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PubMed1999

Increased fetal DNA concentrations in the plasma of pregnant women carrying fetuses with trisomy 21.

BACKGROUND: The recent discovery of the presence of circulating cell-free fetal DNA in maternal plasma opens up new prenatal diagnostic applications and provides new avenues for clinical investigation. It is of research and potential diagnostic interest to determine whether fetal trisomy 21 may be associated with quantitative abnormalities of circulating fetal DNA in maternal plasma. METHODS: Maternal plasma samples were prospectively collected from two centers situated in Hong Kong and Boston. Samples collected from Boston consisted of 7 women carrying male trisomy 21 fetuses, 19 carrying euploid male fetuses, and 13 carrying female fetuses. Samples collected from Hong Kong consisted of 6 women carrying male trisomy 21 fetuses, 18 carrying euploid male fetuses, and 10 carrying female fetuses. Male fetal DNA in maternal plasma was measured using real-time quantitative Y-chromosomal PCR. RESULTS: For patients recruited from Boston, the median circulating fetal DNA concentrations in women carrying trisomy 21 and euploid male fetuses were 46.0 genome-equivalents/mL and 23.3 genome-equivalents/mL, respectively (P = 0.028). For patients recruited from Hong Kong, the median circulating fetal DNA concentrations in women carrying trisomy 21 and euploid male fetuses were 48.2 genome-equivalents/mL and 16.3 genome-equivalents/mL, respectively (P = 0.026). None of the samples from women carrying female fetuses had detectable Y-chromosomal signals. CONCLUSIONS: Abnormally high concentrations of circulating fetal DNA are found in a proportion of women carrying fetuses with trisomy 21. The robustness and reproducibility of real-time PCR analysis of maternal plasma makes it a valuable tool for cross-institutional collaboration involving centers located in different parts of the world.

Biomarkers↗
PubMedDate not supplied

Child welfare education and training: future trends and influences.

Based on a review of current economic, political, social, and professional trends, the authors propose recommendations for child welfare education and training. Future partnerships between child welfare agencies and schools of social work will need to incorporate cross-system collaboration, multiculturalism, and family-centered approaches with a broader conceptualization of child well-being.

Child↗
PubMed2000

University of Wisconsin IAIMS planning: organizational challenges within a faculty governance model.

The University of Wisconsin-Madison Health Sciences Schools are currently in the planning stage of developing an Integrated Advanced Information Management System (IAIMS). The planning phase of this project attends to the unique opportunities that are found at the flagship campus of a large state university system. Statewide teaching and research initiatives and accelerated campus-level capital development challenge the planners to create an IAIMS plan that anticipates an emerging health science environment. Additionally, UW-Madison has an organizational culture with a strong tradition of faculty governance, which provides a very desirable and flexible decision-making environment for a cross-discipline collaborative information management initiative. Development of a shared IAIMS vision conflicts with a governance model that most directly supports intradepartmental decision-making. The challenge presented here for an IAIMS initiative has less to do with hard wiring a technical infrastructure and more to do with increased stakeholder cooperation in a highly decentralized organization with autonomous information systems.

Faculty↗
PubMed2003

Changing the law, changing the culture: rethinking the "sleepy resident" problem.

Ms. Whetsell examines the Bell Regulations, which limit New York's hospital residents' work hours and require increased supervision from senior doctors, in light of the currently pending federal bill that seeks to do the same. The article argues that the federal government should draw lessons from the New York experience before proceeding with similar guidelines. The article notes that many roadblocks have prevented successful implementation of the New York policy, including a long-standing tradition of "hazing" first-year residents with long, unsupervised hours; medical community resistance to the notion of residents' sleep deprivation and dislike of government interference; and a general fear within the medical community of increased medical malpractice liability and other indicia of "blame culture." The Article concludes that the most effective approach to patient safety related to residency sleep deprivation should work within hospital culture, not against it. The proposed alternative approach would encourage patient safety strategies that value teamwork and cross-discipline collaboration, and consequently result in greater satisfaction for residents, hospitals, and patients.

Fatal Outcome↗
PubMed1992

Pretreatment anxiety level as differential predictor in outpatients with panic disorder.

The pretreatment anxiety level is supposed to be a very important unspecific treatment factor. Main purpose of this study is to test whether the patients' pretreatment anxiety level is a general or a specific predictor of treatment response and whether mildly, moderately, and severely anxious patients can be differentially characterized by other diagnostic and clinical variables. 103 patients (37 males, 66 females; mean +/- sd age 35.6 +/- 9.5 years), a subsample of the Second Phase of the Cross-National Collaborative Panic Study, were included in the present study. A high positive correlation of initial anxiousness with the number of panic attacks at the end of treatment was found, moreover high positive correlations with most other baseline assessments. Initially severely anxious patients are the severest ill patients with the least treatment response, and that in all treatment groups. The pretreatment anxiety level predicts the number of panic attacks as well as the degree of avoidance behavior in both drug groups, whereas it predicts anticipatory anxiety intensity in the placebo group.

Adult↗
PubMed2003

Targeted laboratory screening for sexually transmitted and bloodborne infections in Wisconsin.

Public health laboratories play an important role in screening programs for asymptomatic diseases of public health importance in high-risk and underserved populations. The implementation of targeted screening strategies for communicable diseases requires thorough planning and evaluation. The Wisconsin State Laboratory of Hygiene (WSLH) systematically selects and evaluates laboratory tests used in communicable disease control programs coordinated by the Wisconsin Division of Public Health. To do this, the epidemiologic features of the disease in potential target populations are carefully assessed, with the choice of laboratory tests based on performance as well as practical and cost considerations. Laboratory testing at WSLH plays a crucial role in screening programs for sexually transmitted and bloodborne infections. Hallmarks of these programs are cross-sector collaboration, empirical selection of laboratory testing methods, and the use of epidemiologic data to develop and evaluate targeted screening strategies.

Blood-Borne Pathogens↗
PubMedDate not supplied

[Alcohol drinking and other risk behaviors among adolescents aged 11-15 years].

The aim of the study was: (1) to assess the prevalence and intensity of alcohol drinking among 11 to 15-year-old Polish adolescents in 2002, (2) to show trends of drinking between 1998-2002, (3) to identify three groups of alcohol-related risk (low, moderate and high intensity of drinking); (4) to test the relationship between belonging to those groups and other health compromising behaviours. The study is based on the fourth series of - Health Behaviour in School-Aged Children (HBSC) A WHO Collaborative Cross-National Study carried out in 2002. A sample was selected as representative of general school population at three age groups - mean age 11.7; 13.7 and 15.7 (N=6383). An international standard questionnaire was used. The results showed that 29% of students, including 51% of 15-years-olds, had been really drunk at least once in the lifetime. 11% of all adolescents, including 21% of 15-year-olds, were identified as the high risk group. In 1998-2002 an increase of adolescents drinking vodka and of girls being drunk was observed. The girls living in towns formed the main group of adolescents with increasing alcohol consumption. In multivariate logistic regression models adjusted, if appropriate, for gender, place of residence and age, being in the group of high alcohol-related risk was associated with higher risk of smoking (odds ratio OR=23.3; 95% confidence interval CI=18.3-30.3), illicit drugs use (for marihuana or hashish OR=49.0; 95% CI=21.3-112.7), early sexual initiation (OR=9.9; 95% CI=7.1-14.1), participation in a physical fight or bullying (OR=5.1; 95% CI=4.2-6.3), and getting injured (OR=1.9; 95% CI=1.6-2.3). Being in the group of moderate alcohol-related risk was also associated with other risk behaviours, with lower, but still significant odds ratios. Presented data can be used in school-based and community-based prevention and intervention activities.

Adolescent↗
PubMed2004

[Sexual initiation and use of condoms and other methods of contraception among 15-year-old adolescents in Poland and other countries].

OBJECTIVE PRESENTATION: (1) Frequency of sexual initiation and use of condoms and other methods of contraception among 15-year old adolescents in Poland and other countries in 2001/2002; (2) Trends of change in these sexual behaviours in Poland between 1990-2002. MATERIAL AND METHOD: Representative samples of adolescents in Poland (mean age 15.7 years) in 1990 (N=1548), 1994 (N=1540), 1998 (N=1638) and 2002 (N=2152) and in other 28 countries (mean age 15.2 - 16.1 years) in 2001/2002, were used. The surveys were carried out in the frame of Health Behaviour in School-Aged Children; a WHO Collaborative Cross-National Study (HBSC), according to an international research protocol. An international standard questionnaire (anonymous) was chosen as an instrument for data collection. It contained four questions concerning sexual behaviour. RESULTS: In Poland, 2002, 20.9% of boys and 9.2% of girls reported sexual intercourse with mean ages respectively 14.1 and 14.7 years. The frequency of sexual initiation was higher (in boys) and the mean age was lower among adolescents living in towns by comparison to those living in cities. More matured adolescents had earlier sexual initiations. 27% of sexually active adolescents reported that either they or their partners had used any methods of contraception during their last sexual encounter. This risk sexual behaviour was more frequent in than cities (respectively: in boys 30.2% and 23.9%; in girls 42.9% and 19.7%). The most common method used was a condom. Between 1990-1998, the percentage of adolescents having sex and using some methods of contraception during their encounter last sexual were observed. Between 1998-2002, frequency of sexual initiation decreased, whereas percentage of non-users increased. In comparison to other countries increased Poland's percentage of adolescents with early sexual initiation in 2001/2002 was low, but the percentage of non-users of contraceptives was the highest. CONCLUSIONS: At risk sexual behaviours are relatively common among 15-year-old adolescents, and more frequent among adolescents living in cities. In comparison to other countries, Polish adolescents the risk of unplanned pregnancies and sexually transmitted diseases is higher. Future monitoring of sexual behaviours is necessary for prevention (including school sexual education) of at risk behaviours.

Adolescent↗
PubMedDate not supplied

[Self-reported health and life satisfaction in school-aged children in Poland and other countries in 2002].

AIM: to present results of the study concerning: self-reported health, frequency of subjective complaints and life satisfaction among adolescents in Poland and 31 other countries. MATERIAL AND METHODS: the survey was carried out in 2001/02, on representative for each country samples of pupils aged 11, 13, 15 years in the frame of HBSC survey (Health Behaviour in School-aged Children: A WHO Collaborative Cross-national Study). The total sample size was 162306, in Poland it was 6383. The international standard questionnaire was used. RESULTS: the majority of adolescents considered themselves as healthy or very healthy and satisfied with their life. These percentages were lower for girls and decreased with age. Every third pupil experienced two or more subjective complaints more than once a week or daily. The highest percentages of adolescents rating their health as fair or poor and unsatisfied with their life were in countries of the former Soviet Union. Multiple health complaints were experienced most often by adolescents in the Mediterranean countries (Greece, Italy, Israel, Spain). In Poland, in comparison with other countries in the survey, adolescents more often rated their health as very good, but many pupils experienced subjective complaints and felt unsatisfied with their life.

Adolescent↗
PubMedDate not supplied

[Risk behaviors syndrome and subjective health and life satisfaction in youth aged 15 years].

UNLABELLED: THE PURPOSE of this study was to define risk behaviour syndrome and its influence on subjective health and life satisfaction in adolescents. MATERIAL AND METHODS: The study was based on the HBSC study (HBSC -- Health Behaviour in School Aged Children. A WHO Cross-National Collaborative Study) carried out in Poland in 2002. The sample (N=2152) was selected as representative of pupils from III grade of secondary schools (mean age 15.7). Multivariate logistic regression models were estimated to assess the risk of poor health, frequent psychological or somatic complaints and low life satisfaction in relation to number of escalated risk behaviours, gender, place of residence, family affluence and school achievements. RESULTS: The index of multiple escalated risk behaviours was derived by summing six components: every day smoking, frequent episodes of drunkenness, drug abuse, early sexual initiation, frequent bullying and fighting (alpha-Cronbach=0.696). Almost 43% of adolescents reported at least one out of six behaviours, while 12%, three or more. The number of risk behaviours is increasing dramatically in adolescents from lower social classes and in students with poor school achievement. Boys are less likely to report poor health and low life satisfaction, but more likely than girls to be involved in multiple health compromising behaviours. Adolescents engaged in 4 or more risk behaviours, comparing to not engaged, were at higher risk of poor health (OR=2.39; CI(OR)=(1.51-3.78)) and low life satisfaction (OR=1.65; CI(OR)=(1.06-2.58)). In girls even single risk behaviour resulted in negative health outcome. CONCLUSIONS: Psychoactive substances abuse, early sexual initiation and frequent contact with violence form internally consistent syndrome of risk behaviours in youth. Adolescents from poor families and with poor school achievements are more likely to be involved in multiple risk behaviours, especially in deprived urban areas. Subjective well-being is highly associated with the expression of risk behaviours.

Adolescent↗
PubMedDate not supplied

[Social determinants of repeated injuries in pupils aged 11-15 years, in Poland].

AIM: To analyse relationships between selected elements of family, school and peer environments and susceptibility to medically treated repeated injuries in pupils aged 11, 13 and 15 yrs in Poland. MATERIAL AND METHODS: The survey was carried out in 2002 on the representative sample of pupils (N=6383), within the Health Behaviour in School-aged Children: A WHO Collaborative Cross-national Study (HBSC). RESULTS: Outcomes of the study indicate that frequency of repeated injuries amounts to 8.6% and rises for pupils from incomplete families (for children living with stepmother OR=3.6, 95% CI 1.40-8.99), being in touch with many friends (OR=2.35, 95% CI 1.82-3.03), whose parents are not ready to help them with school problems (OR=4.28, 95% CI 2.24-8.18) and teachers are not friendly (OR=2.79, 95% CI 1.78-4.38). CONCLUSIONS: Improving relations in families and schools can help in decreasing the frequency of repeated injuries among adolescents.

Adolescent↗
PubMedDate not supplied

[Unfounded dieting among adolescent girls and socio-economic status of their families].

UNLABELLED: AIM OF THE STUDY was to examine: the prevalence of dieting and other weight control behaviour among adolescent girls without body mass excess (BMI 90 percentile or less); relationship between weight control practices and the socio-economic status of the girls' families by age and place of residence. MATERIAL AND METHODS: Data from HBSC (Health Behaviour in School-aged Children: A WHO Collaborative Cross-national Study) surveys, carried out in Poland in 2002 in representative sample of girls aged 11.7; 13.7 and 15.7 (N= 2774) was used. An international standard questionnaire (anonymous) has been chosen as an instrument for data collection. Two indicators of socio-economic status (SES) were developed by researchers in the HBSC study: FAS (Family Affluence Scale) and PFW (Perceived Family Wealth). RESULTS: 18.8% of adolescent girls were engaged in dieting and other weight control behaviour, 25.1% were in the risk group (girls who think that they should loose some weight). The prevalence of these behaviours increase with age, is higher among girls living in cities than in villages. The prevalence of weight control behaviour is higher among girls from families with higher SES. The risk of unfounded weight control behaviour is higher among 15-year old, girls living in town in families with higher SES. CONCLUSIONS: Unfounded dieting and other weight control practices among adolescent girls should be recognized as a new risk behaviour; future studies are necessary for assessment of causes and range of these behaviours as the basis for development of preventive programmes.

Adolescent↗
PubMed2004

[Retrospective overview of medically treated non-fatal injuries in pupils aged 11-15 years in Poland (1994-2002)].

The aim of the study was to analyse: annual occurrence of injuries in pupils aged 11, 13 and 15 years in Poland, common location of injury occurrence and type of activity, as well as the type of body harm. The results of the survey were compared with similar studies in 1994 and 1998 and series of trends were drawn. The survey was carried out in Poland within the Health Behaviour in School-aged Children. A WHO Collaborative Cross-national Study (HBSC). The representative sample (N = 6383) was selected by two-stage, cluster drawing with stratification by place of residence. As the survey instrument the international questionnaire was used, translated and adapted for national purposes. Selected determinants of injuries were examined by crude odds (OR) with 95 per cent confidence interval (CI) calculated from contingency tables with the use of EPI INFO 6.04d software. Results of the study indicated the linear increase of non-fatal injuries among 11, 13, 15 years old pupils in 1994-2002 (from 17.6% to 28.4%) and even more evident increase of repeated injuries in the same time (from 2.1% to 8.6%, respectively). School and home were the most common location of injuries occurrence, while training for sport was the most common type of activity. Boys, living in urban areas were at highest risk of injuries in total, and by selected injuries outcomes. An increase of awareness that injuries are preventable and implementation of well know in the world prevention strategies are needed to stop disadvantageous trends in non-fatal medically treated injuries among school-aged children.

Adolescent↗
PubMed2005

Bullying in Lithuanian schools in 1994-2002.

This study provides overview of the extent of bullying in Lithuanian primary and secondary schools using findings from the 2002 Health Behavior in School-Aged Children (HBSC): WHO Collaborative Cross-National Study. This study examined the prevalence of being bullied and bullying others among 11-, 13- and 15-year-old children. The study was based on the data of three surveys conducted in Lithuania in 1994, 1998 and 2002. The results showed that 36% of boys and 32% of girls were bullied and 40% of boys and 28% of girls were bulling others at least two times a month in the previous couple of months. There was a significant difference in responses according to the living place - higher percentage of pupils living in village reported being bullied as compared with pupils living in town. The extent of bullying among school pupils was similar in 1994-2002. This study showed that the highest percentage of bullying was in Lithuania. CONCLUSION. This study showed that the highest percentage of bullying was in Lithuania. Thus, bullying is a psychological and pedagogical problem connected with public health. It must be solved by various professionals immediately.

Adolescent↗
PubMed1994

[The national plan for development projects in disease prevention and health promotion. Background, organization and progress 1989-91].

A five-year national programme for development projects in disease prevention and health promotion in Norwegian municipalities was implemented in 1989. Major goals were to stimulate the municipal health services to increase their health promotion activities and to gain experience of alternative organizational developments, such as inter-municipal and cross-sectoral collaborative health promotion efforts. During the first three years, 43% of Norway's municipalities applied for grants and 26% received them. The smaller municipalities applied less often and received fewer grants than the larger municipalities did. In all, a total of NOK 61 million was granted for 258 projects covering a wide range of individual and environmental health promotion areas. So far, the programme seems to have generated renewed interest for health promotion work in Norwegian municipalities.

Health Promotion↗
PubMed1997

Changing the legacy of suicide.

In the United States, despite the increase in knowledge about suicide, the rate of suicide has remained virtually unchanged for the past 30 years. The members of the American Association of Suicidology (AAS) are uniquely qualified to determine what, if anything, can be done to reduce the rate of suicide. The restructuring of the association has produced the potential for cross-divisional collaboration, and yet conventional membership boundaries have resulted in unrealized opportunities to impact the rate of suicide. Dr. Edwin Shneidman, stated in Albert Cain's 1972 landmark book Survivors of Suicide that "postvention is prevention for the next generation" (p. x). The ability to design, implement, and study an effective model of postvention is within the considerable talents of our membership; however, doing so will require the commitment and flexibility of the entire association. By making postvention collaboration a goal of the association we can bring a national focus on suicide that could change the legacy of suicide.

Adolescent↗
PubMed2006

Post-genomic science: cross-disciplinary and large-scale collaborative research and its organizational and technological challenges for the scientific research process.

We examine recent developments in cross-disciplinary science and contend that a 'Big Science' approach is increasingly evident in the life sciences-facilitated by a breakdown of the traditional barriers between academic disciplines and the application of technologies across these disciplines. The first fruits of 'Big Biology' are beginning to be seen in, for example, genomics, (bio)-nanotechnology and systems biology. We suggest that this has profound implications for the research process and presents challenges both in technological design, in the provision of infrastructure and training, in the organization of research groups, and in providing suitable research funding mechanisms and reward systems. These challenges need to be addressed if the promise of this approach is to be fully realized. In this paper, we will draw on the work of social scientists to understand how these developments in science and technology relate to organizational culture, organizational change and the context of scientific work. We seek to learn from previous technological developments that seemed to offer similar potential for organizational and social change.

Biological Science Disciplines↗