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PubMed1994

A preliminary study of opening-up meditation college adjustment, and self-actualization.

The effects of opening-up meditation on college adjustment and self-actualization were examined with 45 subjects who were divided into groups for opening-up meditation, relaxation, and control using scores on the Anxiety Scale of the College Adjustment Scales. Subjects also completed the Personal Orientation Inventory. 1 hr. of training for the meditation and relaxation groups was given and 20 min./day practice requested. After 2 and 4 wk. anxiety and family problem scores significantly increased for the meditation group as did scores on the Feeling Reactivity Scale. Analysis was compromised by high dropout (leaving 3, 4, and 3 subjects, respectively, in the meditation, relaxation, and control groups).

Adaptation, Psychological↗
PubMed2006

Liver adenomatosis: classification of MR imaging features and comparison with pathologic findings.

PURPOSE: To retrospectively compare the clinical manifestation and magnetic resonance (MR) imaging features of liver adenomatosis with pathologic findings. MATERIALS AND METHODS: This study had institutional review board approval, and informed consent was waived. Twenty patients were classified on the basis of pathologic findings into three groups: those with a steatotic, those with a peliotic, and those with a mixed (steatotic and peliotic) form of liver adenomatosis. MR images were reviewed in consensus by two abdominal radiologists, and findings were compared with the pathologic classification. Statistical evaluation was performed with the Student t test. RESULTS: All patients were women (mean age, 39 years +/- 10 [standard deviation]). Lesions of the steatotic form (n = 7) showed (a) a mean diameter of 6.3 cm +/- 1.7, (b) slightly hyperintense signal on T2-weighted images, (c) hyper- or isointense signal on T1-weighted images with a signal dropout with fat suppression sequences, and (d) moderate enhancement at the arterial phase with no delayed enhancement. Lesions of the peliotic form (n = 7) showed (a) a somewhat larger size (8.3 cm +/- 3.6), (b) markedly hyperintense signal on T2-weighted images, (c) iso- or hyperintensity on T1-weighted images with no signal dropout with fat suppression sequences, and (d) strong arterial enhancement and persistent enhancement at the portal and delayed phase. Lesions of the mixed form (n = 6) included a combination of imaging features of the steatotic and peliotic forms. Lesions, however, were significantly larger in the mixed form than in the steatotic form (10.3 cm +/- 4, P < .05). CONCLUSION: There are three patterns of MR imaging features of liver adenomatosis that are associated with three pathologic forms (steatotic, peliotic, and mixed).

Adenoma, Liver Cell↗
PubMed2003

The problem is getting us to stop. What teens say about smoking cessation.

BACKGROUND: Low participation and high dropout in many teen cessation programs may be due to lack of fit between teens' needs and the way programs are delivered. Qualitative studies, designed to identify and understand preferences of intervention participants and barriers to participation, offer opportunities to customize programs and improve their reach and effectiveness. METHODS: Two sets of focus groups with high school students were held in the Portland, OR, metropolitan area to elicit reactions to two smoking cessation programs and discuss motivations for and experiences with quitting. Thirty-three students (15 girls, 18 boys) participated in the first set of four focus groups; 40 students (21 girls, 19 boys) in the five focus groups for the second. RESULTS: Participants preferred programs that respect the challenges that teens face in quitting, and acknowledge their choice in making the decision to quit. Teens wanted nonjudgmental and confidential support from cessation counselors, and preferred counselors who are ex-smokers, give useful quit tips, and can provide support for quit attempts. Private, computer-based programs and personalized telephone services were options for delivering cessation information and support. CONCLUSION: Teen smokers can supply valuable information to improve youth cessation programs to fit teen lifestyles, respect the challenges teens face, and acknowledge their choice in making the decision to quit.

Adolescent↗
PubMed1991

A comparison of users and nonusers of a school-based health and mental health clinic.

This study compares student health and mental health knowledge, behavior, and access to services for adolescents who used and did not use a school-based health and mental health clinic. Data were collected as part of an anonymous, self-administered survey completed by all students in a school housing a clinic that had been in operation for a school year. Comparisons of clinic users and nonusers revealed differences in health- and mental health-related knowledge and behavior and access to needed care. The clinic was found to be serving adolescents at high risk for a variety of psychosocial problems (e.g., drug use, depression, dropout).

Adolescent↗
PubMed1994

Potential impact on vaccination coverage levels by administering vaccines simultaneously and reducing dropout rates.

BACKGROUND: Retrospective immunization coverage surveys conducted during 1991 and 1992 demonstrated that coverage levels for the routine childhood vaccines by 24 months of age in selected urban areas of the United States ranged from 10% to 52%, far below the US Public Health Service goal of 90%. Therefore, appropriate programmatic changes must be identified and incorporated. METHODS: We analyzed coverage survey data collected from 21 sites to measure the potential impact on coverage levels of implementing selected changes in vaccination practices. In a multistaged cluster survey design, school health records of kindergarten or first-grade students were randomly selected and dates of vaccination assessed. We evaluated changes in the vaccination practices, such as eliminating missed opportunities for simultaneous administration of vaccines and ensuring that children initiated the vaccination series on time (ie, by 3 months of age). We then calculated potential increases in coverage levels for a best-case scenario. RESULTS: From 77% to 96% of all children in the 21 sites had received at least one vaccination by their first birthday. Children were 2.3 to 17 times more likely to be up to date on their vaccinations by 24 months of age if they were up to date at 3 months of age. Each child had many opportunities for the simultaneous administration of diphtheria and tetanus toxoids and pertussis (DTP) vaccine, oral polio vaccine (OPV), and measles-mumps-rubella (MMR) vaccine that, if used appropriately, could have potentially raised coverage levels by 12% to 22% (median, 17%). The highest coverage levels could have been attained if all children had started the series on time and if advantage had been taken of all opportunities for simultaneous vaccination. Coverage levels for four doses of DTP vaccine, three doses of OPV, and one dose of MMR vaccine would have increased from a baseline of 10% to 52% to levels of 54% to 83%. CONCLUSIONS: Although the majority of children received a vaccination by their first birthday, the coverage level at 24 months of age was low. Tracking systems are needed to ensure that children do not drop out of the system once they have begun the vaccination series. In addition, all children who are late in beginning their vaccination series are at increased risk of not completing the recommended vaccination series on time, and these children need intensive follow-up and recall efforts. Also, providers need to administer all needed vaccines simultaneously.

Child, Preschool↗
PubMed1992

Outcome at discharge for clients in a psychiatric day care program.

The effectiveness of a psychiatric day care program was assessed in terms of the outcome at discharge for 79 clients. One-third of the clients were employed, either full-time or part-time (in case of students, at school), during the postprogram period of three months or more. Another one-third left the program prematurely with or without exacerbation of psychotic symptoms. Clients having premature termination were significantly less adherent to outpatient clinic visits and/or psychotropic medication. Family's understanding of and cooperation in the program were significantly less favorable in clients with early termination. The possible strategies for reducing the dropouts were discussed.

Adult↗
PubMed1993

Risk-taking behaviour of Cape Peninsula high-school students. Part I. Introduction and methods.

In this study, risk-taking behaviour of Cape Peninsula high-school students was investigated. Suicidal behaviour, cigarette smoking, alcohol consumption, drug use, road-related behaviour, violent behaviour and sexual behaviour were included. This article, the first in a series, describes the rationale and methodology of the project. Sixteen schools were selected so as to yield a representative sample of schools in the three major education departments in the Cape Peninsula (administered by the Department of Education and Training and the Houses of Assembly and Representatives). The final sample size was 7,340 school students. A self-administered questionnaire was completed in a normal school period. Estimates for each education department were weighted to produce an overall estimate. The results are presented by standard and home language(s), and gender. Limitations of the study include its cross-sectional nature; the possibility of under- and over-reporting; the exclusion of important groups of adolescents such as absentees and dropouts, and those attending specialised and private schools; and not being able to present the results separately for each education department.

Adolescent↗
PubMed1990

Preadolescent peer status, aggression, and school adjustment as predictors of externalizing problems in adolescence.

The comparative effectiveness of preadolescent aggressive behavior, peer rejection, and school functioning were evaluated in the prediction of adolescent delinquency and school maladjustment. Fifth-grade children (n = 112, 69% white, 53% male, M = 11 years old) were followed forward for 7 years until the end of high school. Rejected children were more likely to have a nonspecific negative outcome and more types of negative outcomes than average, popular, or neglected children, particularly among the white students. However, in regression models containing sex, race, aggression, frequent school absences, low grades, and rejection, the only significant predictor of juvenile delinquency or of a nonspecific negative outcome was aggression toward peers. Both aggression and frequent school absences were significant predictors of early school withdrawal. Analyses for the white children in the sample revealed that both rejection and aggression best predicted to the nonspecific negative outcome, whereas aggression alone best predicted to school dropout and to having one or more police contacts. Implications for future longitudinal outcome research and for risk-group identification in racially heterogeneous samples are discussed.

Absenteeism↗
PubMed2006

"We were treated like adults"--development of a pre-medicine summer school for 16 year olds from deprived socioeconomic backgrounds: action research study.

OBJECTIVE: To develop a one week widening access summer school for 16 year old pupils from non-traditional backgrounds who are considering applying to medical school, and to identify its short term impact and key success factors. DESIGN: Action research with partnership schools in deprived inner city areas in five overlapping phases: schools liaison, recruitment of pupils and assessment of needs, programme design, programme delivery, and evaluation. The design phase incorporated findings from one to one interviews with every pupil, and workshops and focus groups for pupils, parents, teachers, medical student assistants, NHS staff, and other stakeholders. An in-depth process evaluation of the summer school was undertaken from the perspective of multiple stakeholders using questionnaires, interviews, focus groups, and observation. PARTICIPANTS: 40 pupils aged 16 years from socioeconomically deprived and under-represented ethnic minority groups. RESULTS: The summer school was popular with pupils, parents, teachers, and staff. It substantially raised pupils' confidence and motivation to apply to medical school. Critical success factors were identified as an atmosphere of "respect"; a focus on hands-on work in small groups; the input of medical students as role models; and vision and leadership from senior staff. A particularly popular and effective aspect of the course was a grand round held on the last day, in which pupils gave group presentations of real cases. CONCLUSION: An action research format allowed us to draw the different stakeholders into a collaborative endeavour characterised by enthusiasm, interpersonal support, and mutual respect. The input from pupils to the programme design ensured high engagement and low dropout rates. Hands-on activities in small groups and social drama of preparing and giving a grand round presentation were particularly important.

Adolescent↗
PubMed2006

Effects of the Sunny Days, Healthy Ways curriculum on students in grades 6 to 8.

BACKGROUND: There are few effective sun-safety education programs for use in secondary schools. Project aims were to create a sun-safety curriculum for grades 6 to 8, and to test whether exposure to the curriculum would increase children's sun-protection behavior. DESIGN: A pair-matched, group-randomized, pre--post test, controlled trial was performed with middle schools as the unit of randomization. Teachers implemented the six-unit sun-safety curriculum in 2001-2003, and analyses were performed in 2003-2004. SETTING/PARTICIPANTS: A total of 2038 children from 30 middle schools in Colorado, New Mexico, and Arizona. MAIN OUTCOME MEASURES: Self-reported sun-protection behavior using frequency ratings and diary. RESULTS: Compared to control schools, children receiving the curriculum reported more frequent sun protection (p=0.0035), and a greater proportion wore long-sleeved shirts during recess (p<0.0001) and applied sunscreen (p<0.0001). Exposure to the curriculum improved knowledge (p<0.0001), decreased perceived barriers to using sunscreen (p=0.0046), enhanced self-efficacy expectations (p=0.0577) about sun safety, and reduced favorable attitudes toward sun tanning (p=0.0026 to <0.0001). In intent-to-treat analyses, the treatment effect was eliminated only under the most conservative assumptions about dropouts. CONCLUSIONS: Educational approaches to sun safety in middle school may be effective for improving children's sun safety. Potential trial limitations include measuring short-term outcomes, focusing on young adolescents, using active parental consent, and testing in the American Southwest.

Adolescent↗
PubMed2005

Improving patient retention and access to oral health care: the CARES program.

Improving access to dental care for patients experiencing barriers such as financial, transportation, or mental health is a public health concern. Dental schools have an obligation to assist patients experiencing such barriers as well as to educate future dentists and allied professionals on how to assist these patients in overcoming barriers. Once admitted to the dental clinic, retention issues can further complicate the provision of dental care. This article will describe an innovative program designed to address biopsychosocial barriers to dental care. Needs assessments of patients sitting in the waiting room of the dental clinic were conducted by master's of social work (M.S.W.) students. Based on needs assessment results, common dental care barriers were identified and served as the foundation for the establishment of a social work program in the dental clinic. Dental students, faculty, and staff refer patients to the social work program when barriers to care are found. These biopsychosocial barriers are addressed by social workers, uniquely qualified professionals in providing case management, advocacy, referrals, education, and services (CARES). Over the course of three years, 80 percent of patients experiencing an identified barrier to the receipt of dental care were retained through social work intervention. These patients were able to receive dental care within the past year. Dental schools can collaborate with social work schools to establish a protocol and assistance program for dental patients experiencing difficulty accessing care, thereby improving oral health status, retention rates, and dental student education.

Adolescent↗
PubMed1990

CTS: a clinical trials simulator.

We describe an interactive clinical trial simulation program (CTS), which provides continuous graphical and numerical output as a simulation runs. CTS is capable of simulating trials with two treatment groups and a binary outcome with options for: (1) up to five prognostic subgroups; (2) one of three methods of randomization; (3) equal or unequal allocation of patients to treatment groups; (4) a null or alternative hypothesis; (5) common methodological problems including biased referrals, false positive and false negative outcome reports, non-compliance, dropouts, crossovers, and co-interventions; (6) six methods of dealing with each of these problems; (7) the type I error rate, and (8) stratified or unstratified analysis. In addition, the current results of a trial in progress may be used as the starting point of the simulation to estimate the power of the trial if carried to completion. A few thousand simulations of a user specified scenario is typically entered and executed in about 5 minutes, permitting a student or clinical investigator to explore a variety of scenarios.

Algorithms↗
PubMed2006

Utility of the theory of reasoned action and theory of planned behavior for predicting Chinese adolescent smoking.

One third of smokers worldwide live in China. Identifying predictors of smoking is important for prevention program development. This study explored whether the Theory of Reasoned Action (TRA) and Theory of Planned Behavior (TPB) predict adolescent smoking in China. Data were obtained from 14,434 middle and high school students (48.6% boys, 51.4% girls) in seven geographically varied cities in China. TRA and TPB were tested by multilevel mediation modeling, and compared by multilevel analyses and likelihood ratio tests. Perceived behavioral control was tested as a main effect in TPB and a moderation effect in TRA. The mediation effects of smoking intention were supported in both models (p<0.001). TPB accounted for significantly more variance than TRA (p<0.001). Perceived behavioral control significantly interacted with attitudes and social norms in TRA (p<0.001). Therefore, TRA and TPB are applicable to China to predict adolescent smoking. TPB is superior to TRA for the prediction and TRA can better predict smoking among students with lower than higher perceived behavioral control.

Adolescent↗
PubMed1977

The lack of communication between doctors and patients.

In their daily work the majority of doctors assume that communication with patients is easy and that it needs no special study. This is a false assumption which starts at undergraduate level, where there is no formalized training of the South African medical student in the art of communication. A mass of literature on communication in medicine has evolved very recently; some of it is reviewed, and a plea is made that urgent attention be devoted to this gap in South African medicine.

Attitude to Health↗
PubMed2006

Asthma status and severity affects missed school days.

Excessive school absence disrupts learning and is a strong predictor of premature school dropout. School-aged children with asthma are absent more often compared to their healthy peers without asthma; yet, the causes are inadequately documented. We sought to determine the difference in mean absence days between children with and without asthma, the relationship between asthma severity and missed days from school, and if incident absences were due to asthma in a predominantly African American urban school district in the Midwestern United States. A cross-sectional analysis was conducted of 9014 students (grades K-12) followed for absenteeism over the 2002-2003 academic year. A subset of 543 students with asthma was assessed for asthma severity and cause of absence. Those with asthma (9.7% of students) were absent (mean = 9.2 days) approximately 1.5 more days compared to those without asthma (mean = 7.9 days) (p = .006). In the analysis comparing asthma severity and absenteeism, after adjusting for demographic variables and enrollment time, mean days absent increased with increasing asthma severity level: mild intermittent (mean = 8.5 days), mild persistent (mean = 11.3 days), moderate persistent (mean = 10.3 days), and severe persistent (mean = 11.6 days) (p = .001). Out of 1537 tracked absences that resulted from illness, 478 (31%) were due specifically to asthma-related symptoms. Children with asthma are absent from school more often compared to their healthy peers and this appears to be driven by the underlying severity of symptoms. (J Sch Health. 2006;76(1):18-24).

Absenteeism↗
PubMed2004

A new delivery system of clobetasol-17-propionate (lipid-loaded microspheres 0.025%) compared with a conventional formulation (lipophilic ointment in a hydrophilic phase 0.025%) in topical treatment of atrophic/erosive oral lichen planus. A Phase IV, randomized, observer-blinded, parallel group clinical trial.

BACKGROUND: Topical application of clobetasol-17-propionate has been diffusely reported as an efficacious therapy in atrophic/erosive oral lichen planus (OLP), without exposing the patient to systemic side-effects. However, prolonged contact and respective topical effects on the oral mucosa should be avoided. OBJECTIVES: The aim of the present study was to evaluate efficacy and compliance of new lipid microspheres loaded with 0.025% of clobetasol propionate (formulation A) compared with a commonly used formulation (a sort of dispersion of a lipophilic ointment in a hydrophilic phase) with the same amount of drug (formulation B) in the topical treatment of OLP. PATIENTS AND METHODS: Fifty patients with symptomatic OLP were enrolled in a controlled single-blind phase IV clinical trial. After a dropout of five patients, a total of 45 patients [12 males and 33 females; mean age 61.1 years (+/- 12.3 SD; range 25-82)] were treated (17 with formulation A and 28 with formulation B, matched for gender and age; P > 0.2) with the same dosage regimen. At times T0, T1 and T2 we evaluated the following parameters: (i) pain score (by linear visual analogue scale; 0-100); (ii) clinical score; (iii) clinical resolution; and (iv) patient compliance. Statistical analysis was calculated using S-Plus 4.0 and SPSS 9.0 (Student's t-test, chi(2), Kolmogorov-Smirnow, Friedman, Student-Newman-Keuls, Mann-Whitney U-test and Spearman tests). RESULTS: Both formulations were found to be similar for parameters ii, iii and iv, although with a better general trend for formulation A; a significant difference was registered for formulation A in terms of a reduction in painful symptoms (parameter i) at time T2 (P = 0.02). CONCLUSIONS: Our results suggest that the new topical drug delivery system (formulation A) may enhance, at least in terms of symptom remission and compliance, the effectiveness of clobetasol propionate at a dose of 0.025% in OLP therapy.

Administration, Topical↗