bluuebunny/crossref_metadata_2025 huggingface dataset:
Malnutrition and “Nutrition Engineering” in Low-Income Countries: A Comment on Alan Berg's Vision of the Nutrition Track Record
Authors: Csete Joanne
Published: May 2005

Alan Berg, senior nutrition advisor at the World Bank, recently asserted that Western nutritionists have engaged in “nutrition malpractice” with respect to undernutrition in developing countries. This “malpractice” results from both an underemphasis on applied research and an education of nutritionists that leaves them unprepared for practical, “how-to” aspects of applying technologies effectively to nutritional deficiency problems. The author criticizes Berg's conceptualization of undernutrition as a technical or “engineering” problem and highlights the need for a better understanding of structural determinants of malnutrition. A critique is also offered of Berg's assertion that political commitment of governments of developing countries and levels of research funding are not important constraints to combatting malnutrition. The author recommends that research and training in applied nutrition should include education of nutritionists from the regions in which the deficiency problems are found.
Technical Writing and Terminal Modification
Authors: Pixton William H.
Published: May 2005

Because of the work of Francis Christensen, sentence-terminal modification was emphasized in college composition from about 1965 to 1980. The structures emphasized included absolutes, restating and summarizing appositives, participial phrases, non-participial adjective phrases, adjectival clauses and prepositional phrases, and adverbial clauses and phrases. This emphasis, however, had little effect on technical writing, in spite of the practical utility of terminal modifiers. This article, therefore, explains the terminal modifiers and exemplifies them in the context of technical writing; it then examines the texts of representative technical reports to determine the extent to which terminal modifiers are currently used. The findings—generally that the report writers do not take full advantage of terminal modification—indicate that increased attention to terminal modifiers, especially the absolute, the summarizing appositive, and the non-participial adjective phrase, would significantly increase the options for effective expression by technical writers.
Production Control and Chronic Stress in Work Organizations
Authors: Houben Gerard J.
Published: May 2005

In modern work organizations, production control is aimed particularly at making more intensive (i.e., more effective and more efficient) use of the work capacity. Usually, performance standards are established and their deviations periodically measured. Following this, adjusting and sanctioning action may be taken. This cyclic process, so characteristic of control processes, may contribute to the development of chronic stress. Based on a rough division of working behavior, this article formulates propositions about the relationship between conditions in which production control “intervenes” in the various areas of working behavior and the development of chronic stress. Areas of working behavior are: direct production, socialization, division of work and allocation of resources, sanctioning, and power development. In formulating the propositions on the development of chronic stress, the author applies insights from organization theory and social-psychological and sociological explanations. In order to avoid undue complications, no systematic use is made of insights into the effects of adequate or inadequate coping behavior on the emergence of chronic stress, or illegitimate action by workers who feel the pressure of production control. To arrive at an explanation of chronic stress, an understanding is needed of both the worker's interpretation of threatening stimuli and the worker's behavior within the control system.
The Origin and Development of the Asbestos Threshold Limit Value: Scientific Indifference and Corporate Influence
Authors: Egilman David S. , Reinert Alexander A.
Published: May 2005

Several recent articles have critiqued the process employed by the American Conference of Governmental Industrial Hygienists in determining Threshold Limit Values. Criticisms have included inadequate data collection, inadequate research, excessive corporate influence, and slow response to informational changes. In this article, the authors address the historical development of the American Conference of Governmental Industrial Hygienists' asbestos exposure guideline. They demonstrate that the proposed guideline was known to be inadequate when it was first proposed, was severely criticized between 1946 and 1968, but nonetheless was promulgated annually and remained unchanged until 1971.
Affective and Symbolic Meanings of Color and Form: Experimental Psychological Approaches
Authors: Oyama Tadasu
Published: May 2005

Affective meanings of colors and forms were studied with the Semantic Differential technique and word-color/word-form associations. Results of word-color associations and word-form associations were in close relation with similarities of affective meanings between words and colors and between words and forms. Cross-cultural comparisons indicated wide generality of affective and symbolic meanings of colors and forms. However, some cultural differences were found, especially in evaluation. Affective meanings of various color-combinations and colored forms were compared with those of component colors and forms. Weighted linear combinations of affective effects of component colors or forms were found in those of color-combinations and color-form combinations, but interaction between components were found important especially in the evaluative dimension.
Anxiety Symptoms and Healthcare Utilization among a Sample of Outpatients in an Internal Medicine Clinic
Authors: Sansone Randy A. , Hendricks C. Michael , Sellbom Martin , Reddington Anne
Published: May 2005

Objective:

In this study, we explored the role of anxiety symptoms (i.e., symptoms that would probably not fulfill DSM criteria) in relationship to healthcare utilization.

Method:

We surveyed 117 outpatients in an internal medicine clinic regarding four types of anxiety symptoms (i.e., mixed anxiety features, generalized anxiety, obsessive-compulsive personality features, worry), and through a retrospective review of medical records, examined healthcare utilization patterns.

Results:

Nearly 28% of participants endorsed “positive” results on at least three of the anxiety-symptom measures. When examined for relationships to healthcare utilization, only obsessive-compulsive personality features demonstrated a significant relationship.

Conclusions:

While anxiety symptoms were common in this primary care sample, their impact on healthcare utilization was limited, in that only obsessive-compulsive personality features demonstrated a relationship.
Student-Teacher: The Learning Machine as an Instructional Device
Authors: Scheftic Carol , Wood George Darlington
Published: May 2005

This article presents QUERIOUS, an educational tool based on expert system technology, functional analysis techniques, and Socratic method. Using a knowledge acquisition device originally developed to allow specialists to impart their knowledge to expert systems, our tool asks students questions, leads them through functional analysis of a problem and, in effect, induces them to teach the system their solution strategy. An existing prototype is described, and a proposal for further development is presented.
Supervising Community Health Workers in Community-Based Delivery of Primary Health/Family Planning Services: Experiences in Mexico, 1977–1982
Authors: Shedlin Michele G. , Wray Joe D. , Correu Sergio
Published: May 2005

The supervision of CHWs in the Mexican Rural Health Program (1977–82) illustrates a wide range of problems and strengths because it was developed within a program based on a strong political mandate to deliver services to an extremely large, as well as culturally and geographically diverse population. This article presents an in-depth perspective on the issues involved in the supervision of community health workers with a focus on the myriad roles and responsibilities which are expected from supervisory personnel. The information and observations which are offered come from program evaluation materials as well as the long-term, first hand experience of the authors with the program discussed.
Obsessive-Compulsive Disorder and Immunocompetence
Authors: Dinn Wayne M. , Harris Catherine L. , McGonigal Kelly M. , Raynard Richard C.
Published: May 2005

Objective:

A postinfectious, autoimmune response may be associated with the development of pediatric obsessive-compulsive disorder (OCD). According to this model, antistreptococcal antibodies cross-react with basal ganglia neurons following streptococcus infection. This autoimmune reaction disrupts a basal ganglia-thalamocortical circuit and generates obsessive-compulsive symptoms. One implication of this model is that prolonged immunologic stress may be a risk factor for OCD. That is, immunologic stress may compromise the blood-brain barrier and permit the influx of antistriatal antibodies into the central nervous system. This article explores one part of this putative relationship by investigating whether adult OCD patients, compared to members of other psychiatric groups, demonstrate a higher incidence of recurrent infections and other conditions suggestive of compromised immune function.

Method:

To test this hypothesis, we conducted a medical records review of 100 consecutive patients evaluated at a private psychiatric clinic specializing in the treatment of anxiety disorders. Sixty-five patients met diagnostic criteria for an Axis-I syndrome. Primary diagnoses included OCD, posttraumatic stress disorder, social anxiety disorder, generalized anxiety disorder, panic disorder with agoraphobia, and dysthymic disorder. Each medical record was reviewed for the presence of target syndromes or presenting symptoms suggestive of compromised immune function.

Results:

Chart review revealed an increased rate of immune-related symptoms and syndromes among OCD patients in comparison to other anxiety and mood disorder groups. Groups did not differ significantly in the incidence of non-immune symptoms and syndromes.

Conclusion:

Adult OCD patients appear to have an increased rate of immune-related diseases above and beyond that seen in other psychiatric disorders.
Nuestra Tierra: A University/Public School Technology Integration Project
Authors: Wiburg Karin M. , Montoya Nidelia , Sandin John
Published: May 2005

This article describes a two-year university/public school project to integrate technology with teaching and learning in a Southwest border school district. The research began by asking, “What would happen if teachers were fully supported in integrating technology in their classrooms; if the curriculum was culturally relevant and meaningful to students; and if the computer was used as a constructivist tool rather than an electronic workbook?” The article describes how goals were developed in alignment with these questions and how the project was collaboratively designed, implemented, and evaluated by university faculty and public school teachers and administrators. Findings demonstrated the potential of university researchers working closely with teachers in classrooms as related to changes in teaching strategies and student learning. The authors also suggest several barriers to technology integration in classrooms that may result from the current organizational structure and culture of schooling.
Population Policy in Colombia: A Holistic Approach
Authors: Bravo Germán A.
Published: May 2005

Development used to be a synonym for economic growth, but today, given the limitations that population growth places upon the increase of per capita income in the developing nations, there is a risk that foreign aid and international technical assistance could equate development with birth control. It is argued that development is something more than simple growth, that population policies must also be considered as an important element of a national strategy taking into account all aspects of the process of development, and that the adoption of such a policy must be a matter reserved to the autonomous decision of each state. This enterprise has been facilitated in the experience of Colombia because of the recent institutional reforms which strengthened the power of the government and institutionalized the process of national planning. This experience is interesting because Colombia used to be considered one of the most traditional countries in Latin America, particularly in the area of population where its political and religious leaders manifested a strong pronatalist tendency.
Community Mobilization for Drainage Improvement: Experience from Three Communities in Ibadan, Nigeria
Authors: Olaseha I. O. , Sridhar M. K. C.
Published: May 2005

A description of how three communities in Ibadan, Nigeria, tackled the problem of waste disposal and drainage improvement. A community diagnosis used numerous research methodologies, including survey, participant and non-participant observation, group discussions, and home visits to establish a baseline and design a community intervention and evaluation. The three community approaches are compared, the differences analyzed, and the strengths of one intervention emphasized.
Archaeological Assemblage Variability in Fishing Locales of the Western Snake River Plain
Authors: Plew Mark G.
Published: May 2005

This article describes assemblage variability at fishing localities on the Western Snake River Plain. Four assemblage types are recognized on the basis of artifact categories and non-artifactual remains which assist in definition of site function and seasonality.
Medical Services in the British Virgin Islands
Authors: Smith P. T.
Published: May 2005

An outline of the geography and history of the British Virgin Islands precedes a review of the present state of medical services in the islands. The collapse of the West Indian plantation economy following emancipation of slaves was followed by a regression to a peasant economy lasting almost a century. The existing political system, financial resources, capital developments, and external aid form a background to the medical services provided. The small, independent population of 10,500 has all the needs, requirements, and demands of many larger states. Services are heavily subsidized by government and coexist with private medical practice. Although the ratio of medical staff to patients is low, a variety of services are provided, especially in public health, maternity care, and child welfare. Some surgery is performed in the islands. A reasonable spectrum of laboratory services exists and is associated with a small blood bank. Environmental sanitation is at an early stage of development but mosquito eradication and garbage and sewage disposal are receiving increasing attention. The future of the medical program depends on efficient financing, economic use of staff, and the reduction of private medical care. The service requires patience and commitment but is a challenging situation for the doctors.
Religious Attendance and Continuity of Care
Authors: King Dana E. , Pearson William S.
Published: May 2005

Objective:

The purpose of this study was to determine whether a relationship exists between religious attendance and continuity of care.

Methods:

We investigated this relationship in a large national database—the National Health and Nutrition Examination Survey III—which contains information on religious attendance, continuity of care, and potential confounders that might mediate the relationship such as health status and socioeconomic status.

Results:

A total of 18,162 participants 17 years of age or older were included in the analysis. People who attended religious services were more likely to have continuity with a provider than people who did not attend such services (65% vs. 35%, p < .001). This association persisted after controlling for demographic, socioeconomic, and health status variables using regression analysis.

Conclusion:

This study documents a significant association between attendance at religious services and continuity with a usual provider. Continuity with a regular medical provider may influence the association of religious attendance and health outcomes.
The Influence of Early Parents' Death on Manifestations of Depressive Symptoms among Young Adults
Authors: Ifeagwazi Chuka Mike , Obieze Ndili
Published: May 2005

This study investigated the influence of early parents' death on manifestations of depressive symptoms among young adults. One hundred students, consisting of 50 orphans (20 male and 30 female) and 50 non-orphans (20 male and 30 female) drawn from 10 secondary schools in Nsukka area of Enugu State, participated in the study. Each student was individually administered the Beck Depression Inventory (BDI), which is a self-report assessment device consisting of 21 items designed to tap the affective, cognitive, motivational, and somatic symptomatology of depression. A 2 × 2 analysis of variance (ANOVA) was used to analyze the data to test the two hypotheses of the study. Results showed that the orphans reported significantly higher depressive symptoms than the non-orphans ( p < .001). There was no significant difference in depressive symptoms reported by male and female subjects. It was concluded from the study that the early loss of both parents through death could predispose an individual to develop some emotional difficulties such as depression later in adult life.
Assessing Culturally-Bound Beliefs Related to Diarrheal Diseases among Rural Women, Chipata District, Zambia: Health Education Implications of a Pilot Study
Authors: Loh Cindy M. , Ormsby Gail M. , Waife Ruth , Njoloma Elizabeth , Cordero-MAcIntyre Zaida
Published: May 2005

This study of rural mothers and health workers in Eastern Zambia illustrates the use of traditional medicines in the treatment of common illnesses, and the seeking of services from traditional healers. It provides a better understanding of knowledge, beliefs, and practices in the field of traditional medicine, and explores the relationship of common cultural-bound beliefs ( Thola, Chibele, Chibambala, Chisi, and Njisi) with feeding practices during pregnancy and early childhood related to diarrheal diseases. In addition, it identifies factors that influence a mother's choice about the use or avoidance of certain foods. This qualitative research process encourages a culturally sensitive community-based approach to creating appropriate health promotion messages and program activities.
Health Planning as a Managerial Ideology
Authors: Krause Elliott A.
Published: May 2005

This paper examines health planning as a form of technocratic ideology in use both by proponents inside government and by outside interest groups in the health field. Ideology and the nature of technocratic power are defined. Health planning is analyzed as occupation, process, and ideology. The ideology in use is analyzed for the following American programs: Hill-Burton, Comprehensive Mental Health Planning, OEO Neighborhood Health Centers, Regional Medical Program, Comprehensive Health Planning. It is concluded that health planning cannot operate in the present sociopolitical context except as an ideology to justify the status quo in health services.
Building Blocks for Young Children's Mathematical Development
Authors: Sarama Julie , Clements Douglas H.
Published: May 2005

This article describes the design principles behind a set of research-based software microworlds included in the Building Blocks program, a PreK to grade 2 software-based mathematics curriculum. Building Blocks approach is finding the mathematics in, and developing mathematics from, children's activity. The materials are designed to help children extend and mathematize their everyday activities, from building blocks to art to songs and stories to puzzles. The 9-step design process model that defines what we mean by “research-based” is described and illustrated.
Physical Exercise and Experienced Bodily Changes: The Emergence of Benefits and Limits on Benefits
Authors: O'Connor Brian P. , Rousseau Francois L. , Maki Susan Anneli
Published: May 2005

Self-reports of levels of physical exercise, experienced bodily changes, and attitudinal and well-being variables were obtained from 407 adults, aged 26 to 95 years. The purpose was to assess the relative magnitudes of the experienced benefits of exercise across the exercise continuum. Cluster analyses identified three groups at each of four age levels: a) sedentary people who experienced negative bodily changes; b) modest exercisers who reported the most positive bodily changes; and c) high exercisers who reported only minimal bodily changes. Psychological barriers to exercise among sedentary people included negative exercise attitudes, attributions of negative bodily changes to aging, and low levels of exercise motivation and self-efficacy. Modest and high exercisers both scored high on attitude and well-being variables.
Early Archaic Settlement on the Southeastern Atlantic Slope: A View from the Rucker's Bottom Site, Elbert County, Georgia
Authors: Anderson David G. , Schuldenrein Joseph
Published: May 2005

In 1981 and 1982 a 160 m2 block was opened into the Early Archaic deposits at the Rucker's Bottom site in northeast Georgia along the upper Savannah River. An assemblage dominated by Palmer points, expedient flake tools, and debitage was recovered, and is compared to Early Archaic assemblages from elsewhere on the southeastern Atlantic slope. While there is considerable variability in the quantity of material recovered from individual sites over the region (something interpreted here as due in large measure to reoccupation), the composition, or content of Early Archaic assemblages is surprisingly uniform. Most assemblages are characterized by crude bifacial core/tools, expedient unifaces, and debitage. Other tool types, particularly hafted bifaces, formal unifaces, and cobble tools, are less common. Extralocal raw materials most commonly appear on sites along major river drainages, while raw material use in the interriverine area appears directed to local sources. A high degree of group mobility, particularly along major drainages, is suggested.
Environmental and Personality Differences between Children of Alcoholics and Their Peers
Authors: Havey J. Michael , Dodd David K.
Published: May 2005

Nonclinical, adolescent children of alcoholics (COAs) and their peers from nonalcoholic homes (CONAs) responded to questionnaires of environmental variables, depression, and anxiety. Multivariate (discriminant) analyses revealed several meaningful differences between the two groups. Although the two groups differed on the measures of anxiety and depression, environmental stressors contributed most to the discriminant function that differentiated between the two groups. Also, gender differences were discovered, suggesting that males and females perceive problem drinking differently and that home environments may be different for the two genders. Implications for research and intervention are discussed.
Infant Mortality and Crisis in Mexico
Authors: Bronfman Mario
Published: May 2005

Data derived from the Encuesta Nacional de Fecundidad y Salud (ENFES) confirm that overall levels of infant mortality in Mexico have been steadily declining. However, a more specific analysis furnishes evidence that this decline has occurred at varying rates within different social groups, reflecting an increase. in social inequalities. The analytical strategy used in this article leads to three basic conclusions: (1) the impact of the economic crisis on infant mortality is reflected not in a reversal of the declining trend but an increase. in social inequalities; (2) certain variables universally accepted as determinants of infant mortality, such as mother's education, seem nonsignificant for some social sectors; and (3) certain biodemographic characteristics assumed to have a uniform mortality-related behavior vary among sectors, suggesting that even these constants are determined by social factors.
Mastery Testing and Student Learning: A Meta-Analysis
Authors: Kulik Chen-Lin C. , Kulik James A.
Published: May 2005

A meta-analysis of forty-nine comparative studies showed that mastery testing generally has positive effects on student learning, but the size of effect in any single study depends on both the stringency of the mastery criterion used with the mastery group and the degree of experimental control employed in the study. Mastery effects were also more pronounced on the less able students in a classroom and were less noticeable in more able students. Finally, the analysis showed that mastery testing increased the amount of time needed for instruction.
Making Sense of the Visual in Technical Communication: A Visual Literacy Approach to Pedagogy
Authors: Portewig Tiffany Craft
Published: May 2005

We employ an array of terms to denote the visual; however, we have not yet agreed on a clear framework for understanding the function and relationship between visual concepts. I propose a literacy approach to the visual so that as educators, researchers, students, and practitioners, we acquire more than skills that rely on changing definitions and technologies but an intellectual faculty that provides the knowledge, understanding, and abilities that the visual affords. Through an analysis of arguments for visual instruction, I present the wayS in which scholars justify their claims about the visual. These arguments uncover the breadth and depth of the visual and contribute to a taxonomy of visual terminology.
Black Couples and Birth Control: Knowledge, Attitudes, and Reported Practices
Authors: Turner Castellano B. , Darity William A.
Published: May 2005

A research project aimed at understanding the process of birth control among black couples is described. This focus has been lacking in the research literature, if not in the theoretical literature. Knowledge, attitudes, and reported practices of matched pairs of black couples in a northern and a southern city were compared. Female partners were found to have more knowledge about birth control methods, more positive attitudes toward specific birth control methods, and reported more usage of birth control methods. When age, education and marital status were controlled, these findings remained essentially the same. The findings are discussed in terms of their relevance to family planning programs and community health education programs among black couples.
Effectiveness of Interactive Videodisc Instructional Programs in Elementary Teacher Education
Authors: Carlson Helen L. , Falk Dennis R.
Published: May 2005

Level three interactive videodisc instructional programs used in ways that create cognitive conflict are more effective in elementary teacher education than are those programs which do not create this involvement. Conflict can be provided through use of the engaging and engrossing videodisc examples either inductively when students work alone or deductively when students engage in peer discussion.
State-Level Evaluations of School Programs Funded under the Drug-Free Schools and Communities Act
Authors: Brandon Paul R.
Published: May 2005

Although the Drug-Free Schools and Communities Act of 1986 and the 1989 Amendments to the Act require states to evaluate their drug-education programs, no guidelines for conducting these evaluations have been produced, and little has been reported on how the states are conducting such evaluations. In this article, the results of a telephone survey on current state-level efforts to evaluate school programs funded under the Act are reported. Some states report studies of the implementation of the program and some report drug- and alcohol-use surveys. Together, these two types of evaluation efforts form the foundation of an approach for conducting evaluations under the Act. Reasons are presented why experimental and quasi-experimental designs might be inappropriate and impractical for the evaluations, and an evaluation approach linking program implementation findings and drug- and alcohol-use survey results is suggested.
Sexual Side-Effects of Psychiatric Drugs
Authors: Segraves R. T.
Published: May 2005

Clinical case reports, clinical series, and a small number of controlled studies provide evidence that many commonly prescribed psychiatric drugs may have untoward effects on sexual function. Both heterocyclic antidepressants and monoamine oxidase inhibitors appear to be associated with ejaculatory impairment. Erectile dysfunction and retarded ejaculation have been associated with neuroleptics. Several benzodiazepines have been reported to interfere with ejaculation. This information has clear significance for the prescribing physician.
Do Area Health Education Center Programs Produce Primary Care Specialists? Results of a Longitudinal Study
Authors: Brooks Charles H.
Published: May 2005

This longitudinal study examined the effect of an urban Area Health Education Center (AHEC) program on choice of primary care as a medical specialty by comparing three groups of medical students. The first group was not exposed to any AHEC clinical training. All other students were variously exposed: one group received AHEC training only in required ambulatory/primary care clerkships, whereas the other group voluntarily took one or more AHEC-sponsored clinical électives. Applying chi-square analysis and the Z-score test for correlated data, no meaningful program effect was found at the end of the fourth year of medical school or seven years after graduation. These results are discussed in the context of program implementation and contemporary medical education in the United States.
Couvade Syndrome: Male Counterpart to Pregnancy
Authors: Klein Hilary
Published: May 2005

Couvade is the common but poorly understood phenomenon whereby the expectant father experiences somatic symptoms during the pregnancy for which there is no recognized physiological basis. Symptoms commonly include indigestion, increased or decreased appetite, weight gain, diarrhea or constipation, headache, and toothache. Onset is usually during the third gestational month with a secondary rise in the late third trimester. Symptoms generally resolve with childbirth. Couvade has been seen as an expression of somatized anxiety, pseudo-sibling rivalry, identification with the fetus, ambivalence about fatherhood, a statement of paternity, or parturition envy. It is likely that the dynamics of couvade may vary between individuals and may be multidetermined.
Technical Editing at the Oak Ridge National Laboratory
Authors: Rainey Kenneth T.
Published: May 2005

Focusing on the crucial role of technical editors and communication managers, the article describes technical editing in environmental and energy research at The Oak Ridge National Laboratory (Oak Ridge, Tennessee). The author examines the kinds of documents prepared, the audiences for whom the documents are intended, and the editing process employed by the Technical Publications Department. The author concludes that communication plays a vital role in complex research and technology and that communicators at The Oak Ridge National Laboratory occupy a central place in the efficient operation of this complex, multipurpose research facility.
“Unfreezing” Lewin: The Case for Alternative Change Strategies in Health Education
Authors: Minkler Meredith
Published: May 2005

Lewin's conceptualization of change as a three part process of unfreezing, changing and refreezing remains a key theoretical underpinning of health education practice. While the concept of refreezing change remains an important one in many health education situations, its application in other situations, e.g., those characterized by uncertainty and complexity, has often been problematic.

It is in these instances that what Biller has termed “contingent change strategies” appear a valuable alternative to the non-contingent approaches of which refreezing is a classic example. Lewin's “spiral of steps” approach to action research, Kahn's “agnostic” use of information and theory, and Mathiesen's concept of “the unfinished” represent three such alternative change approaches. The last in particular, with its stress on the process of change rather than its completion, holds relevance for those situations in which health educators are concerned with broad system change rather than solely with short term reforms within the existing system.
Evaluation of Health Care Quality by Consumers
Authors: Kelman Howard R.
Published: May 2005

Ideological and conceptual issues arising out of the involvement of consumers in health care quality determination are identified. Historically and currently, criteria and procedures for quality review and assessment have reflected the values and interests of the professional providers of health care. This perspective restricts the role of the consumer to that of either a nonparticipant or a data source, at best.

If the social values and merits for health care provision of consumer involvement in quality determination are to be realized, then this perspective will need to be modified, and our knowledge base of consumer criteria of health care quality will need to be enlarged. Although the perspectives of providers and consumers are thought to be antagonistic, they may not, in fact, be so. Some suggested areas of needed research, necessary to policy development and implementation, are offered.
Worker Participation in Occupational Health Research: Theory and Practice
Authors: Mergler Donna
Published: May 2005

In the area of occupational health, progressive scientists in many countries are attempting to carry out scientific inquiry into the effects of working conditions on the health of workers in a participatory relationship with workers. The author proposes an action research model to describe the underlying research process, taking into account the interests of both workers and academics. For worker/scientist cooperation to be effective, means must be found for the two groups to work on an equal footing. Workers' participation in occupational health research projects takes two forms: informational input—workers' knowledge of working conditions and health problems systematized and used to better understand the work situation and its effects on health and well-being; and partnership—workers' participation in the design and realization of all stages of the research project. Institutional context and worker participation are analyzed in the present article in the light of the experiences of our research group, Group de Recherche-action en Biologie de Travail (Action Research on Work Biology), at the Université du Québec à Montréal. The group has been involved in action research with unions for the past ten years under the terms of a signed agreement between the University and the two major Québec unions, the Féderation des travailleurs (travailleuses) du Québec and the Conféderation des syndicats nationaux.
A Systems Approach to the Treatment of Chronic Encopresis
Authors: Margolies Robert , Gilstein Kenneth W.
Published: May 2005

This article addresses two issues which have received little attention from researchers or practitioners; encopresis as a chronic disorder, and its treatment via a systems-based approach to therapy. Chronic encopresis is viewed as a complex process rather than a static, symptomatic entity, with emphasis placed on the significance of family transactional patterns in the maintenance of the symptom. The case of a fourteen year old encopretic male is presented to illustrate the utility of assessing family contexts relevant to symptom display.
Trade and Exchange among the Mohawk-Iroquois: A Trace Element Analysis of Ceramic Smoking Pipes
Authors: Kuhn Robert D.
Published: May 2005

This study reports the results of a trace element analysis of Mohawk-Iroquois ceramics. The objective of the research was an attempt to identify trade ceramics, specifically ceramic smoking pipes, in Mohawk assemblages. Over 400 ceramic artifacts were analyzed using an X-ray fluorescence technique to determine their trace element compositions. Control samples of pottery were utilized to demonstrate differences in the elemental composition of regional clay resources, and ceramic pipes of known provenience were then identified as to their probable region of origin. The results indicate that ceramic pipes were common trade items among the Mohawk. The trade and exchange of pipes is interpreted as a phenomenon of Iroquois gift giving and reciprocity involving a material class of important symbolic value.
Diagnosis and Treatment of Depression in the Elderly
Authors: Kim Kye Y. , Hershey Linda A.
Published: May 2005

Depression and suicide are significant problems in the elderly, both in terms of their severity and their prevalence. It is particularly difficult to distinguish depression from early dementia, since elderly depressed patients often deny mood disorder and focus on their memory problems. This differential diagnostic dilemma is further complicated by the fact that 20 percent of Alzheimer-type dementia patients have moderate to severe depression. An even higher prevalence of depression can be seen in elderly patients with stroke or Parkinson's disease. Most all of the depressive disorders of the elderly are amenable to one form or combination of therapies: pharmacologic, electro-convulsive, or psychotherapy. Tricyclic antidepressants are often associated with adverse drug reactions in the elderly, so alternatives such as MAO inhibitors, alprazolam, bupropion and psychostimulants are currently being explored in this patient population.
The Utility of the Ces-D as a Depression Screening Measure among Low-Income Women Attending Primary Care Clinics
Authors: Thomas Janet L. , Jones Glenn N. , Scarinci Isabel C. , Mehan Daniel J. , Brantley Phillip J.
Published: May 2005

Objective:

Depressive disorders are among the most common medical disorders seen in primary care practice. The Center for Epidemiologic Studies-Depression (CES-D) scale is one of the measures commonly suggested for detecting depression in these clinics. However, to our knowledge, there have been no previous studies examining the validity of the CES-D among low-income women attending primary care clinics.

Method:

Low-income women attending public primary care clinics ( n = 179, ages 20–77) completed the CES-D and the Diagnostic Interview Schedule for the DSM-IV (DIS-IV).

Results:

The results supported the validity of the CES-D. The standard cut-score of 16 and above yielded a sensitivity of .95 and specificity of .70 in predicting Major Depressive Disorder (MDD). However, over two-thirds of those who screened positive did not meet criteria for MDD (positive predictive value = .28). The standard cut-score appears valid, but inefficient for depression screening in this population. An elevated cut-score of 34 yielded a higher specificity (.95) and over 50 percent of the patients who screened positive had a MDD (positive predictive value = .53), but at great cost to sensitivity (.45).

Conclusion:

Results indicated that the CES-D appears to be as valid for low-income, minority women as for any other demographic group examined in the literature. Despite similar validity, the CES-D appears to be inadequate for routine screening in this population. The positive predictive value remains very low no matter which cut-scores are used. The costs of the false positive rates could be prohibitive, especially in similar public primary care settings.
A Critique of the Life Style Concept in Public Health Education
Authors: Coreil Jeannine , Levin Jeffrey S.
Published: May 2005

A review and critique of the “life style” concept in health education is presented. The conceptual origins, evolution, and current operational definitions of the term are examined in light of its implications for health education practice oriented toward behavioral intervention at the level of the individual. Antecedents to the rise of life style change strategies are traced to concurrent developments in popular culture, health policy, and social science theory. The authors take the position that, in many respects, life style intervention departs significantly from the public health ethic, and call for a critical reappraisal of the concept by health educators.
Grammatical Voice and Person in Technical Writing: Results of a Survey
Authors: Ramsey Richard David
Published: May 2005

A survey-experiment at the University of Leeds, England, attempted to resolve two questions: (1) Are some grammatical structures more efficient than others in communicating scientific fact? and (2) Do students pursuing different academic disciplines have correspondingly different value systems with regard to technical writing and technical subject matter? The results of the survey, which sampled 300 students, indicated yes to both questions. Particularly ironic was the finding that the third-person passive voice, so commonly the style of twentieth-century technical English, is disadvantageous from a communication standpoint.
Decentralization and Primary Health Care: Some Negative Implications in Developing Countries
Authors: Collins Charles , Green Andrew
Published: May 2005

Decentralization is a highly popular concept, being a key element of Primary Health Care policies. There are, however, certain negative implications of decentralization that must be taken into account. These are analyzed in this article with particular reference to developing countries. The authors criticize the tendency for decentralization to be associated with state limitations, and discuss the dilemma of relating decentralization, which is the enhancement of the different, to equity, which is the promotion of equivalence. Those situations in which decentralization can strengthen political domination are described. The authors conclude by setting out a checklist of warning questions and issues to be taken into account to ensure that decentralization genuinely facilitates the Primary Health Care orientation of health policy.
Collaborative Problem-Solving with Logo: Effects of Group Size and Group Composition
Authors: Guntermann Edgar , Tovar Mariela
Published: May 2005

This study investigated productivity in individuals versus groups of two or three as well as the interaction processes underlying differences between dyads and triads and differences between male, female or mixed groups learning LOGO on microcomputers. Thirty-six students aged ten learned LOGO individually or in groups of two or three for one session, had a practice session, then were required to produce a graphic in LOGO for the experimental session. No differences were found between individuals and groups, in terms of productivity. Group interaction (as measured by the Bales Interaction Process Analysis [1], was found to be similar in two and three person groups. However, significant ( p < .05) differences were observed among male, female, and mixed groups. The direction of these differences were as follows: males displayed more solidarity than females or mixed groups, the female group members were much more likely to express agreement with their peers than were members of the males group. There was also more asking of information in the male groups than the female groups. Finally, males expressed much more antagonism than females or mixed groups. These results are discussed in light of previous studies in this area.
Incidence of Near-Death and Intense Spiritual Experiences in an Intergenerational Sample: An Interpretation
Authors: Thomas L. Eugene , Cooper Pamela E. , Suscovich David J.
Published: May 2005

Incidence of near-death and intense spiritual experiences were determined for a sample of 305 persons ranging in age from seventeen to eighty-five. Near-death experiences were reported by 28 per cent, and intense spiritual experiences by 34 per cent. Incidence of near-death reports did not vary significantly by age of respondents, but elderly respondents were significantly less likely to report intense spiritual experiences. Persons who reported a near-death experience were significantly more likely to report an intense spiritual experience as well. Probable causes for the relative infrequent reports of near-death and intense spiritual experiences among elderly respondents are explored, as well as reasons for association found between these types of experiences for the entire sample.
The Culture Broker Revisited: Historical Archaeological Perspectives on Merchants in Delaware, 1760–1815
Authors: De Cunzo Lu Ann
Published: May 2005

This study draws on historical archaeological data from eighteenth- and nineteenth-century Duck Creek, Delaware to interpret local merchants as culture brokers. Such a focus on merchants and brokering helps transcend the recently revived discourse in historical archaeology that sets ethnographic community study in opposition to the world system paradigm.
The Cognitive Psychodynamics of Acting: Character Invasion and Director Influence
Authors: Neuringer Charles , Willis Ronald A.
Published: May 2005

In order to evaluate the presence and extent of 1) Character Invasion (the effect of the character on the actor) and 2) Director Influence (the effect of the director on actors' conceptualizations of their characters), measures of semantic meaning were administered to the actors participating in a production of Macbeth. The actors were asked to assess 1) how they perceived their characters and 2) how they perceived themselves at four crucial times during the rehearsal to performance process (first read-through, first run-through, first dress rehearsal, and fourth performance). The director was also asked to assess his conceptualizations of the play's characters at each of the aforementioned four occasions using the same semantic meaning measurement device. An analysis of the ratings casts doubt on both the character invasion and director influence hypotheses. However, there does seem to be an indirect director effect on the actors' stage behaviors.
Who Benefits from Cooperative Computer-Assisted Instruction?
Authors: Mevarech Zemira R.
Published: May 2005

The purpose of the present study was to examine the differential effects of cooperative and individualized computer-assisted instruction (C-CAI vs. I-CAI) on mathematics achievement, amount of invested mental effort (AIME), academic recognition, and social acceptance of high and low achieving students. Participants were third grade students ( N = 110) who were randomly assigned to either C-CAI or I-CAI settings. Results showed that while high achievers benefited equally well in C-CAI and I-CAI settings, low achievers tended to progress faster and to expend greater AIME in C-CAI than in I-CAI settings. In addition, the study showed that interpersonal relationships relating to both academic recognition and social acceptance were more positive in C-CAI then in I-CAI settings. The theoretical and empirical implications of the results are discussed.
A History of Medical Scientists on High Heels
Authors: Linder Marc , Saltzman Charles L.
Published: May 2005

For 250 years medical scientists have propagandized about the health hazards of high-heeled shoes, which originated four centuries ago. Physicians, however, largely unaware of their own profession's tradition, keep reinventing the diagnostic wheel. This professional amnesia has held back the momentum of the process of educating the public. Consequently, despite these warnings, millions of women continue to wear high-heeled shoes. This article describes the history of the medical profession's recognition of this worldwide health problem and the current understanding of the deleterious and often irreversible biomechanical effects of high-heeled shoewear. The article emphasizes that the reemergence of high heels and of medical interest in them in the third quarter of the 19th century, following their disappearance in the wake of the French Revolution, was associated with increasing pressure by employers to wear such shoes for long hours at work. Although medical scientists have recognized this specifically occupational phenomenon for more than a century, full-scale epidemiological studies may be necessary to bring about substantial social-behavioral change.