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PubMed2005

Funding opportunities in endoscopic imaging research.

Advances in gastrointestinal endoscopy have greatly enhanced the clinicians' ability to diagnose and treat many digestive disorders. During the last 30 years, some new therapeutic endoscope techniques have become the standard of care, and other newer evolving technologies are being evaluated. Despite these endoscopic advances, there has been expressed concern that federal funding of endoscopic research has lagged behind other evolving technologic and scientific discoveries. This article provides an overview of the background of one federal agency's attempt to engage the endoscopy community in the research enterprise through a variety of mechanisms of career development, grant support, and endoscopic research and development.

Biomedical Research↗
PubMedDate not supplied

Professional image: enhanced or inhibited by attire?

Nursing faculty have expressed concern about inappropriate dress of students and staff in the clinical setting. The researchers developed and administered a Likert-type questionnaire to faculty and students from 50 randomly selected, National League for Nursing-accredited baccalaureate nursing programs. The perceptions of professional attire of students and faculty were compared and analyzed. The tool assessed effects of demographic variables, such as age, gender, and curriculum level. In addition, questions assessed subject's opinions about attire options such as jumpsuits, "scrubs," tee-shirts, sweatshirts, hemlines, traditional white uniform, street clothes, hair length, jewelry, and nail length. Attire preferences significantly correlated with faculty age and teaching level. The older faculty preferred more traditional attire, and faculty in the upper division of the curriculum preferred more nontraditional attire. This same correlation was found for older students and for students enrolled in the upper division. Faculty influence on students' perceptions of attire was also addressed. Students reported that faculty positively influenced their perceptions of professional image. Students also believed that faculty were professionally attired in the classroom and clinical setting.

Adult↗
PubMed2000

Stigma and mental disorder: conceptions of illness, public attitudes, personal disclosure, and social policy.

The end of the last millennium witnessed an unprecedented degree of public awareness regarding mental disorder as well as motivation for policy change. Like Sartorius, we contend that the continued stigmatization of mental illness may well be the central issue facing the field, as nearly all attendant issues (e.g., standards of care, funding for basic and applied research efforts) emanate from professional, societal, and personal attitudes towards persons with aberrant behavior. We discuss empirical and narrative evidence for stigmatization as well as historical trends regarding conceptualizations of mental illness, including the field's increasing focus on genetic and neurobiological causes and determinants of mental disorder. We next define stigma explicitly, noting both the multiple levels (community, societal, familial, individual) through which stigma operates to dehumanize and delegitimize individuals with mental disorders and the impact of stigma across development. Key developmental psychopathology principles are salient in this regard. We express concern over the recent oversimplification of mental illness as "brain disorder," supporting instead transactional models which account for the dynamic interplay of genes, neurobiology, environment, and self across development and which are consistent with both compassion and societal responsibility. Finally, we consider educational and policy-related initiatives regarding the destigmatization of mental disorder. We conclude that attitudes and policy regarding mental disorder reflect, in microcosmic form, two crucial issues for the next century and millennium: (a) tolerance for diversity (vs. pressure for conformity) and (b) intentional direction of our species' evolution, given fast-breaking genetic advances.

Attitude to Health↗
PubMed2003

Effects of historic PCB exposures on the reproductive success of the Hudson River striped bass population.

Scientists and regulatory agencies have expressed concern that exposures to polychlorinated biphenyls (PCBs) might be contributing to reductions in the abundance of fish populations exposed to these chemicals. The specific effects of concern involve impairment of fish reproduction, including both reduced egg production and decreased viability of eggs and larvae. We tested hypotheses concerning the effects of PCBs on fish populations using long-term data sets available for the striped bass population of the Hudson River, NY, a population that has long been a subject of regulatory concern because of potential effects of PCB exposures. The data sets examined include both measurements of PCB concentrations in adult female striped bass over the period from 1976 through 1997 and estimates of the numbers of striped bass eggs, larvae, and juveniles produced annually during this same period. We found strong correlations between estimates of the abundance of spawners and the number of eggs and larvae produced by those spawners and also between independent estimates of year-class strength derived from different sampling programs. However, we found no relationships between PCB exposure and any measure of striped bass abundance or reproduction. Although inconsistent with the expected effects of PCB exposures, trends in all measures of striped bass abundance and reproductive success were consistent with the expected effects of striped bass harvest restrictions that were imposed during the 1980s. Our results demonstrate a need for caution in inferring risks to populations in nature from effects observed in laboratory studies.

Animals↗
PubMed2004

Mycotoxin risk assessment for the purpose of setting international regulatory standards.

The 2003 Council for Agricultural Science and Technology Mycotoxin report states that one 21st century goal is the development of uniform regulations worldwide for foodborne mycotoxin contamination. This study informs that endeavor by a risk assessment and economic analysis of two important mycotoxins: fumonisins and aflatoxins. The goals are to identify the nations that would be most heavily impacted by tighter mycotoxin regulations, examine costs and benefits as a function of regulatory stringency, and address risk-risk tradeoffs between health benefits and economic losses from compliance with those regulations. Among industrial nations, the United States would experience the heaviest economic losses from more precautionary mycotoxin standards. Environmental conditions in the developing world, however, are more conducive to mycotoxin accumulation in crops. Contrary to concerns expressed among policymakers, the less developed countries that would likely experience the greatest loss from tighter mycotoxin standards are not sub-Saharan African nations, but China and Argentina. If a fumonisin standard of 0.5 mg/kg were adopted worldwide, total export losses from fumonisins in corn may exceed 300 million dollars annually: 3-fold higher than if the less stringent U.S. standard of 2 mg/kg were adopted. Likewise, export losses from aflatoxins in peanuts may exceed 450 million dollars under the current EU regulatory standard of 4 microg/kg: almost 5-fold higher than if the U.S. standard of 20 microg/kg were adopted. Stricter standards are unlikely to improve health significantly. In developing nations such as China where hepatitis B and C are prevalent, tighter aflatoxin standards may increase health risks until improved control methods for aflatoxins are found, as high-quality crops may be exported instead of being consumed domestically.

Aflatoxins↗
PubMed2005

Evaluation of pheromone release from commercial mating disruption dispensers.

Pome fruit growers and crop consultants have expressed concerns about the seasonal release performance of commercial codling moth mating disruption dispenser products. Because of these concerns, we developed a laboratory flow-through volatile collection system (VCS) for measuring the volatile release of the codling moth sex pheromone, codlemone, from commercially available hand-applied dispensers. Under controlled air-flow and temperature conditions, the released vapor was trapped onto a polyurethane foam adsorbent followed by solvent extraction, solvent reduction, and GC/MS determination. Method recovery and breakthrough validations were performed to demonstrate system reliability before determining codlemone release from commercial dispensers field-aged over 140 days. The volatile collection was carried out in a consistent manner among five dispenser types most commonly used by growers, so that direct comparison of performance could be made. The comparison showed differences in the amount of pheromone released and in the patterns of release throughout the season between dispenser types. The variation in release performance demonstrates the need for routine evaluation of commercially marketed mating disruption dispensers. We believe that the simple and cost-effective volatile collection system can assist pheromone dispenser manufacturers in determining seasonal dispenser performance before new products are introduced into the commercial market and in rapidly verifying dispenser release when field-aged dispenser efficacy is in question.

Agriculture↗
PubMed1997

Radio frequency radiation (RFR): the nature of exposure and carcinogenic potential.

Epidemiologic evidence on the relation between radio-frequency radiation (RFR) and cancer is reviewed. Radio-wave communications are used extensively in modern society; thus, we are all subject to RFR created by radio, television, wireless telephony, emergency communications, radar, etc. Interest in the health effects of RFR has been motivated by the rapid growth in wireless communications and by media reports expressing concern that specific diseases may be caused by RFR exposure, e.g., from cellular telephone handsets. Due to the ubiquitous presence of RFR, the public health implication of any connection between RFR and cancer risk is potentially significant. (It is important to keep RFR distinct from power-line electromagnetic fields.) Comparison of potential risks from RFR exposure with other occupational and environmental health risks requires evaluating the level of support from available epidemiology, from studies with laboratory animals, and from mechanistic or biophysical information about the interaction of RFR with living tissues. A large number of studies have been done with laboratory animals and with in vitro systems; a more limited set of epidemiologic studies is available. Effects from RFR exposure that lead to temperature increases have been consistently reported, but 'non-thermal' effects have not been substantiated. Also, there are no mechanistic theories that support 'non-thermal' interactions with biology. Evidence to support a causal relationship between exposure to RFR and human cancers is scant. Our present state of knowledge about exposure, mechanisms, epidemiology, and animal studies does not identify significant cancer risks.

Animals↗
PubMed2002

The lay user perspective on the quality of pharmaceuticals, drug therapy and pharmacy services--results of focus group discussions.

BACKGROUND: This article presents the results of a study on quality of pharmacy services and perceived risk of pharmaceuticals. The results presented here are part of a multi-study evaluation of major changes in drug distribution in Iceland. OBJECTIVES: This sub-study addressed the question: what is the lay user perspective on pharmaceuticals and pharmacy services, including their perception of risk? METHODS: To answer this question, seven focus group discussions were conducted with pharmacy customers in different locations in Iceland following new drug distribution legislation in 1996. RESULTS: The lay perspective emphasizes a definite split between lay and expert views on the value and quality of pharmaceuticals, drug therapy and pharmacy services, as well as in their assessment of risk. Participants voiced spontaneous criticism of the roles of both physicians and pharmacists in drug therapy; and expressed concern about the quality and safety of pharmaceuticals. Some scope for shared values was noted between the legislative goals and the lay user perspective, despite the fact that the public was in no way involved in the drafting of the new legislation. CONCLUSION: The results of this study raise questions about the nature and extent of the perceived gap between the medical and pharmacy professions on the one side and the lay public and health policy decision-makers on the other side in their views on the quality and safety of pharmaceuticals and pharmacy services.

Adult↗
PubMed2003

Legal interventions for child victims.

Many commentators have expressed concern over the plight of children in the nation's court system, fearing that child victim/witnesses might suffer significant trauma. In efforts to alleviate this presumed trauma, new laws were passed and traditional procedures were modified. This paper synthesizes available research addressing 2 questions pertaining to the mental health needs of child victims: (1) To what extent are children traumatized by their involvement in the justice system, and (2) What interventions are effective in reducing children's trauma? The review concludes that most children can testify without suffering long-term adverse effects. It also identifies elements of the justice system that appear to heighten stress for children. Finally, it suggests several strategies that might be effective in alleviating that stress.

Child↗
PubMed2004

HIPAA transition: challenges of a multisite medical records validation study of maternally linked birth records.

Numerous researchers have expressed concern over the impacts on medical records availability of the newly effective Medical Information Privacy rule, as authorized by the Health Insurance Portability and Accountability Act (HIPAA). The increased costs associated with compliance with the rule, and the increased potential for financial liability, raises the possibility that hospitals may be less likely to participate in such research, resulting in a decrease of the validity of multisite studies designed to represent an entire population. Our multisite medical record validation study, designed to assess the accuracy of maternally linked birth records, provides an overview of a number of HIPAA implementation challenges. We found that the new HIPAA rule presents new challenges for those who rely on the release of medical record information for epidemiologic research. At the very minimum, increased compliance costs associated with human subjects protection and increased administrative burden for researchers would seem to be inevitable as medical institutions address the requirements of the new HIPAA rule by instituting more complex and thus more cumbersome procedures. Researchers should anticipate increased costs and plan accordingly when budgeting for human subjects review processes.

Birth Certificates↗
PubMed2003

Predicting the spread of herbicide resistance in Australian canola fields.

A common concern expressed about the commercial release of transgenic canola into cropping systems is the risks of unwanted gene flow between varieties. Experimental data is emerging that answers some of the theoretical questions that have been posed when considering gene flow on a landscape scale. This study developed models that utilise some of this published data in an attempt to quantify the spread of transgenes in a commercial farming system. The models, which included bootstrapping the empirical data and three mathematical simulations, were compared with each other and the published data. One of the mathematical models estimated average resistance frequency by imposing a Poisson distribution around the published mean value for a single transgenic field surrounded by conventional canola fields and the other two were derived from the theory that pollen flow decreased with distance in the form of a log decay curve. The predictions of all models suggested that the average frequency of resistance occurring from pollen flow in neighbouring canola fields, even when multiple transgenic fields are adjacent to the conventional fields, are likely to be below the current internationally accepted thresholds for contamination.

Australia↗
PubMed2003

Quality of life of children and adolescents after kidney or liver transplantation: child, parents and caregiver's point of view.

A cross-sectional study was performed to assess quality of life (QoL) after kidney or liver transplantation during childhood. Self-questionnaires explored children, adolescent and parent QoL. Seventy-five transplant children, 36 transplant adolescents, 67 mothers, 34 fathers and 67 caregivers filled out the questionnaires; they were compared with a reference population. Children reported a rather good QoL, but their extra-family involvement appeared not as satisfactory as that of the reference population children. Adolescents reported a very high QoL when completing the structured format scale; however, their responses to open-ended questions showed qualitative differences compared with those of a reference population: they expressed concern about their body or health, less pleasure than ordinary adolescents to manage by themselves, and a poor relationship with peers. Mothers indicated a deep impact of the child's illness on their own QoL, and the need for psychological support. In conclusion, a rather good QoL is a long-lasting feature of kidney and liver transplantation in children. Such an assessment is mandatory to identify remaining impairments in some selected areas, either in the recipient or family.

Adolescent↗
PubMed2002

Evaluation of an undergraduate community-based course in Family Dentistry.

This study aimed to determine dental students' expectations of attending a community clinic to provide family dental care and to assess how well the course met their expectations. Prior to the start of the course, 30 final year students were asked about the type and number of patients they expected to treat, the types of treatment they thought they would provide and additional skills, if any, they might gain and also about any worries they had about the course. The responses were used to compile a questionnaire, completed by the students after finishing the course. The students treated more patients a day than expected and underestimated the range of treatments carried out at the clinics, particularly trauma and advanced restorative work. Additional communication skills and increased confidence and quality of work were among the cited gains. Concerns expressed prior to the course had largely been eliminated, although some students still had reservations about National Health Service paperwork, treatment planning and running late. It was concluded that The Family Dentistry Course more than fulfilled students' expectations and it gave them enhanced skills in patient management and clinical competency.

Adult↗
PubMed1991

Psychopathy and the DSM-IV criteria for antisocial personality disorder.

The Axis II Work Group of the Task Force on DSM-IV has expressed concern that antisocial personality disorder (APD) criteria are too long and cumbersome and that they focus on antisocial behaviors rather than personality traits central to traditional conceptions of psychopathy and to international criteria. We describe an alternative to the approach taken in the rev. 3rd ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R; American Psychiatric Association, 1987), namely, the revised Psychopathy Checklist. We also discuss the multisite APD field trials designed to evaluate and compare four criteria sets: the DSM-III-R criteria, a shortened list of these criteria, the criteria for dyssocial personality disorder from the 10th ed. of the International Classification of Diseases (World Health Organization, 1990), and a 10-item criteria set for psychopathic personality disorder derived from the revised Psychopathy Checklist.

Antisocial Personality Disorder↗
PubMed1996

Perceptions of baby talk, frequency of receiving baby talk, and self-esteem among community and nursing home residents.

Community-living seniors (n = 113) and nursing home residents (n = 43) provided their impressions of baby-talk and neutral-talk scenarios and completed measures of functional health, need for succorance, and self-esteem. Two orthogonal dimensions were found in perceptions of baby talk: Warmth and Superiority. The personality trait of need for succorance was consistently associated with perceptions of warmth in baby talk, whereas functional health, age, and institutionalization were associated with perceptions of superiority. Significant interactions were found between perceptions of baby talk and frequency of receiving baby talk in the prediction of self-esteem, providing suggestive evidence for previously expressed concerns about potentially harmful effects of receiving baby talk on self-esteem among seniors who have negative perceptions of baby talk. However, older persons with positive perceptions of baby talk reported higher self-esteem when they frequently received baby talk, in accordance with person-environment theory. The self-esteem interaction for men occurred on the Superiority dimension, whereas the interaction for women occurred on the Warmth dimension.

Activities of Daily Living↗
PubMed1992

Moderated regression analysis and Likert scales: too coarse for comfort.

One of the most commonly accepted models of relationships among three variables in applied industrial and organizational psychology is the simple moderator effect. However, many authors have expressed concern over the general lack of empirical support for interaction effects reported in the literature. We demonstrate in the current sample that use of a continuous, dependent-response scale instead of a discrete, Likert-type scale, causes moderated regression analysis effect sizes to increase an average of 93%. We suggest that use of relatively coarse Likert scales to measure fine dependent responses causes information loss that, although varying widely across subjects, greatly reduces the probability of detecting true interaction effects. Specific recommendations for alternate research strategies are made.

Adult↗
PubMed2000

Null hypothesis significance testing: a review of an old and continuing controversy.

Null hypothesis significance testing (NHST) is arguably the most widely used approach to hypothesis evaluation among behavioral and social scientists. It is also very controversial. A major concern expressed by critics is that such testing is misunderstood by many of those who use it. Several other objections to its use have also been raised. In this article the author reviews and comments on the claimed misunderstandings as well as on other criticisms of the approach, and he notes arguments that have been advanced in support of NHST. Alternatives and supplements to NHST are considered, as are several related recommendations regarding the interpretation of experimental data. The concluding opinion is that NHST is easily misunderstood and misused but that when applied with good judgment it can be an effective aid to the interpretation of experimental data.

Data Interpretation, Statistical↗
PubMed1990

Injuries to elite wheelchair athletes.

The purpose of this project was to describe the nature, type, and frequency of athletic injuries incurred by the elite wheelchair athlete. Nineteen athletes participated in a 1-year injury recall study at an elite wheelchair training camp. An injury was defined as anything the athlete expressed concern about and (a) caused a loss of participation due to an injury or illness or (b) an injury in which a fracture, dislocation, or subluxation occurred and the athlete was able to continue participation. There were 10 male and 9 female subjects who reported their injuries from 1 June 1987 to 31 May 1988. Fifty injuries were reported, strains and muscular injuries accounted for almost half of the injuries. Physicians were the primary care provider for 37% of the injuries, followed by physical therapists and athletic trainers at 26% and 15% respectively. Slightly over 57% of the injuries were classified as minor, missing 7 days or less of participation and 32% were classified as major, missing 22 days or more of participation. The upper extremity was the most frequently injured, followed by the lower extremity, head and spine, and illnesses. Conventional treatments of ice, heat, modalities, and medications, were the most common methods of treating these injuries. Flexibility and strength training programmes should be implemented throughout the competitive season. Careful consideration of the training programme and workout intensity should also be evaluated.

Arm Injuries↗