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PubMed1992

The uses of theory in health advocacy: policies and programs.

This paper illustrates the utility of theory for health educators who advocate for health promotion policies and programs. It describes how diffusion of innovation and other social science theories were employed by a statewide coalition called the Health Promotion and Education Council of Virginia in its effort to reduce premature and preventable death and disability in the state. To this end the Council sought legislative action to accelerate the diffusion of health promotion throughout the state. Discussing elements of diffusion theory such as working through opinion leaders, creating information-exchange relationships, and tailoring the attributes of the innovation to achieve its objectives, the paper reviews the process through which the Council became an effective advocate, and the strategies it devised to communicate the innovation of health promotion to legislators. The legislation that was generated by the work of the legislative study committee and future uses of theory are also discussed.

Diffusion of Innovation↗
PubMed2000

Development and assessment of a general theory of cervical carcinogenesis utilizing a severe combined immunodeficiency murine-human xenograft model.

OBJECTIVE: Currently, we lack a theoretical explanation for why squamous cell cervical cancer develops predominantly in specific sites (i.e., along the squamocolumnar junction). We therefore implanted human cervical tissues containing the transformation zone in severe combined immunodeficiency (SCID) mice and studied morphology, steroid effects, gene expression, and human papillomavirus (HPV) factors. METHODS: Normal and dysplastic human cervical tissues (3 x 2 mm) were placed subcutaneously in SCID-beige mice and later assessed by in situ hybridization for HPV 16/18 DNA and by immunohistochemistry for expression of CD31, keratin, proliferating-cell nuclear antigen, HPV 16 E6, p53, and Notch-1 (a binary cell fate determination protein). Some normal tissues were implanted with either a 90-day release 1.7-mg 17beta-estradiol pellet or a 5-mg tamoxifen pellet; others were infected prior to implantation with human recombinant adenovirus 5 vector containing a human cytomegalovirus promoter-driven beta-galactosidase gene and later assessed by X-gal staining. RESULTS: Murine and human vessels formed anastomoses by 3 weeks. For at least 11 weeks, normal tissue retained the transformation zone and normal cell-type-specific keratin expression and exhibited normal proliferation; Notch-1 was present only in the basal cell layer. Dysplastic tissues exhibited koilocytosis, increased levels of cellular proliferation, and aberrant keratin, p53, and Notch-1 expression; HPV 16/18 DNA and HPV 16 E6 protein were detected for at least 6 weeks. Squamous metaplasia of normal cervical epithelium resulted from estrogen exposure, and a predominant columnar differentiation pattern was associated with tamoxifen administration. Through stable adenovirus infection, beta-galactosidase was expressed for at least 6 weeks. CONCLUSIONS: This small manipulatable xenograft model maintains normal and dysplastic human cervical epithelium through neovascularization. Neoplastic tissue retains HPV 16/18 DNA and a premalignant phenotype, including elevated levels of cellular proliferation and aberrant keratin, p53, and Notch-1 expression. These attributes constitute essential features of a biologic model through which one may study HPV-mediated human disease and may be superior to cell culture and transgenic murine systems. Furthermore, this may serve as a model for gene therapy. Finally, we suggest that the normal cervical epithelium is maintained through putative interactions between the Notch locus and cell cycle growth regulators such as p53 and pRb. Neoplastic cervical epithelium may arise through disruption of this pathway. This theory may be testable in our animal model.

Animals↗
PubMed1991

Adolescent women's contraceptive decision making.

A modified rational decision model incorporating salient events and social influences (particularly from sexual partners) is used to analyze adolescent women's consistent use of oral contraceptives (OCs) over a six-month period. Data are taken from a panel study of 308 clients of an inner-city family planning clinic. Expected OC use was computed for each subject on the basis of subjective expected utility (SEU) theory, and is found in multivariate analyses to be a significant predictor of actual OC use. In addition, variables representing baseline and follow-up partner influences, the salience of pregnancy for the subject, and positive side effects of OCs during the first months of use are found to predict OC use. Partner's support of OC use during follow-up and positive side effects of OCs are found to predict OC use among subjects for whom OC use was not the expected decision according to baseline SEU. Implications of the findings for models of adolescents' contraceptive behavior and for clinicians are discussed.

Adolescent↗
PubMed1990

Utilization of composite laminate theory in the design of synthetic soft tissues for biomedical prostheses.

There are several advantages of using composite design considerations for the preparation of biomedical soft tissues. Using a composite laminate design, a wide range for compliance results, proving that the prosthesis compliance can be altered without a concomitant variation of other properties. The trend of compliance as a function of the reinforcement angle is discussed for an angle-ply composite of low compliance constituents, as well as the implications for stress-strain behaviour. Experimental examples pertinent to prosthetic arterial design are presented.

Biocompatible Materials↗
PubMed2005

Theory and methodology for utilizing genes as biomarkers to determine potential biological mixtures.

PURPOSE: Genetically determined mixture information can be used as a surrogate for physical or behavioral characteristics in epidemiological studies examining research questions related to socially stigmatized behaviors and horizontally transmitted infections. A new measure, the probability of mixture discrimination (PMD), was developed to aid mixture analysis that estimates the ability to differentiate single from multiple genomes in biological mixtures. METHODS: Four autosomal short tandem repeats (STRs) were identified, genotyped and evaluated in African American, European American, Hispanic, and Chinese individuals to estimate PMD. Theoretical PMD frameworks were also developed for autosomal and sex-linked (X and Y) STR markers in potential male/male, male/female and female/female mixtures. RESULTS: Autosomal STRs genetically determine the presence of multiple genomes in mixture samples of unknown genders with more power than the apparently simpler X and Y chromosome STRs. Evaluation of four autosomal STR loci enables the detection of mixtures of DNA from multiple sources with above 99% probability in all four racial/ethnic populations. CONCLUSIONS: The genetic-based approach has applications in epidemiology that provide viable alternatives to survey-based study designs. The analysis of genes as biomarkers can be used as a gold standard for validating measurements from self-reported behaviors that tend to be sensitive or socially stigmatizing, such as those involving sex and drugs.

Black or African American↗
PubMed2002

An exploration of health beliefs and attitudes of smokers with vascular disease who participate in or decline a smoking cessation program.

The descriptive cross-sectional aspect of this study compared a group of smokers with peripheral arterial disease who chose to participate in a smoking intervention with a group of smokers with peripheral arterial disease who declined to participate. The longitudinal aspect of this study used Ajzen and Fishbein's(1) Theory of Reasoned Action, Keeney's(2) Expected Utility Decision Theory, and Prochaska and DiClemente's(3) Transtheoretical Model of Change to describe the influence of this smoking cessation program on the beliefs and attitudes about smoking in group 1. Smokers completed a smoking beliefs questionnaire with vascular disease at baseline and after 13 weeks of smoking cessation intervention. Smokers who did not want to participate in the smoking cessation program also completed this questionnaire for comparison. Statistically significant differences were found to differentiate people who enrolled in the smoking cessation program from those who did not. Subjects in group 2 smoked less per day, were less educated, were less often diagnosed as having peripheral arterial disease, were found to be more in the precontemplation stage of change in smoking cessation, cared more about what their physician and family thought they should do, and perceived themselves to be at less risk for developing more severe circulatory problems if they did not quit smoking. After 13 weeks, participants in both groups 1 and 2 were found to smoke significantly less per day. No support was found for the expectation that the smoking intervention would influence stage of change in smoking behavior or attitudes and beliefs about the risks of smoking to the participants' health after 13 weeks.

Adult↗
PubMed2000

Utility of Biochemical Systems Theory for the analysis of metabolic effects from low-dose chemical exposure.

Adverse health outcomes from exposure to chemical agents are of increasing interest in human and ecological risk assessment and require the development of new analytical methods. Such methods must be able to capture the essence of integrated networks of biochemical pathways in a mathematically feasible fashion. Over the past three decades, Biochemical Systems Theory has been successfully applied to numerous biological systems. It is suggested here that S-system models derived from BST can provide the means for assessing chemical exposures and their effects at the metabolic level. This article briefly reviews essential concepts of S-systems and provides generic examples of chemical exposure scenarios. S-system models can be considered mechanistic, since their components are measurable quantities (e.g., concentrations, fluxes, enzyme activities, and rates). As dynamic models, they can be used to assess immediate and long-term metabolic responses to environmental stimuli. Direct mathematical analysis for low exposures leads to simple dose-response relationships, which have the form of power-law functions. Thus, if the S-system model yields an appropriate description of chemical exposure and its metabolic effects, the dose-response relationship for low exposures is linear in logarithmic coordinates. This result includes as a special case the standard linear relationship in Cartesian coordinates with zero intercept.

Dose-Response Relationship, Drug↗
PubMed1995

Utilizing Peplau's psychodynamic theory for stroke patient care.

A theory which enables the recipient of care to identify health-care needs is paramount. Hildegard Peplau's (1952) theory of psychodynamic nursing enables this process to occur in collaborative identification and resolution of need. The psychodynamic approach can direct the user to focus on the psychosocial problems created by a stroke. The advantages and limitations of the theory are still to be investigated with the continued application to varied clinical situations. There is a need to generate an expanded research-based taxonomy of psychosocial interventions for this client group.

Cerebrovascular Disorders↗
PubMed2001

The class that would not read: utilizing Bion's affect theory in group.

While Bion's group theory continues to inspire contemporary group psychotherapists, his theory of human emotion is not as well known. Bion also introduced a system of alphabetical and mathematic symbols to offer a shorthand for his epistemology in order to make his ideas accessible, flexible, and practical for the working clinician. This article presents aspects of Bion's theory and metapsychological shorthand to conceptualize effectual dimensions of group process, thinking operations, and countertransference. The constructs considered include Klein's paranoid-schizoid and depressive positions; manic defenses; basic assumptions; "proto-mental" and "pre-monitory" emotions; instinctive drives L, H, and K (plus or minus); beta elements; and alpha functioning. With these ideas, the author was able to work through aspects of a group experience in which, as leader, he unknowingly found himself at an opposite affective pole from the members.

Affect↗
PubMed1985

The utility of Kohlberg's theory of moral development among adult probationers in a restitution field setting.

Probationers ordered to pay restitution were classified by Kohlberg's Stages of Moral Development in order to (a) identify background correlates of moral development; (b) explore the relation between moral development and restitution compliance; and (c) differentially identify facilitating circumstances of restitution. The research was conducted in Albuquerque, New Mexico, from 1978 to 1980. Sixty-three probationers were interviewed and classified by moral development, I-level, and by ratings on relevant personality dimensions. Six-month follow-up data were collected from probation records. The results revealed significant relationships (p less than .05) between moral development and ethnicity, education, occupation, income, prior fines, weapons possession, knowing the victim, I-level, responsibility, and empathy. In addition, high-maturity offenders were more likely to reimburse their victims than were low-maturity offenders. Finally, multivariate analysis revealed numerous circumstances of restitution that differentially impacted upon offenders' compliance with the terms of restitution.

Adolescent↗
PubMed2001

Theoretical description of transdermal transport of hydrophilic permeants: application to low-frequency sonophoresis.

Application of ultrasound enhances transdermal transport of drugs (sonophoresis). The enhancement may result from enhanced diffusion due to ultrasound-induced skin alteration and/or from forced convection. To understand the relative roles played by these two mechanisms in low-frequency sonophoresis (LFS, 20 kHz), a theory describing the transdermal transport of hydrophilic permeants in both the absence and the presence of ultrasound was developed using fundamental equations of membrane transport, hindered-transport theory, and electrochemistry principles. With mannitol as the model permeant, the role of convection in LFS was evaluated experimentally with two commonly used in vitro skin models- human cadaver heat-stripped skin (HSS) and pig full-thickness skin (FTS). Our results suggest that convection plays an important role during LFS of HSS, whereas its effect is negligible when FTS is utilized. The theory developed was utilized to characterize the transport pathways of hydrophilic permeants during both passive diffusion and LFS with mannitol and sucrose as two probe molecules. Our results show that the porous pathway theory can adequately describe the transdermal transport of hydrophilic permeants in both the presence and the absence of ultrasound. Ultrasound alters the skin porous pathways by two mechanisms: (1) enlarging the skin effective pore radii, or (2) creating more pores and/or making the pores less tortuous. During passive diffusion, both HSS and FTS exhibit the same skin effective pore radii (r = 28 +/- 13 A). In contrast, during LFS, r within HSS is greatly enlarged (r > 125 A), whereas r within FTS does not change significantly (23 +/- 10 A). The observed different roles of convection during LFS across HSS and FTS can be attributed to the different degrees of structural alteration that these two types of skin undergo during LFS.

Administration, Cutaneous↗
PubMed1988

Safety belt promotion: theory and practice.

The purpose of this paper is to provide practitioners a rationale and description of selected theoretically based approaches to safety belt promotion. Theory failure is a threat to the integrity and effectiveness of safety belt promotion. The absence of theory driven programs designed to promote safety belt use is a concern of this paper. Six theoretical models from the social and behavioral sciences are reviewed with suggestions for application to promoting safety belt use and include Theory of Reasoned Action, the Health Belief Model, Fear Arousal, Operant Learning, Social Learning Theory, and Diffusion of Innovations. Guidelines for the selection and utilization of theory are discussed.

Accidents, Traffic↗
PubMed2003

Behavioural studies of strategic thinking in games.

Game theory is a mathematical language for describing strategic interactions, in which each player's choice affects the payoff of other players (where players can be genes, people, companies, nation-states, etc.). The impact of game theory in psychology has been limited by the lack of cognitive mechanisms underlying game-theoretic predictions. 'Behavioural game theory' is a recent approach linking game theory to cognitive science by adding cognitive details about 'social utility functions', theories of limits on iterated thinking, and statistical theories of how players learn and influence others. New directions include the effects of game descriptions on choice ('framing'), strategic heuristics, and mental representation. These ideas will help root game theory more deeply in cognitive science and extend the scope of both enterprises.

Journal Article↗
PubMed1987

[Economic approaches to fertility: a comparative analysis of the New Home Economics and Easterlin theories].

"The purpose of this paper is to provide a comparative analysis of the New Home Economics and Easterlin theories of fertility, within a critical context. It is emphasized that in spite of similarities between the two theories, each makes distinct contributions: while one stresses the cost of children as a determinant of fertility, the other stresses the importance of material aspirations through the relative income concept." (SUMMARY IN ENG AND SPA)

Adolescent↗