergoing harsh psychosocial stress (e.g., hunger, lack of housing, broken homes, family unemployment, etc.), are increasingly becoming a population at-risk. In this paper, the authors describe an original drug prevention program that was developed in Israel aimed at teaching resiliency skills to 5th and 6th grade children growing up in a poverty stricken, urban community. The program, drawing on social learning theory, utilizes an attractive, cartoon illustrated, computer program combined with games, role-playing and group work techniques to prevent future drug use in preadolescent children.

Child↗
PubMed2004

Recommendations to develop an intervention for Japanese youth on weight management.

In the last 20 years the average change in BMI among Japanese youth is minimal, but significant changes appear when the categories of overweight/obesity and underweight are investigated within gender. Now intervention programs for Japanese youth on weight management need to be developed. To address the issue, there are a series of steps that could be undertaken utilizing theory of behavior change. Using the Transtheoretical Model-Stages of Change as the health promotion theory an intervention could be developed that would tailor messages to the level of the stage of readiness to weight change that exists among youth. Different aspects of the intervention could be developed and targeted to groups of youth by their needs. To assist with planning and development of the intervention principles of Intervention Mapping could be used to guide development using data from a needs assessment survey to: a) determine youths' knowledge, attitudes and beliefs about body size, b) determine youth's barriers to change in body size, c) determine parental knowledge, attitudes and beliefs about body size, d) determine parental barriers to change in youth body size, e) determine the prevalence of health problems from low and high BMI of young females and males, f) determine which youth are at risk-rural/urban areas, socioeconomic status.

Adolescent↗
PubMed1995

The Short-Form 36 (SF-36) Health Survey and its use in pharmacoeconomic evaluation.

The Short-Form 36 (SF-36) Health Survey is a brief self-administered questionnaire that generates scores across 8 dimensions of health. It has been found to be reliable, and valid in terms of criteria such as agreement with clinical diagnosis and disease severity, but its underlying values have not been tested against patient preferences. The SF-36 was not devised for use in economic evaluation. The SF-36 may be used in cost-minimisation analyses, where the dimension scores can be shown to reflect people's values for health at an ordinal level, but it cannot be used in either cost-effectiveness or cost-utility analyses. The dimensions scores of zero to 100 do not provide a common currency and, where there is conflict between the dimension scores, there is no basis for establishing an overall health benefit. Furthermore, in clinical trials, the usual comparison is between mean or median scores, which assumes risk neutrality and does not take adequate account of the relationship between the value of health and time. Although they are under pressure to assess the cost effectiveness of healthcare interventions, researchers and policy analysts must resist short-cut methods of deriving a single index from the SF-36 that are based on arbitrary aggregation schemes, because these ignore people's preferences and the crucial quantity/quality trade-off, and therefore cannot be used in economic evaluations. However, the rich descriptive material and multidimensionality of the SF-36 may have potential for use in economic evaluation. Multi-attribute utility theory provides a way of deriving a single index based on elicited values, but it requires a major restructuring of the scales of the SF-36. Alternatively, SF-36 responses may provide material for constructing health scenarios that could then be valued on a holistic basis.

Attitude to Health↗
PubMed1998

Impact of the 1970 legal BAC 0.05 mg% limit legislation on drunk-driver-involved traffic fatalities, accidents, and DWI in Japan.

Official statistics of motor vehicle fatality data have indicated that alcohol involvement in fatal crashes has declined substantially in Japan since 1970. The national campaign against drunken driving in Japan provides a natural experiment in which to test the predictions of deterrence theory. Utilizing official data over the 1960-1995 period, we report conclusive evidence that 1970s legislation is having a measurable and long-term effect on alcohol-related motor vehicle fatalities. Enactment of the lower legal blood alcohol limit with a combination of other severe sanctions has been more desirable in the prevention of alcohol-related fatalities in the long term as shown in this study. Further extensive research is necessary to investigate performance at the lower legal limit in other societies in order to inspire a strong "international lobby" to support the reduced legal blood alcohol limit for drivers all over the world, as there is no doubt that a reduction in alcohol-impaired driving will result in a substantial savings of human lives and resource worldwide.

Accidents, Traffic↗
PubMed1976

The mathematics of cleft lip and palate treatment evaluation: measuring the desirability of treatment outcomes.

A study was undertaken to investigate the applicability of utility theory to cleft lip and palate treatment decision making. Questionnaires were used to assess value judgements and attitudes toward risk from 119 individuals associated with seventeen cleft lip and palate treatment centers. Significant differences were found to exist between the values expressed by clinicians grouped according to their specialty or the facility to which they were affiliated. Fathers of cleft lip and palate children differed from cleft palate teams in their judgements regarding the relative values of speech and cosmetic treatment outcomes. No such differences were found between team members and mothers, however. It is suggested that these differences affect the desirability of treatment decisions and the outcomes that follow from them. Therefore, cleft lip and palate treatment planning and the evaluation of alternative therapeutic interventions might be based on a mathematical theory of decision making that explicitly incorporates the subjective assessment of a child's habilitative needs and the goals of the habilitative process.

Cleft Lip↗
PubMed1986

An analysis of migratory systems: 2. Operational framework.

"This is the second in a series of three interrelated papers which aim to combine evolutionary migration models with stochastic utility theory. The first paper dealt with migratory dynamics. Here the details are given of a choice model, established by McFadden, which can be used in conjunction with migratory dynamics thus providing an explicit link between the macroproperties of the population system and human behaviour. First, the structure of transition probabilities is derived under a two-level decision to migrate. An argument is then given about the empirical form of these probabilities, and the discussion closes with a method which can be used for their maximum likelihood estimation."

Behavior↗
PubMed1988

Nickel as a micronutrient element for plants.

The detrimental effects of excessive Ni on plant growth have been well known for many years. More recent evidence indicates that Ni is required in small amounts for normal plant growth and development. Ni is an essential component of urease in plants and microorganisms. A deficiency of Ni in plants is reported to result in necrotic lesions in leaves in response to toxic accumulations of urea. Urease plays an essential role in mobilization of nitrogenous compounds in plants, a process that is especially important during seed germination and fruit formation when protein reserves are degraded into amino acids. Arginine, an abundant amino acid in plants, when degraded produces urea as a product and urease is needed for urea utilization. Theories of urea formation during allantoin degradation in Glycine max have been recently refuted. In G. max ureides apparently are metabolized via an amidohydrolase reaction with subsequent degradation of ureidoglycine, yielding glyoxylate, NH+4 and CO2. No evidence is available for the formation of urea in this pathway. Nitrogen-fixing symbionts, such as Rhizobium and Bradyrhizobium, contain two known Ni enzymes: urease and hydrogenase. Optimum growth of nodulated legumes and actinorhizal plants may depend on an adequate supply of Ni to meet the requirements of the Ni-requiring enzymes in host plants and endophytes. The seeds of severely Ni-deficient Hordeum are completely inviable, thus providing conclusive evidence for the essentiality of Ni for this species. The evidence indicates that Ni must be added to the list of micronutrient elements generally required by plants.

Nickel↗
PubMed1986

Out-of-home child placement and family adaptation: a theoretical framework.

McCubbin and Patterson's (1983) model of family adjustment and adaptation to stress was summarized and applied to families' decisions for in-home versus out-of-home placement of children with severe mental retardation. Basically, three factors (demands on the family, the family resources, and the family's perspective on the situation) were viewed as interacting in three phases (adjustment, restructuring, and consolidation) to produce an outcome, measured on a bonadaptive to maladaptive continuum. Research on differences between families who seek residential placement and those who do not was summarized and organized within this framework. Out of this theoretical foundation implications for future research and intervention were developed. Recommendations include basing future research more directly on theory, utilizing multivariate techniques in research, and developing multifaceted early intervention programs that emphasize family values as well as family needs.

Adaptation, Psychological↗
PubMed1995

Health, illness, and healing in an uncertain era: challenges from and for medical sociology.

The current situation in health care organizations, among providers and for people, dramatically challenges the "business as usual" roles of medicine, government, insurance companies, the community, and the university. Health care reform marks the first attempt in a century to consider a reconstruction of the social contract between society and medicine. While sociology stands as one of the earliest social sciences to systematically study the health care arena and create a health-focused subfield, there is a perception, not without support, of a desertion of identity from within, an encroachment by other areas from without, and abandonment by the parent discipline. We argue that these situations in medical arenas and in research fields require serious rethinking. The key lies in understanding how these phenomena are related to each other and to larger social forces, and how they offer opportunities, rather than signal limitations, to medical sociologists. We turn to the theoretical tools of sociology to help unravel the complicated challenges that face both policymakers and researchers. After framing these issues in a sociology of knowledge perspective, we use the case of "utilization theory" to illustrate the connections between society and systems of care (as well as studies of them) and to create a future agenda. We end by raising three basic questions: (1) Why is a sociological perspective critical to the understanding of change and reform in health care? (2) Why is medical sociology critical to the survival of the general sociological enterprise? and (3) Why is general sociology critical to the research agenda in medical sociology?

Health Care Reform↗
PubMed1994

The standard gamble method: what is being measured and how it is interpreted.

OBJECTIVE: The Standard Gamble (SG) technique is recommended for measurement of individuals' preferences under uncertainty and to express the outcome of different therapeutic choices in utility values to be used in clinical decision analysis and health program evaluation. The article alerts users of this technique to problems stemming from inappropriate interpretation of results of measurements using the SG method. STUDY DESIGN: We review different situations where the SG method is used to measure individuals' or group preferences. PRINCIPAL FINDINGS: We demonstrate inappropriate interpretation of the time dimension at the individual level; issues stemming from the aggregation of individual utility values measured using different time horizons; the potential for double counting of the time preference effect when discounting future quality-adjusted life years (QALYs); and problems associated with using the SG technique to measure temporary health states. CONCLUSIONS: The inappropriate interpretations stem mainly either from ignoring the time dimension, which is inextricably bound to the health of the individual, or form adding assumptions, in addition to those required by von Neumann-Morgenstern (vNM) utility theory, that are not supported by empirical evidence. An alternative approach to QALYs, the healthy years equivalent (HYE), which incorporates the SG but avoids many of these problems, is described.

Decision Support Techniques↗
PubMed1994

[Sensitivity and specificity in AIDS screening system].

The interest in the optimal combination of the diagnostic tests is growing in terms of reasoning rationale and cost-effectiveness of the diagnostic system. As an example of the two-stage test system, we investigated the sensitivity, specificity, and posterior probabilities of the HIV screening system with incomplete information of the conditional independency between the enzyme immunoassay and the Western Blot. The theoretical analysis of the probabilistic reasoning of the HIV screening system could provide us with the upper and lower limits of the predictive positive value, given the prior probability of HIV infection. Consequently, we could show that the lower and the upper boundaries of the predictive positive value are, respectively, 4.07% and 100% for the low risk group (prevalence of HIV: 0.01%), while 99.86% and 100% for the high risk group (prevalence of HIV: 62%). These analyses imply that clinicians must be very careful in the interpretation of the positive test result in the HIV screening system, depending on how the risk of HIV infection of the patient is estimated in advance. In addition to the probabilistic analyses of the test parameters, the approach by use of the utility theory is favorable for the issue of optimizing the diagnostic test sequences. It remains for future investigation.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Parents' versus physicians' values for clinical outcomes in young febrile children.

OBJECTIVE: To compare how parents and physicians value potential clinical outcomes in young children who have a fever but no focus of bacterial infection. METHODS: Cross-sectional study of 100 parents of well children aged 3 to 24 months, 61 parents of febrile children aged 3 to 24 months, and 56 attending staff physicians working in a children's hospital emergency department. A pretested visual analog scale was used to assess values on a 0-to-1 scale (where 0 is the value of the worst possible outcome, and 1 is the value for the best) for 22 scenarios, grouped in three categories according to severity. Based on the three or four common attributes comprising the scenarios in a given group, each respondent's value function was estimated statistically based on multiattribute utility theory. RESULTS: For outcomes in group 1 (rapidly resolving viral infection with one or more diagnostic tests), no significant group differences were observed. For outcomes in groups 2 (acute infections without long-term sequelae) and 3 (long-term sequelae of urinary tract infection or bacterial meningitis), parents of well children and parents of febrile children had values that were similar to each other but significantly lower than physicians' values for pneumonia with delayed diagnosis, false-positive diagnosis of urinary tract infection, viral meningitis, and unilateral hearing loss. For bacterial meningitis with or without delay, however, the reverse pattern was observed; physicians' values were lower than parents'. In arriving at their judgment for group 2 and 3 scenarios, parents gave significantly greater weight to attributes involving the pain and discomfort of diagnostic tests and to diagnostic error, whereas physicians gave significantly greater weight to attributes involving both short- and long-term morbidity and long-term worry and inconvenience. Parents were significantly more likely to be risk-seeking in the way they weighted the attributes comprising group 2 and 3 scenarios than physicians, ie, they were more willing to risk rare but severe morbidity to avoid the short-term adverse effects of testing. CONCLUSIONS: Parents and physicians show fundamental value differences concerning diagnostic testing, diagnostic error, and short- and long-term morbidity; these differences have important implications for diagnostic decision making in the young febrile child.

Attitude of Health Personnel↗
PubMed1993

Wisconsin cystic fibrosis chest radiograph scoring system.

A new clinical scoring system for patients with cystic fibrosis is needed because of recent advances in diagnosis and treatment which have changed the course of this disease. Chest radiograph scoring is the best objective measure of pulmonary disease for longitudinal studies beginning with infants; however, based on pilot studies, previous scoring systems are not sensitive enough in discriminating between degrees of mild lung disease. Therefore, a new radiographic scoring system was developed with the goal of achieving both sensitivity and reproducibility. This objective was pursued by applying multiattribute utility theory, using a panel of interpreters with expertise in cystic fibrosis radiology, and employing mathematical modeling techniques to weight the various components. The system was developed and validated in three phases including comparison to the Brasfield method of quantitative radiology. The data demonstrate that the new system can be applied reliably and conveniently to generate reproducible scores of pulmonary disease severity. Evaluation of the scores by four independent raters using chest radiographs from 61 patients at an average age of 8.37 years revealed good agreement with a .714 Kendall coefficient of concordance. Assessment of serial changes over time was performed using a group of 176 chest radiographs from 25 patients ranging from 4 weeks to 6 years old; this showed that the Wisconsin system generates score differences that are greater in magnitude with disease progression compared with the Brasfield method. Therefore, the new method is more sensitive to progression of mild disease and should be superior to prior radiographic scoring systems for evaluating therapies designed to modify the early course of disease. The Wisconsin system is designed to be useful in longitudinal clinical studies involving young children with cystic fibrosis and is capable to detecting progression from normality to mild lung disease.

Adolescent↗
PubMed1995

Using knowledge maintenance for preference assessment.

Most real-life decisions require the decision maker to make trade-offs in order to fulfill multiple conflicting objectives. This is especially true in medical decision making while selecting the optimal therapy plan from among competing therapy plans for a patient. Multi-attribute utility theory provides a framework to specify these trade-offs for optimal decision making based on the preferences of the decision maker. However traditional preference-assessment techniques are difficult to implement and rarely elicit the true preferences of the decision maker. We describe a new preference-assessment method based on the concept of knowledge maintenance where the preference model is changed each time it makes an incorrect recommendation. The method is implemented in a decision-theoretic system to evaluate competing three-dimensional radiation treatment plans. The preference-assessment method leads to preference models which perform better than preference models elicited using traditional assessment techniques.

Abdominal Neoplasms↗
PubMed2003

Theory of research utilization enhancement: a model for occupational therapy.

BACKGROUND: There is a pressing need for occupational therapists to provide research-based practice, yet there is little understanding of the specific strategies and processes individual practitioners use to integrate research evidence into their clinical practice. METHOD: Using grounded theory method, the self-reported research utilization strategies of a sample of 11 elite occupational therapists practicing in adult stroke rehabilitation were examined. The triangulation of the interview data, the organizational policies of their workplaces, and existing theoretical concepts and processes of research utilization resulted in the development of a theory and a practice model to guide research utilization in occupational therapy. RESULTS: The Theory of Research Utilization Enhancement for Occupational Therapists, and the Model of Research Utilization in Occupational Therapy are presented, and their implications for practice, policy, education and future research are discussed. PRACTICE IMPLICATIONS: Built upon the Occupational Performance Process Model, the theory and model are proposed as guides to enhance therapists' ability to maintain a client-centred approach while informing clinical practices with research evidence. The application of structured reflection, case application and peer consultation facilitate the integration of research evidence into clinical practices.

Adult↗
PubMed2004

Predicting 9Be nuclear magnetic resonance chemical shielding tensors utilizing density functional theory.

The structures of a series of beryllium containing complexes have been optimized at the B3LYP/6-31G(d) level and their (9)Be magnetic shielding values have been determined using B3LYP/6-311G+g(2d,p) and the gauge-including atomic orbital (GIAO) method. The calculated chemical shifts are in excellent agreement with experimental values. The performance of a variety of NMR methods (SGO, IGAIM, CSGT) were also examined but were found to be inferior to the GIAO method at the chosen level of theory employed. The theoretical method has been utilized to predict the beryllium chemical shifts of structurally characterized complexes for which no measured (9)Be NMR spectrum exists, and to investigate a literature complex with an unusual (9)Be NMR chemical shift. A new standard for beryllium NMR in nonaqueous solvents has been suggested.

Journal Article↗
PubMedDate not supplied

Utility of the theory of planned behavior for understanding exercise during breast cancer treatment.

Preliminary evidence indicates that physical exercise may be an effective strategy for helping cancer patients cope with the negative side-effects of their treatment. The purpose of the present study was to examine the utility of the theory of planned behavior in understanding cancer patients' motivation to exercise during treatment. A total of 164 women who had been diagnosed with breast cancer within the previous 2 years participated in the study. A retrospective design was used wherein these women were asked to recall their beliefs and exercise behavior during cancer treatment using a self-administered, mailed questionnaire. Results showed that: (1) the salient beliefs of breast cancer patients concerning exercise were different from those of the healthy population; (2) intention and perceived behavioral control were significant determinants of exercise during cancer treatment; and, (3) attitude and subjective norm were significant determinants of intention. It was concluded that the theory of planned behavior may be a viable framework on which to base interventions designed to promote exercise during cancer treatment. The results of this study are preliminary, however, and more sophisticated research designs to examine this question are warranted.

Adaptation, Psychological↗