Denise M. Lishner

Changing Teaching Practices in Mainstream Classrooms to Improve Bonding and Behavior of Low Achievers

This paper reports the effects of a package of instructional methods on the academic achievement, behavior, and social bonding of seventh grade students who were low achievers in math. Proactive classroom management, interactive teaching, and cooperative learning methods were included. Low achievers in experimental classrooms showed more favorable attitudes toward math, more bonding to school, greater expectations for continuing schooling, and less serious misbehavior as measured by suspensions and expulsions from school than did their low-achieving control counterparts at the end of one academic year. Among low achievers, significant effects of the teaching practices were not found for California Achievement Test scores or for self-reported delinquency or drug use. The results suggest that interventions in mainstream classrooms can promote school attachment and deter misbehavior among low-achieving students. The absence of short-term effects on standardized achievement scores suggests possible alternatives to the authors’ hypotheses, whereas the absence of short-term effects on self-reported delinquency and drug use was consistent with the authors’ hypotheses of delayed effects for these variables.

Predictors of comprehensive surgical treatment in patients with ovarian cancer

Providing appropriate surgical treatment for women with ovarian cancer is one of the most effective ways to improve ovarian cancer outcomes. In this study, the authors identified factors that were associated with a measure of comprehensive surgery, so that interventions may be targeted appropriately to improve surgical care.

Delinquency and Drug Abuse: Implications for Social Services

Recent studies have revealed common risk factors for adolescent drug abuse and delinquency. This evidence suggests that efforts to prevent adolescent substance abuse and chronic serious delinquency should target the same factors. The same interventions may decrease the risk of both of these forms of adolescent antisocial behavior. Further, given the high rates of drug use among delinquents, drug-abuse intervention and treatment programs are clearly needed for delinquent populations. This article explores the evidence linking adolescent drug use and delinquency, examines shared and distinguishing factors in the etiology of each, and discusses implications for prevention and treatment.

Reported referral for genetic counseling or BRCA 1/2 testing among United States physicians†‡

Genetic counseling and testing is recommended for women at high but not average risk of ovarian cancer. National estimates of physician adherence to genetic counseling and testing recommendations are lacking.

Emergency department use by the rural elderly

This study uses Medicare data to compare emergency department (ED) use by rural and urban elderly beneficiaries. The U.S. Health Care Financing Administrations National Claims File was used to identify services provided to Medicare beneficiaries in Washington State in 1994. Patients were classified by urban, adjacent rural, or remote rural residence. We identified ED visits and associated diagnostic codes, assigned severity levels for presenting conditions, and determined the specialties of physicians providing ED services. The rural elderly living in remote areas are 13% less likely to visit the ED than their urban counterparts. Causes of ED use by the elderly do not vary meaningfully by location. Most ED visits by this group are for conditions that seem appropriate for this setting. Given the similarity of diagnostic conditions associated with ED visits, rural EDs must be capable of dealing with the same range of emergency conditions as urban EDs.

The effect of federal grants on medical schools' production of primary care physicians.

OBJECTIVES Title VII of the Health Professions Educational Assistance Act of 1976 was created to encourage the production of primary care physicians. This study explored recent trends in the proportion of US medical school graduates entering primary care in relationship to Title VII funding. METHODS The American Medical Association Physician Masterfile was used to determine the specialty choice of all students graduating from American medical schools between 1960 and 1985. RESULTS The proportion of graduates entering primary care rose from 19.7% in 1967 to 31.1% in 1976 and remained stable for the subsequent decade. The increase occurred before implementation of Title VII. Rural, state-owned medical schools with departments of family medicine tend to produce a greater proportion of primary care physicians than urban private schools without family medicine departments. CONCLUSIONS The values of American medical schools and the reward structure of American medical practice favor the production of specialists over primary care physicians. Although Title VII helped to encourage and sustain the development of primary care educational programs at both the medical student and graduate levels, an increase in the proportion of primary care physicians will require fundamental changes.

Etiology and Prevention of Antisocial Behavior in Children and Adolescents

This chapter reviews the existing evidence on childhood predictors and correlates of antisocial behavior, presents a theory integrating these factors, and describes a prevention project based on a theory that has demonstrated positive effect on youngsters at risk of involvement in delinquent behavior.

Needle-sharing practices and risk for AIDS transmission among intravenous drug users in Seattle

Sharing of needles by intravenous drug users is known to be one of the major means for the transmission of the HIV virus into the general population. In Seattle, where liberal laws make acquisition of needles relatively easy, it has been assumed that needle sharing is not a significant problem. Results of a survey of 212 methadone maintenance clients demonstrated that needle sharing is quite prevalent among intravenous drug users in this area and that addicts fail to sterilize their needles between uses. Because the rate of HIV infection among Seattles intravenous drug users is relatively low, immediate intervention efforts by public health authorities can prevent a rapid acceleration of the infection rate.

How are symptoms of ovarian cancer managed

A study was undertaken to identify the diagnostic approaches that primary care physicians and gynecologists undertake in women with symptoms associated with ovarian cancer.