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Negotiating cultural consensus in a breast cancer self-help group.

This article describes a shared model of the breast cancer experience negotiated by the members of a spontaneously organized breast cancer self-help group in eastern North Carolina. In the course of sharing their personal experience narratives with one another, these women worked to negotiate points of agreement among the varying sources of knowledge and oftentimes conflicting belief systems they held about breast cancer. The synthetic model they created rejected many of the assumptions underlying the dominant biomedical view of cancer "survivorship," particularly its emphasis on the autonomous individual as decision maker and its attendant male-gendered sports and military imagery--assumptions that often implicitly structured the agendas and topics discussed in the formal, medically sanctioned support groups these women found unappealing. The implications for theories about the construction of shared cultural models and for continuing efforts to design support groups to meet the needs of a diverse patient population are explored.

Black or African American↗

Children's sleep: an interplay between culture and biology.

Pediatricians provide a major source of knowledge for parents about children's behavior and development, although their advice is largely based on their own cultural values and beliefs in interaction with their personal and clinical experience. This review presents cross-cultural aspects of children's sleep behavior in industrialized and complex modern societies and provides a basis for understanding dimensions and mechanisms of cultural differences. We submit that it is the interaction between culture and biology that establishes behavioral and developmental norms and expectations regarding normal and problematic children's sleep. Pediatricians need to recognize the cultural environment in which children live and be knowledgeable about how cultural beliefs and values of both families and physicians interact with the needs and biological characteristics of individual children.

Adolescent↗

[Group process in nursing: possibilities and limits].

This work shows studies and reflections about the utilisation of groups in nursing assistance. As an aim sought to identify, through nurses perspective, aspects about their motivations to work with groups, their source of knowledge and relevant points of their experience with groups. The results demonstrates that nurses recognise the therapeutic value of groups in assistance and provide suitable conditions to its development. However, difficulties to handling groupal situations are limiting elements to develop this activity that reveal the human sentiment meander, indicating that nurse group co-ordinator needs, beyond theoretical establishment, to practice by their self-knowledge to provide an ambient and a interpersonal relationship able to obtain the real significance of this activity.

Attitude of Health Personnel↗

Referrals by traditional birth attendants in northeast Brazil.

Between October 1980 and July 1981, 1,878 women were attended by traditional birth attendants (TBAs) at four obstetric units in rural areas surrounding the city of Fortaleza in Northeast Brazil. Of these women, 232 (12.4 per cent) were referred to a hospital in Fortaleza for delivery. The most important indicators for referral to hospital were: presence of an antenatal problem, complication of labor, or malpresentation. Based on record review, 65 referred women with none of these conditions were classified as low risk and 42 women not referred were classified as high risk (at least one such condition present). Of 1,878 deliveries, 32 (17 per 1,000) terminated as fetal deaths, and 12 infants died before discharge from hospital or obstetric unit (six per 1,000). The death rate was much higher for the high-risk cases (156 per 1,000 referrals, 95 for nonreferrals). Although some women may have been inappropriately referred while others who should have been were not referred, the system of referral has allowed TBAs to attend uncomplicated deliveries and to refer women with complications.

Adolescent↗

Coping with schizophrenia: patterns in later adulthood.

By exploring the subjective experience of older people, this study investigated whether the coping framework developed with younger adults with schizophrenia could be applied to people with schizophrenia over the age of 50 years. Fifteen participants diagnosed with schizophrenia, over the age of 50, were recruited from clubhouses and given a semi-structured interview to identify what, if any, coping strategies were used to manage persistent symptoms. The results indicated that the coping strategies used by this older sample were similar to those reported by earlier studies with younger populations. However, it was reported that the efficacy of the coping strategies had increased as the participants had grown older and accepted their illness. Older adults with schizophrenia are capable of employing strategies to manage their illness and should be considered an important source of knowledge for younger individuals who struggle with the illness and for mental health professionals who work with the chronically mentally ill.

Adaptation, Psychological↗

Ethno-social peculiarities of the reproduction of the intelligentsia.

Trends in the formation of a multiethnic intelligentsia in the USSR are analyzed. "Fundamental attention [is] given to the numerical dynamics of students and specialists from the indigenous population within the over-all makeup of the intelligentsia; to factors ensuring a stable reproduction of a non-Russian intelligentsia; to peculiarities of the ethnic composition of the intelligentsia in the various republics; and to the role of the geographical mobility of school graduates and young specialists in the formation of the ethnic make-up of the student body and the intelligentsia." The analysis concerns the nationalities for which the various republics are named.

Behavior↗

Outcomes of an AIDS prevention program for methadone patients.

Methadone maintenance patients are at risk of contracting or transmitting HIV through intravenous drug use and/or unsafe sexual practices. An outcome evaluation of a voluntary AIDS prevention program for methadone patients in three clinics (two experimental, one control) is reported. The prevention program included three components: didactic AIDS education, HIV antibody counseling/testing, and facilitated peer support groups. Participation in AIDS education was associated with increased knowledge of AIDS risks and with improved attitudes toward condoms. Peer group participation was associated with improved attitudes toward the use of condoms and with increased use of condoms. Learning of HIV seronegativity was related to increased self-efficacy and decreased intravenous drug use risk behaviors. Rates of participation in the prevention program were disappointing, but the program seemed beneficial for those patients who did become involved.

Acquired Immunodeficiency Syndrome↗

AI-generated familiarity estimates are a useful new source of information about word knowledge in Simplified Chinese.

This study evaluated the usefulness of AI-generated estimates of word familiarity for predicting word difficulty in Simplified Chinese, building on previous research in alphabetic languages. We found that familiarity estimates produced using large language models (LLMs) showed moderate-to-strong correlations with human familiarity ratings. These LLM estimates were the most effective predictors of both word naming and lexical decision times, surpassing traditional metrics such as word frequency and human familiarity ratings, while the latter still provided modest, non-overlapping variance. GPT-4o with English instructions produced superior results compared to the Chinese-centered models currently available. The results imply that LLM familiarity estimates are a valuable resource for Chinese psycholinguistics, supporting work across experimental design, modeling, and norming. We release familiarity estimates for 27,624 words for unrestricted research and educational use.

Humans↗

AIDS in Thailand.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

A method of self-directed learning in continuing medical education with implications for recertification.

A method of self-directed learning for physicians that can be used to satisfy a portion of specialty board recertification requirements integrates contract learning (self-formulated learning plans), information brokering (linking physicians with consultants and community resources), and collegial networking (discussion groups). The method encourages physicians to focus on educational objectives, supplies learning resources, and promotes interactions with colleagues in study groups. Fifty-nine (53%) of the 102 learning goals update physicians' knowledge. Print sources and discussions with experts were the commonest resources used. Forty-five (49%) of 91 participants completed their learning plans. Forty-nine (74%) completed projects were judged successful in achieving their goals. Twenty-five (45%) of 56 physicians responding to a questionnaire stated that the method was superior to traditional continuing medical education. Fifty-two percent of the participants found the method as effective as traditional continuing medical education. Proof of accomplishment allows the method to be used as part of a specialty board recertification process.

Certification↗

The Women and Infants Demonstration Project: an integrated approach to AIDS prevention and research.

The Women and Infants Demonstration Project is a multisite, behavioral intervention research effort funded by the Centers for Disease Control. The project is evaluating a theory-based, integrated intervention model to increase the use of condoms for prevention of both sexually transmitted diseases (STDs) and unintended pregnancy among women and their partners at risk of infection with HIV. The importance of utilizing carefully targeted, credible and persistent risk reduction interventions to effect lasting behavior change has become evident over the last ten years of the AIDS epidemic. The theory-based intervention components being evaluated in this intervention study involve one-on-one stage-tailored outreach; the development and distribution of community-tailored HIV prevention materials, called role-model stories; and the development of organizational and peer networking, all within a community mobilization framework. This article describes each of the intervention components being evaluated during this 5-year study. Such an intervention effort represents an important contribution in the design of community-level AIDS prevention intervention efforts which support individual-level behavioral changes by women at risk for HIV and other sexually transmitted infections.

Adolescent↗

Gallup charity survey shows giving patterns.

The Coalition of National Voluntary Organizations undertook this survey to broaden understanding of contribution habits. The results provide a rich source of knowledge about giving patterns and insight into America's giving habits.

Charities↗

A psychosocial model of health behavior: implications for nutrition education, research and policy.

The paper presents a multidimensional psychological model of determinants of health behavior, tested empirically in three countries to ascertain its validity. The model postulates that given that ethnic, socioeconomic, and biological statuses (exogenous variables) are homogeneous, a health risk-taking behavior in a population is a function of direct, additive, and interaction effects of five categories of independent variables both internal to the persons and external in the action environment. Although the model is tested on contraceptive behavior, it is argued that the determinants and basic processes of this risk-taking behavior are similar to those involved in other health risk behaviors and that the five basic factors identified affect nutritional behaviors as well. The paper presents several broad implications on the model for nutrition education and research; but holds that specific implications could be best derived by the specialists in nutrition field.

Contraception↗

[Sources of finance for provincial occupational health services. Theory and practice].

The financing of occupational health services (OHS) at the provincial level is an important issue in view of the transformation process going on not only in OHS but also in the overall health care system in Poland. New principles of financing must be now based on the cost and effects analyses. Thus, the question arises on how to provide financial means adequate to needs of health care institutions resulting from their tasks and responsibilities. The gaps existing in the information system have encouraged us to examine the situation in regard to the structure of financing and internal allocation of financial means. The objectives were formulated as follows: to characterise the sources of financial means received by provincial OHS centres; to analyse the structure of financial means derived from various sources, taking into account forms of financial administration, using the data provided by selected centres; to define the relation between the financial means being at the disposal of OHS centres and the scope of their activities; The information on the financing system was collected using a questionnaire mailed to directors of selected OHS centres. The information collected proved to be a valuable source of knowledge on the above mentioned issues as well as on how far the new system of financing associated with a new form of financial administration--an independent public health institution--has already been implemented. The studies indicated that at the present stage of the OHS system transformation it is very difficult to formulate conclusions on the financing administration in provincial OHS centres.

Capital Financing↗

Ecological factors associated with adolescent pregnancy: a review of the literature.

Adolescent pregnancy, the disproportionate number of births to unmarried adolescents, the potential disadvantages for both mothers and their children, and the commensurate costs to society have received the attention of researchers in a variety of disciplines. This article reviews and synthesizes the disparate literature on psychosocial factors associated with adolescent pregnancy using Bronfenbrenner's ecological model. Social influences within the macrosystem, mesosystem, and microsystem are examined. Policy and service delivery recommendations are offered.

Adolescent↗

[Health outcomes research].

Health outcomes research (HOR) is an important source of knowledge regarding the effectiveness of health care treatments and interventions which focus on providing benefits in terms of those results which are important for patients. Medical research has traditionally focussed on the measurement of clinical variables, such as symptoms or laboratory tests, as a means of determining the results of medical interventions. Although HOR uses such tests, it also places great emphasis on the use of other measures such as health-related quality of life, satisfaction with treatment, and cost-effectiveness. The results obtained should be incorporated in the evaluative process and in disease management to determine the effectiveness of health care services in improving the population's health.

Cost-Benefit Analysis↗