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PubMed1991

A survey of drinking patterns during medical school.

Several studies have documented the common use of alcohol among medical students and the significant fraction of students (7% to 17%) who show a pattern of alcohol abuse. Many authors have pointed out the implications of physician impairment due to alcoholism, presently estimated at about 10%. We surveyed 263 junior and senior medical students, and our data support earlier surveys of the prevalence of alcohol abuse and indicate that students tend to drink less heavily and less frequently after entering medical school. The clinically proven CAGE questions used in the survey showed statistically significant associations between heavy or frequent drinking before and during medical school, but only 4.2% of respondents indicated that school officials had asked whether they had a drinking or drug abuse problem. Given these findings, we suggest the routine administration of screening instruments to medical students, using education and minimal intervention strategies with individuals at risk.

Alcohol Drinking↗
PubMed1992

Nurses' attitudes toward patients with AIDS and AIDS-related risk factors.

Three variables were experimentally manipulated by simulation measurement using six vignettes in a completely randomized, partial hierarchical, experimental design: medical diagnosis (AIDS v. non-AIDS), sexual orientation (heterosexual v. homosexual) and intravenous drug-use history (IVDU v. non-IVDU). Following each vignette, the same Prejudicial Evaluation Scale (PES) and Social Interaction Scale (SIS) were used to measure nurses' attitudes toward patients and their willingness to interact with patients. Vignette questionnaires were randomly assigned to 360 acute-care nurses. Although sexual orientation was found not to influence PES and SIS scores, an AIDS medical diagnosis and a history of intravenous drug use were found to increase nurses' negative attitudes toward patients significantly and reduce their willingness to interact with patients. Study findings did not vary according to nurses' age, academic preparation or previous practice experience with patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1992

A population-based study of neuroblastoma incidence, survival, and mortality in North America.

PURPOSE: The purpose of this study was twofold: (1) to provide a population-based estimate of neuroblastoma incidence, disease stage and age distribution, and survival and mortality rates in North America; and (2) to compare these figures in the province of Quebec at a time shortly before the institution of province-wide screening with those in a population-based control group, the Greater Delaware Valley (GDV) Pediatric Tumor Registry. MATERIALS AND METHODS: In Quebec, the four major pediatric teaching hospital records were searched for children with a diagnosis of neuroblastoma. Tumor board registry data and information supplied to the Division of Vital Statistics were also reviewed. Birth statistics were obtained from the population registry. The GDV Pediatric Tumor Registry is a population-based registry of pediatric cancer covering all of Delaware and parts of New Jersey, Pennsylvania, and Maryland. Age, stage of disease, and follow-up data were obtained through December 31, 1989, with Evans neuroblastoma staging data used for all comparisons. RESULTS: One hundred thirty children with neuroblastoma were identified in Quebec and 165 in the GDV, in a combined population of 3,178,736 children. The annual incidence of neuroblastoma was 10.95/10(6) under the age of 15 years and 27.75/10(6) between the ages of 0 and 4 years. The annual mortality rate due to neuroblastoma was 4.89/10(6) and 9.10/10(6) for the age groups 0 to 14 and 0 to 4, respectively. The overall 10-year survival rate for the 295 cases of neuroblastoma was 55%. The 10-year survival rates for patients with Evans stage I-IV and IVS disease were 88%, 90%, 63%, 21%, and 81%. There was no significant difference observed in the incidence, mortality, or survival in the two populations. CONCLUSION: These data represent the first large, population-based description of the clinical presentation and outcome of patients with neuroblastoma in North America, with no significant differences noted between Quebec patients and the GDV patients.

Adolescent↗
PubMedDate not supplied

Substance misuse and HIV/AIDS risks among delinquents: a prevention challenge.

In the United States, there is growing concern that adolescents are at increasing risk for HIV-1 infection due to recreational substance use and sexual activity. Self-report questionnaires from a sample of 224 incarcerated delinquents quantified associations between drug use, sex, and other behaviors which risk HIV-1 infection. High rates of substance use and HIV-risking behaviors were found. Significant correlations between levels of substance use and both behavioral and attitudinal barriers to HIV/AIDS prevention programming were observed. This evidence and other subgroup differences in denial of vulnerability and in practice of preventive behaviors indicate the need for different approaches to prevention. An integrated HIV/AIDS and substance misuse prevention program is discussed as a viable alternative to the usual knowledge-enhancing programs.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Aftercare/relapse prevention and the self-help movement.

This paper presents the background and initial experiences of a treatment evaluation involving self-help techniques and principles as a means of providing aftercare services for stabilized methadone maintenance patients. It describes the Clinically Guided Self-Help (CGSH) model, which focuses on community reintegration and places emphasis on social network components following a period of primary treatment and demonstrated client stability. From our experiences, we have identified needs and issues that are of concern to stabilized clients, and we have distilled a paradigm for responding to these in a self-help group format. The model permits clients to establish their own agenda of interests and, guided by staff, to engage in a process geared toward maximum participation of their part. The model is clinically based in that staff and participants are engaged in working on present adjustment concerns. The overall goal of the investigators is to generate the prerequisite skills for successful adaptation of self-help concepts and techniques to the particular needs and interests of individual methadone maintenance programs and clients.

Aftercare↗
PubMed1992

The liberating effects of RN-to-BSN education.

This study investigated whether postlicensure baccalaureate education was associated with decreased acceptance of oppressed status for nursing and the self, with behavioral changes in job performance, and in joining a professional organization. Selected writings of Freire (1970a, 1970b, 1973) concerning education of the oppressed were used to form the conceptual framework. Baccalaureate education was conceptualized as a means of overcoming oppression-related behaviors and attitudes in nurses. The criterion measures were self-reports of job performance, joining the American Nurses Association (ANA), self-concept measurements, and perception of nursing measured by a semantic differential. Except for self-concept, which remained unchanged, all the findings were in the predicted direction supporting the conceptual framework.

Adult↗
PubMed1992

Nursing intensity. Going beyond patient classification.

Two patient classification systems, Medicus and GRASP, were compared to the Patient Intensity for Nursing Index (PINI). Approximately 50% of the variability in both classification systems was not accounted for by PINI items. The patterns of correlation between PINI items and GRASP and Medicus scores indicated that these two classification systems do not measure nursing resource use in the same way. Nurse administrators should be aware that estimates of nursing care costs will vary depending on the patient classification system used to measure nursing intensity.

Costs and Cost Analysis↗
PubMedDate not supplied

Influenza viruses in birds of the Atlantic flyway.

Isolation of type A influenza viruses from the feces of 5013 birds of 16 species was attempted during a 33-month study (1977-79). Seventy viruses were isolated from the feces of 3403 ring-billed gulls in Baltimore, Md., during 16 months of sampling. Six hemagglutinin (HA) subtypes and seven neuraminidase (NA) subtypes in 15 combinations were found. The H13N6 virus was the only subtype found each year and accounted for 40% of the isolates. The rate of isolation from gulls was 0.26% in the cold months and 3.0% in the warm months. Hemagglutination-inhibition (HI) and elution-inhibition antibody profiles reflected the presence of some but not all of the viruses isolated. In mute swans, the rates of seroconversions were 16% for HA antibody and 14% for NA antibody, whereas the viral isolation rate was 0.4% over a 3-year period. Both the H5 and the N2 subtypes, which were responsible for the lethal chicken outbreaks in 1983 in Pennsylvania, were isolated from gulls in 1978 in association with subtypes not found in the chicken virus. Also, seroconversions for the H5 HA occurred in mute swans in 1978.

Age Factors↗
PubMedDate not supplied

AIDS-related risk factors, medical diagnosis, do-not-resuscitate orders and aggressiveness of nursing care.

Three variables were experimentally manipulated through simulation in six case study vignettes: AIDS-related risk factors (gay v. IVDU), medical diagnosis (AIDS v. non-AIDS), and DNR orders (DNR order v. no DNR order). Following each vignette, the same 13-item, 6-point Likert-type Aggressiveness of Nursing Care Scale (ANCS) was used to measure nurses' attitudes toward aggressiveness of nursing care. Questionnaires were randomly assigned to 600 acute care nurses. Although AIDS-related risk factors were not found to influence ANCS scores, a non-AIDS medical diagnosis and DNR orders significantly reduced aggressiveness of nursing care attitudes. Study findings did not vary according to nurses' age, academic preparation, or previous practice experience with persons with AIDS or DNR orders.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Serologic survey for Borrelia burgdorferi antibody in horses referred to a mid-Atlantic veterinary teaching hospital.

Blood samples obtained from 13 of 100 (13%) and 6 of 91 (7%) horses at the George D. Widener Hospital for Large Animals in the months of June and October, respectively, had antibody to Borrelia burgdorferi as determined by ELISA. Horses from the states of New York, Maryland, Delaware, New Jersey, and Pennsylvania were seropositive for B burgdorferi. The frequency of antibody response in horses from New Jersey was greater (P less than 0.05) than the frequency of antibody response in horses from Pennsylvania or that of horses from the other states combined. Statistically significant difference was not found when a comparison was made between horses with serotiter and open diagnosis of neurologic or musculoskeletal disease and horses with negative serotest results and open diagnosis of neurologic or musculoskeletal disease.

Animals↗