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PubMed2006

The internet as a research tool in the study of associative learning: an example from overshadowing.

The present study aimed to replicate an associative learning effect, overshadowing, both in the traditional laboratory conditions and over the internet. The experimental task required participants to predict an outcome based on the presence of several cues. When a cue that was always trained together with a second cue was presented on isolation at test, the expectancy of the outcome was impaired, which revealed overshadowing. This experimental task was performed by undergraduate students (N=106) in the laboratory and by a different set of anonymous participants over the internet (N=91). Similar levels of overshadowing were obtained in both locations. These similarities show that web-delivered experiments can be used as a complement of traditional experiments.

Association Learning↗
PubMed2006

Family dinner meal frequency and adolescent development: relationships with developmental assets and high-risk behaviors.

PURPOSE: To examine associations between family meal frequency and developmental assets and high-risk behaviors among a national sample of adolescents. METHODS: Anonymous surveys were distributed to 99,462 sixth to 12th grade students from public and alternative schools in 213 cities and 25 states across the United States. Logistic regression analyses tested differences in assets and high-risk behaviors by family dinner frequency. RESULTS: Consistent positive associations were found between the frequency of family dinners and all developmental assets, including both external (e.g., support, boundaries and expectations; odds ratio [OR] 2.1-3.7) and internal assets (e.g., commitment to learning, positive values, social competencies, and positive identity; OR 1.8-2.6); relationships were attenuated, but remained significant after adjusting for demographics and general family communication and support. Consistent inverse relationships were found between the frequency of family dinners and all high-risk behaviors measured (i.e., substance use, sexual activity, depression/suicide, antisocial behaviors, violence, school problems, binge eating/purging, and excessive weight loss; OR .36-.58), relationships were attenuated, but remained significant after adjusting for demographics and family factors. CONCLUSIONS: The findings of the present study suggest that the frequency of family dinner is an external developmental asset or protective factor that may curtail high-risk behaviors among youth. Creative and realistic strategies for enhancing and supporting family meals, given the context within which different families live, should be explored to promote healthy adolescent development. Family rituals such as regular mealtimes may ease the stress of daily living in the fast-paced families of today's society.

Achievement↗
PubMed2001

A survey on parent-child conflict resolution: intrafamily violence in Italy.

OBJECTIVE: The purpose of this paper was to investigate factors associated with intrafamily violence toward children in Italy. Family structure and the characteristics of both caretakers and children were explored. Their association with the incidence of minor and severe violence was analyzed to test the hypothesis that child physical abuse is related to a combination of different factors involving the family as a whole. METHOD: This research was carried out by submitting an anonymous questionnaire to 2388 families residing in Tuscany, Italy. The form included two sections, one related to the family cultural substrate, and to potentially influential events affecting the family during the year 1998. The other one, taken from the conflict tactics (CT) scales, presented a hierarchy of possible responses to conflict. RESULTS: Physical punishment appeared to be a general behavior in Italy, because the incidence of minor violence was 77%. The incidence of severe violence was about 8%. When considering family, caretaker, and child characteristics mostly associated with physical punishment in Italy, we found that families with a low income, where caretakers had health problems or were stressed, and with younger and more "problematic" children presented the highest risk of intrafamily violence during conflict resolution. CONCLUSIONS: The results point to the importance of a balance between potentiating and compensatory factors in complex and dynamic relationships among family members, to avoid strategy resolution of conflict ultimately leading to violence. Moreover, minor and severe violence appeared to be two related but different phenomena.

Adult↗
PubMed2000

[Postcoital hormonal contraception: study on the attitudes and prescription of primary care physicians].

OBJECTIVE: To study the understanding, attitudes and practice of primary care doctors in the prescription of hormonal post-coitus interception, along with the social and demographic, educational, legal and ethical variables associated with this prescription. DESIGN: Cross-sectional descriptive study. SETTING: Area IV de INSALUD in Asturias. PARTICIPANTS: Family doctors, excluding locums (n = 178). MEASUREMENTS AND RESULTS: An anonymous self-administered questionnaire with 33 questions, re-sent once, between November 1999 and February 2000. The association-independence of variables was contrasted through the chi 2 test (a statistically significant association if p < 0.05). 77% responded, 51% of whom were men. Average age was 43 (SD = 6.69), with professional experience of 17 years worked (SD = 6.87). 47% were family doctors and 39% general practitioners. 85% worked in health centres; 46% in urban settings. 71% were catholics, 73% (95% CI: 66%-80%) had been asked on at least one occasion in the previous six months for the post-coitus pill (PCP), with demand greater in the urban environment (83%). 18% considered the PCP an abortion method. 88% said they would prescribe it (95% CI: 82.5%-93.5%), of which 30% (95% CI: 16%-44%) did so according to WHO recommendations. 100% of the "non-prescribers" were catholics. CONCLUSIONS: Most doctors receive requests for the PCP and prescribe it on demand, though prescription varies with age, categories and, in particular, religious belief. Only a third prescribes according to WHO recommendations.

Adult↗
PubMed1994

Improving medical residents' attitudes toward HIV-infected persons through training in an HIV staging and triage clinic.

PURPOSE: To assess the effect of a weekly outpatient clinic for staging and triage of newly identified human-immunodeficiency-virus (HIV)-infected patients on medical residents' attitudes and knowledge regarding care of HIV-infected persons. METHOD: Twenty-one second- and third-year medical residents who participated in the Diagnostic Evaluation Unit (DEU) of Boston City Hospital's Clinical AIDS Program from July 1991 through December 1991 were matched with a control group of 20 residents. Both groups of residents were asked to anonymously complete self-administered questionnaires before, immediately after, and three months following the DEU rotation. Responses were compared using repeated measures analysis of variance, two-tailed t-tests, and chi-square analysis. RESULTS: Compared with the controls, the DEU residents showed an increased sense of feeling adequately trained to provide primary care to HIV-infected patients immediately after the rotation (p = .0002), which was sustained at the three-month follow-up (p < .001). Compared with the controls, the DEU residents also showed improved general attitudes toward treating persons with acquired immune deficiency syndrome, which persisted at the three-month follow-up, although these changes were not significant. CONCLUSION: The experience in an HIV staging and triage clinic had a positive effect on the confidence and attitudes of the medical residents. Similar training experiences may increase the willingness and capacity of physicians to provide primary care to HIV-infected persons.

Analysis of Variance↗
PubMed2006

The health beliefs of hospital staff and the reporting of needlestick injury.

AIM: The aim of this study is to examine the connection between the health beliefs of hospital staff (doctors, nurses and auxiliary staff) and their failure to report needlestick injuries. BACKGROUND: Needlestick injury to hospital staff is quite frequent and can result in infections and disease, but staff frequently do not report the injury despite their awareness of the risk of blood-borne pathogens. METHODS: Five questionnaires were constructed based on three existing research tools and were tested for validity and reliability. Two hundred and forty questionnaires were distributed to eight randomly chosen departments of a single Israeli hospital. Seventy-six percent of the questionnaires were anonymously completed and returned. RESULTS: Nurses had the highest rate of needlestick injury, followed by auxiliary staff and doctors. Auxiliary staff showed the highest rate of compliance with the duty to report such injuries, while doctors showed the lowest. Perceived severity of contractable disease, the perceived efficacy of reporting injuries and overall motivation to maintain health were the best predictors of reporting compliance. Non-compliers emphasized the negative aspects of reporting the injuries, primarily that it took up too much time. CONCLUSIONS: The solution to non-compliance with the duty to report must be a targeted investment in training and education. Relevance to clinical practice. Finding the reasons for compliance and non-compliance with the duty to report needlestick injuries will help in designing educational programmes for hospital staff and in determining a strategy for improving health behaviour.

Accidents, Occupational↗
PubMed2004

Hookups or health promotion? An exploratory study of a chat room-based HIV prevention intervention for men who have sex with men.

This study sought to explore an online intervention that was initiated by an AIDS service organization to reduce sexual risk within a geographically-oriented chat room frequented by men who have sex with men (MSM). Analyses of bio lines, user profiles, and chat room discussions were used to understand and characterize the online prevention intervention. Six predominate discussion topics were identified, including (a) sexual risk reduction strategies (e.g., safer "barebacking"), (b) HIV testing options, (c) local alternatives for nonsexual social support, (d) referrals for youth, (e) resources related to "coming out," and (f) access to risk reduction materials and supplies. The perceived anonymity promoted by the Internet and the health educator's established relationship with the men in the chat room contributed to the success of this intervention. This analysis suggests that an online HIV/AIDS prevention intervention may reach MSM inaccessible in traditional venues typically used for intervention delivery.

Adult↗
PubMed1999

Effects of executive function impairment on change processes and substance use outcomes in 12-step treatment.

OBJECTIVE: A strong clinical rationale exists to hypothesize that neuropsychological impairment interferes with treatment-initiated change, thereby leading to poor outcome. This study examined the relationship of executive function impairment, change process factors and substance use outcomes in a sample of substance users in intensive 12-step treatment. METHOD: Participants were 118 individuals entering residential or intensive day treatment at two traditional treatment programs. Participants were assessed at entry into treatment, at discharge from treatment, and at 1 and 6 months following treatment. Participants were administered a battery of measures to assess executive function impairment, processes hypothesized to mediate change in 12-step treatment, negative prognostic indicators and substance use outcomes. RESULTS: More than half the sample showed some form of executive function impairment. Executive function impairment did not directly predict worse substance use outcomes nor difficulty acquiring or maintaining change processes. However, impairment significantly moderated the relationship between change processes and outcome. Change processes were strongly related to outcome for unimpaired individuals but weakly related for impaired individuals. CONCLUSIONS: Executive function impairment is not a significant predictor of poor treatment response in 12-step treatment. However, analyses suggest that impaired and unimpaired individuals traverse different pathways in achieving equivalent outcomes.

Adult↗
PubMed1993

Religiosity and drug abuse among psychiatric inpatients.

Clinical impressions and data from a limited number of studies suggest that membership in certain groups such as Alcoholics Anonymous may promote well-being and abstinence from alcohol and drugs. The present study examines measures of religiosity and drug/alcohol consumption in an inpatient psychiatric population in order to test the possible association between these variables. One hundred sixty-eight adult admissions to a private psychiatric hospital were asked to complete the Religious Involvement Questionnaire (RIQ), a self-report instrument containing validated measures of intrinsic and extrinsic religiosity. Responses of general adult psychiatric patients (N = 103) were compared with those of patients admitted to a chemical dependence unit (N = 65). Correlations between alcohol/drug use and RIQ responses were measured for the entire sample. Patients admitted for chemical dependence were significantly less likely than general adult psychiatry patients to avoid certain food/music/drink because of their religion, and were less likely to help with the running of their church. Measures of alcohol, hallucinogen, and prescription drug consumption had significant negative correlations with religiosity scores. Chemically dependent patients differ from psychiatric patients with other diagnoses on measures of religiosity. Religious belief and involvement may be clinically relevant variables in the treatment outcome of chemically dependent patients.

Adult↗
PubMed1996

[The development of a test for evaluating the knowledge of and attitudes on human immunodeficiency virus infection in primary health care professionals].

OBJECTIVE: To compose both a multiple choice test (MCT) to evaluate primary care professionals' understanding of HIV infection and a scale to measure their attitudes towards it. DESIGN: Validation of questionnaires. SETTING: Ciutat Vella health district (City of Barcelona) and university teaching hospitals in Barcelona. PARTICIPANTS: 11 residents specialising in contagious disease, 12 residents from other specialties, 32 general practitioners and 34 nurses from primary care, and 64 sixth-year medical students. INTERVENTIONS: A self-filled, anonymous questionnaire, completed under supervision. MEASUREMENTS AND MAIN RESULTS: All subjects answered a MCT with 21 questions of 4 reply options about their understanding of HIV infection, as well as a Likert-type 5-point attitudes scale containing 10 items. One question on the MCT was eliminated because of Lack of discrimination. The test of understanding gave the PC professionals sufficient guarantees of reliability and validity. CONCLUSIONS: A useful questionnaire for assessing PC professionals' understanding and attitudes towards HIV infection has been gained.

Acquired Immunodeficiency Syndrome↗
PubMed2005

The gambling follow-up scale: development and reliability testing of a scale for pathological gamblers under treatment.

OBJECTIVE: To provide preliminary data on the Gambling Follow-Up Scale (GFS), a new scale assessing recovering gamblers. Secondary goals included assessing the impact of "work status," "family relationship," "leisure," and "enrolment in Gamblers Anonymous (GA)" on gambling (all items from the scale), together with the impact of treatment. METHOD: Using the GFS, 3 independent raters interviewed gamblers under treatment. The sample was collected in 2 university centres in the city of São Paulo, Brazil. Patients attended psychotherapy coupled with psychiatric follow-up, participation in GA, or both. RESULTS: We interviewed 47 pathological gamblers; 13 were interviewed twice, with a minimum interval of 6 months, for a total of 60 GFS interviews. Interviews took on average 6.0 minutes, SD 2.7. Interrater concordance ranged from 82% to 95% (intraclass correlation coefficient range 0.85 to 0.99, P < 0.001). A factorial analysis showed a 1-factor solution (Eigenvalue = 2.4, 47.6% of total variance accounted). "Leisure," "frequency and time gambling," and "family relationship" showed considerable loadings (0.84; 0.71; 0.71),whereas "enrolment in GA" and "work status" showed moderate loadings (0.59; 0.56). A linear regression model significantly correlated gambling (R2 = 0.356; P < 0.001) with "leisure" and length of treatment. Treatment modalities affected "leisure" (F2,43 = 5.00, P = 0.011), with GA attendees reporting more regular and gratifying activities. CONCLUSIONS: The GFS showed interrater reliability and construct validity. More leisure and lengthier treatment were significantly relAted to less gambling. GA enrolment seemed to particularly benefit the quality of leisure. Future studies could profit from the quickness and simple structure of the GFS in providing shareable outcome measures.

Adult↗
PubMed2001

Anonymous reporting of HIV infection: an evaluation of the HIV/AIDS surveillance system in Norway 1983-2000.

Several European countries are considering implementing surveillance systems for HIV infection, but questions remain regarding patient confidentiality. The population-based HIV/AIDS surveillance system in Norway integrates anonymous HIV case reports from laboratories and clinicians and named AIDS case reports. This evaluation includes a description of the system, evidence of system attributes, estimation of resources for system operations, and documentation of the system's usefulness. HIV case reports provide a far better picture of the epidemic than AIDS reports. The median delay between positive HIV test and reporting was 30 days (interquartile range 18-49 days). Completeness of demographic and epidemiologic information in the surveillance database ranges from 60 to 100%. Information on pre-AIDS mortality and emigration is incomplete. The system cost euro 25,200 in 1999. Results are published every week and used for planning of health care and prevention. We conclude that the Norwegian surveillance system with anonymous reporting of HIV cases is simple, inexpensive and flexible, and capable of providing a representative and timely overview that guides prevention. The system fulfils its objectives while respecting confidentiality and adhering to ethical principles. A similar system may be considered in other countries.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Puerto Rican primary physicians' knowledge about folic acid supplementation for the prevention of neural tube defects.

BACKGROUND: We conducted a study of a group of primary physicians in Puerto Rico to evaluate their knowledge about folic acid supplementation to prevent neural tube defects. METHOD: The study design was transverse-correlational. A total of 66 primary physicians in two hospitals (public and private) participated in the study. The sample was nonrandom and opportunistic, and only those physicians present in the hospitals at the moment of distribution of the questionnaires participated. A self-administered and anonymous questionnaire was used. Descriptive statistics and cross-tabular analysis were used to describe the results of this study. Inferential statistics were also used, including Chi square and t-tests to establish the associations/differences between physician knowledge and the independent variables. RESULTS: Of the participants, 87.9% demonstrated an inadequate knowledge about folic acid supplementation for the prevention of neural tube defects as part of preconception care and only 12.1% demonstrated adequate knowledge. Older physicians had greater knowledge about folic acid. Also, women demonstrated greater knowledge about folic acid than did men. Most of the physicians who always recommend supplementation to their patients demonstrated a greater knowledge about folic acid, and all participants with adequate knowledge came from the public hospital. CONCLUSIONS: Despite a concerted effort by the Health Department of Puerto Rico to provide education in the importance of folic acid supplementation to reduce the incidence of neural tube defects, primary physicians in two Puerto Rican hospitals generally have not availed themselves of this training and showed a lack of knowledge on this important clinical issue.

Adult↗
PubMed2006

Placental trophoblast inclusions in autism spectrum disorder.

BACKGROUND: Microscopic examination of placental tissue may provide a route to assessing risk and understanding underlying biology of autism. METHODS: Occurrence of a distinctive microscopic placental morphological abnormality, the trophoblast inclusion, was assessed using archived placental tissue. The rate of occurrence of trophoblast inclusion-positive slides observed for 13 individuals with autism spectrum disorder (ASD) was compared to the rate in an anonymous consecutive birth cohort. RESULTS: The occurrence of inclusion positive slides was significantly greater in the ASD group compared to the control group (6/27 slides, 22.2% vs. 12/154, 7.8%; Fisher Exact Test, two-tailed p = .033; relative risk 2.85). The proportion of positive cases was also greater in the ASD group (5/13 cases, 38.5% vs. 8/61, 13.1%; Fisher Exact, two-tailed p = .044; relative risk 2.93). Behavioral severity scores did not differ across groups of inclusion positive (N = 4) and negative (N = 8) ASD individuals. CONCLUSIONS: Although probably not functionally detrimental or causative, the greater occurrence of placental trophoblast inclusions observed in ASD individuals may reflect altered early developmental processes. Further research is required to replicate the basic finding, to understand the basis for the trophoblastic abnormality, and to determine the utility of the measure in early detection of ASD.

Adolescent↗
PubMed2005

Childhood abuse in Swedish female users of psychiatric services.

INTRODUCTION: The aims of this study were to investigate: (1) the prevalence of childhood abuse in women admitted to psychiatric services in a county in the south of Sweden; (2) who the perpetrators were; and (3) the women's self-reported consequences of childhood abuse. METHOD: The study had a cross-sectional design and was a part of a more comprehensive study. An anonymous self-reported questionnaire was used which included both closed and open-ended questions. The data material were analysed by means of descriptive statistics, Mann-Whitney U-test and manifest content analysis. RESULTS: The total number of women who participated in the study was 259, 51% of whom reported experiences of abuse during childhood, with 53% of these having been exposed to more than one type of abuse. The most frequent perpetrator was the woman's parents; mainly the fathers but also the mothers turned out to be frequent perpetrators of abuse. Some 75% of the women reported current psychological problems in adulthood related to abuse in childhood. According to a manifest content analysis, five themes of self-reported psychological problems emerged: psychiatric problems, shortcomings in social relations, poor self-confidence, fears and bad memories.

Adolescent↗
PubMed1996

Unlinked anonymous HIV screening of pregnant women in a low-prevalence population.

Unlinked anonymous screening was optimized and used for a survey of HIV prevalence in Finland. In 1993, 66,170 serum samples, covering more than 99% of pregnant women in the country were tested in pools of 5 sera. The pools tested were coded but it was possible to trace the region from where the samples had been collected. A total of 5 positive samples were found corresponding to a prevalence of 1/13,000 (0.01%) which is in accordance with prevalence estimates from earlier serosurveys and the national HIV registry. Information from voluntary regional HIV-testing programmes for pregnant women indicated that probably at least 3 of these positive cases had been identified by voluntary testing. Nine commercial EIAs were evaluated to investigate the effect of pooling on sensitivity and specificity of anti-HIV detection. Only 3 EIAs detected all pools with known positive samples. Individual sera from repeatedly positive pools were tested using the same EIA and positive results were confirmed by Western blot. This algorithm saved more than 80% of the cost compared to the conventional test algorithm used in diagnostic laboratories. The savings were mainly due to the reduced number of primary and supplemental tests.

AIDS Serodiagnosis↗
PubMed1990

HIV infection among Quebec women giving birth to live infants.

This is the first anonymous unlinked seroprevalence study in Canada to use serum samples from newborns to determine the seroprevalence rate of human immunodeficiency virus (HIV) infection among childbearing women. Of the 68,808 samples tested 42 were confirmed as positive, for an overall crude seroprevalence rate of 6.1 per 10,000 live births (95% confidence interval [CI] 4.4 to 8.3), or 1 woman in 1638. Women who lived on Montreal island had an overall rate of 17.9 per 10,000 live births (95% CI 12.2 to 25.4), or 1 woman in 559. We observed a significant association between revenue index and seroprevalence; the rates were as high as 46.4 per 10,000 live births (95% CI 18.7 to 95.3), or 1 woman in 216, for Montreal island postal code areas with revenue indexes 20% or more below the provincial median. Extrapolation of the data suggested that 56 women with HIV infection gave birth to a live infant during 1989 in Quebec. Even though attempts to generalize the data from childbearing women to women of childbearing age have an inherent conservative bias, the results of our study suggest that 988 women (95% CI 713 to 1336) aged 15 to 44 years in Quebec had HIV infection in 1989. The actual number is likely substantially higher. The need for well-designed, creative interventions to prevent further HIV transmission to women is evident. Planning for the provision of medical and psychosocial services sensitive to specific needs of women who are already infected should start immediately.

Adolescent↗
PubMed1997

Let's party tonight: drinking patterns and breath alcohol values at high school parties.

BACKGROUND AND OBJECTIVES: This study sought to determine whether the number of alcohol-containing beverages consumed by adolescents attending a "typical" high school weekend party was planned or spontaneous. A second objective was to understand the role of the designated driver and whether he or she honored a pledge of sobriety. METHODS: A printed, anonymous survey with signed informed consent was distributed to 52 high school students from three different suburban high schools during three weekend high school parties. In addition, subjects underwent breath alcohol testing using the Intoximeter breath alcohol instrument. Salivary alcohol measurements were also obtained using Alco-Screen. Levels were measured in volunteers on entry and exit from the party. RESULTS: Fifty-two students volunteered to participate in the survey. Eleven participants volunteered to be designated drivers, nine of whom did not drink alcohol at this party. By the end of each party, the 26 boys had consumed a mean of 10 drinks, and the 16 girls had consumed 4.1 drinks, almost exactly what they had predicted at the time of arrival. By departure time, 22 (54%) of the drinkers had a breath alcohol value of .10 g/dL or greater, while only three (7%), had alcohol values of .02 g/dL or less. Blackouts were common and had been experienced by 73% of all the students surveyed. Twenty-seven percent of those surveyed had been involved in some form of physical violence while drinking. Eleven percent of the female participants reported being sexually assaulted while they or their attacker were drunk. Most of the 42 drinkers believed that it was acceptable for designated drivers to drink at least two beers. Two intoxicated designated drivers were driven home by sober friends. CONCLUSIONS: High school students in this study knew before attending a party the quantity of beer they would consume. Survey participants believed that it is acceptable practice for designated drivers to drink alcohol at parties; 13% of those who intended to drive after these parties were intoxicated.

Adolescent↗