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Purpose: The purpose of this study was to gather data from first- and second-year dental hygiene students concerning their perceptions of the benefits and possible impediments to effective patient communication. Additionally, the students were asked to theorize as to the impact emerging communication technologies could have on oral health promotion, practice administration and patient/provider communication. Methods: A self-administered questionnaire of 6 open-ended queries was employed. Thematic analysis was conducted to reveal themes related to their perceived ability to effectively communicate, perceived barriers to communication, possible solutions to lessen or eliminate these barriers, and the impact of emerging technologies on interpersonal communication. Results: The questionnaire was completed by 63 of 68 students (93%). Patient apathy and patient unwillingness to change detrimental health-related habits were the most frequently cited barriers to effective communication. Of the students having patient contact, many stated that they were less sure of their ability to communicate effectively if the patient differed from themselves, such as being elderly or being from another culture. While most of the students believed their fundamental communication skills were good, many noted that improving their higher-order skills, such as conveying empathy or displaying a nonjudgmental attitude, were essential to being more effective communicators. Many students felt emerging technologies such as universal translators could potentially assist them in overcoming some of their perceived deficiencies. Conclusion: While perceived inadequacies will likely diminish as the students gain more experience in school and later in private practice, dental hygiene programs may wish to consider implementing additional structured educational experiences to better prepare students to address patient apathy and to effectively convey a sense of personal compassion. Promoting student involvement in community outreach activities and providing a variety of service learning opportunities, including foreign travel, may broaden student experiences and deepen their awareness and appreciation of verbal and nonverbal communications displayed by differing cultures. Keywords: behavioral research; dental and dental hygiene workforce models; education concepts and theory; health literacy; qualitative analysis This study supports the NDHRA priority area, Health Promotion/Disease Prevention: Assess strategies for effective communication between the dental hygienist and the client., INTRODUCTION As health educators, dental hygienists are salient contributors to comprehensive health care, and they are often a source of information concerning the risks and benefits of proposed dental treatments. [...]

OBJECTIVE--There is limited information from large-scale prospective studies regarding the prediction of type 1 diabetes by specific types of pancreatic islet autoantibodies, either alone or in combination. Thus, we studied [...]

OBJECTIVE--The purpose of this study was to describe the development of the Diabetes Distress Scale (DDS), a new instrument for the assessment of diabetes-related emotional distress, based on four independent [...]

OBJECTIVE--This study evaluated the Diabetes Outpatient Intensive Treatment (DOIT) program, a multiday group education and skills training experience combined with daily medical management, followed by case management over 6 months. [...]

More than 71,000 relatives of type 1 diabetic patients have been screened for cytoplasmic islet cell antibodies (ICAs), GAD65 autoantibodies (GAAs), and ICA512 autoantibodies (ICA512AAs). Among those 71,148 relatives, 2,448 [...]

Previous studies suggest that after 6 years of discordance, identical twin pairs rarely become concordant for type I diabetes. With up to 39 years of follow-up from the onset of diabetes in the index twin, we determined how many discordant twins have evidence of β-cell autoimmunity and how many develop overt diabetes. We longitudinally followed 23 pairs of identical twins (or triplets) that were selected from a total group of 30 pairs because they were discordant for type I diabetes when first ascertained. Seven developed diabetes after 3,3,7, 8,9,31, and 36 years of discordance. By survival analysis, the concordance after 10 years from the onset of diabetes in the index twin was estimated as 23% (96% confidence interval, 5-40% ), increasing to 38% (95% confidence interval, 8-69%) after 31 years. Among 16 twins remaining nondiabetic at last follow-up (8-39 years of discordance), 12 were assessed with serial intravenous glucose tolerance tests and a total of 407 measurements by radioassay of antibodies against three defined autoantigens (glutamic acid decarboxylase, insulin, and the recently cloned molecule ICA512). Two-thirds (8 of 12) had evidence of β-cell autoimmunity (persistently positive autoantibody levels) and/or first-phase insulin release less than the 1st percentile of control subjects. In summary, identical twins may develop diabetes after a prolonged period of discordance and approximately two-thirds of long-term discordant twins have evidence of persistent β-cell autoimmunity and/or β-cell damage. The concordance for β-cell autoimmunity, therefore, is much higher than for overt diabetes. This suggests that additional environmental or non-Mendelian genetic factors or time are required for the development of type I diabetes. Diabetes 44: 1176-1179, 1995, Type I diabetes is a complex autoimmune disease in which both genetic and environmental factors are implicated. Estimates of the concordance among identical twins are low, ranging from 13 to [...]

HLA-DQBL alleles confer susceptibility and resistance to insulin-dependent diabetes mellitus (IDDM). We investigated whether the susceptibility alleles DQB1*0302 and DQB1*0201 affect progression to diabetes among islet cell antibody-positive ([ICA.sup.+]) first-degree [...]

Chloral hydrate is commonly used to sedate children for diagnostic or therapeutic procedures. The drug has been extensively used for many years, but there are remarkably few data on its long-term health effects. Concern in this regard is raised by recent studies showing chloral hydrate to be genotoxic, causing chromosome changes and other effects in vivo and in vitro. In addition, chloral hydrate is a reactive metabolite of trichloroethylene, a known carcinogen, and is structurally similar to other carcinogenic intermediates. Two carcinogenicity studies performed using the oral route of administration in mice indicate that the drug is potentially carcinogenic - in one case after a single dose lower than the typical dose used for sedation. Practitioners should be aware of chloral hydrate's genotoxicity and potential carcinogenicity. Discretion in its use seems appropriate until further studies clarify its long term health consequences., INTRODUCTION Chloral hydrate has been used as a sedative-hypnotic since at least 1869 (1). Today, it is used extensively in pediatrics, emergency medicine, radiology, dentistry, and other clinical settings for [...]

Since you already have diabetes, the research achievements in preventing diabetes may not affect your life. But they may have great impact on the lives of your children and future [...]

Fathers with type I diabetes transmit diabetes to their offspring 2-3 times more frequently than mothers with type I diabetes. This phenomenon has provoked both genetic and nongenetic hypotheses, but [...]

In September 1988 we investigated reports of seizures in persons who had eaten taquitos, a commercially prepared snack food. We identified and interviewed 5 persons with new-onset seizures within 12 hours of eating taquitos, all purchased during a 1-week period from a single store. Leftover taquitos were found to contain endrin, a highly toxic chlorinated hydrocarbon pesticide. Although tissue confirmation of exposure to endrin was not possible and the level of contamination in the tested taquitos was below that previously thought to be capable of inducing seizures, the pattern of symptoms and the common time and place of purchase strongly suggested that the seizures were due to endrin-contaminated taquitos. The source of endrin contamination could not be determined. This episode is the first report of illness associated with endrin-contaminated food products in the United States., Pesticides are widely used on food crops in the United States; in 1988, 76.7 million tons of pesticides were used in California alone.[1] Pest-control products are also extensively used in [...]

A significant proportion of relatives of patients with insulin-dependent (type 1) diabetes with high titers of cytoplasmic islet cell autoantibodies (ICAs) do not progress to overt diabetes with up to 8 yr of follow-up. This may reflect that follow-up of such relatives has not been long enough to observe diabetes, that despite expression of identical ICAs, some relatives will not progress to diabetes; or that there is heterogeneity in what is identified as ICA. We identified a subset of ICA that was restricted in its species (not reacting with mouse islets) and cell-type reactivity within islets (Β -cell specific). Only one of eight relatives whose sera had the restricted pattern of reactivity progressed to overt diabetes, and on sequential evaluation, all but the one relative who progressed to diabetes have maintained normal first-phase insulin secretion to intravenous glucose. In contrast, by life-table analysis, 70% of relative expressing nonrestricted ICA became diabetic within 5 yr of follow-up (1 of 8 vs. 16 of 25 diabetic at last follow-up, P < 0.02). Moreover, preliminary data suggest a significant association of the human leukocyte antigen DQB1*0602 allele of DR2 haplotypes with the restricted ICA pattern (4 of 5 DQB1*0602 restricted vs. 0 nonrestricted ICA, P = 0.0006). We propose that expression of a genetically determined restricted ICA pattern confers a markedly lower risk for progression to diabetes. Our studies suggest that relatives with restricted ICA may comprise most [ICA.sup.+] relatives who do not develop diabetes or abnormal first-phase insulin secretion on follow-up of >5 yr and that expression of such autoantibodies may be associated with the 'protective' DQB1*0602 allele. Diabetes 41.347-53, 1992, Our understanding of the pathophysiology of insulin-dependent (type 1) diabetes has increased such that type diabetes is considered a chronic autoimmune disease with a long prodromal phase [1-3]. During this [...]

Aldicarb is the strongest of the carbamate pesticides and the most potent pesticide on the market. These pesticides work by blocking the breakdown of acetylcholine, a hormone released by nerves that mediate the function of muscles, parts of the brain, and secretory systems, such as the digestive tract. Inadvertent human exposure to carbamates leads to diarrhea, salivation, sweating, possible muscle twitching or paralysis, and altered mental states. Aldicarb is restricted to certain uses and is illegal to use on crops such as watermelon because it may become incorporated in the flesh of the fruit. The largest known outbreak of food-borne pesticide illness occurred in California and neighboring states when watermelons treated with aldicarb were distributed through food markets. The impact and outcome of this epidemic on individual health and on the California Department of Health Services and California Department of Food and Agriculture are described. Pesticide-related illness and coincident illnesses, such as viral gastroenteritis, were differentiated as best as possible by the presence of fever. (Fever is unlikely in pesticide food poisoning.) Of 1,376 reports of illness, 77 percent were probable or possible carbamate-related illnesses. Many cases were mild, but 17 individuals required hospitalization. Of 6 reported deaths, none could be attributed to ingestion of aldicarb. Of 47 pregnant women who may have ingested the fruit, 2 stillbirths occurred; however, fetal tissues tested negative for aldicarb. This epidemic illustrates the difficulty of tracking contaminated foods once they have entered the distribution network. (Consumer Summary produced by Reliance Medical Information, Inc.), Pesticide Food Poisoning from Contaminated Watermelons in California, 1985 ON JULY 3, 1985, the Oregon Department of Health notified the California Department of Health Services (CDHS) of several cases of [...]

Within the last three years there have been several reported outbreaks of food poisoning from melons or cucumbers related to the use of an insecticide, aldicarb (tradename Temik, produced by Union Carbide). The insecticide works by interfering with the synthesis of acetyl cholinesterase, an enzyme required for metabolizing acetylcholine, a neurotransmitter substance. The poisoning is reversible, but causes the following symptoms: diarrhea, vomiting, tearing, salivation, constriction of the pupil (miosis), and convulsion. In extreme situations, poisoning could lead to death. Before the use of aldicarb, a group of 12 male volunteers were used to establish safe levels. Not only is aldicarb itself poisonous, but two specific break-down products are also biologically active, aldicarb sulfoxide (ASO) and aldicarb sulfone (AS). While ASO has roughly the same toxic powers as aldicarb, AS is 27-times less toxic. The aldicarb group of insecticides are classified as systemic because they are incorporated into all parts of plants including the roots, stems, leaves, and fruit. Outbreak one occurred in 1978 and involved cucumbers; outbreak two occurred in 1985 from contaminated watermelons; outbreak three, in 1987, also involved watermelons; outbreak four occurred the following year and was traced to contamination of hydroponically grown English cucumbers. This study examines individual known cases of aldicarb poisoning and includes a description of symptoms, and when available, an analysis of samples of contaminated foodstuffs. Epidemiologic investigation indicates that the present standards for aldicarb poisoning are too high. It is of particular interest that incidents of aldicarb poisoning involve members of the cucurbitaceae family of plants which include cucumbers, melons, squash, and pumpkins. Questions remain regarding the toxicity of aldicarb, the possibility that unknown metabolites of aldicarb may be involved, and the exact dose of these compounds necessary to induce gastrointestinal difficulties. Until these and other questions concerning this family of insecticides are better known, it is prudent for health departments to monitor for outbreaks of aldicarb poisoning. (Consumer Summary produced by Reliance Medical Information, Inc.), Aldicarb Food Poisonings in California, 1985-1988: Toxicity Estimates for Humans DURING THE FAST 3 y, California has experienced several outbreaks of foodborne poisoning with aldicarb sulfoxide (ASO), a metabolite of [...]

The essentiality of vitamin A for normal human health is well known. Likewise, problems of vitamin A deficiency and hypervitaminosis A have been recognized for many years. Concerns about the [...]

All diabetes research depends on much of the research that came before it. Often a discovery in one area may provide the key that will unlock information on a different [...]

In pilot studies, high (60%) fructose (HF) diet decreased the incidence of diabetes in NOD mice compared to a regular chow (RC) diet. The associated decrease in islet insulitis, serum [...]

A group of first degree relatives of patients with Type 1 diabetes mellitus (DM), who had high risk for developing diabetes have been enrolled in this pilot study. These individuals [...]

The identification of the B cell autoantigens targeted by autoantibodies in type 1 diabetes have led to the development of assays that, in theory, could be used to screen populations [...]

We combined three elements to form an outpatient `immersion' diabetes treatment program: an intensive series of diabetes education sessions, daily medical management, and a group structure which compresses everything into [...]

Subcutaneous (sc.) insulin prevents diabetes in NOD mice and currently is being used in human intervention trial in high-risk relatives with pre-diabetes. The reason for the success of the sc. [...]

More than 16,000 relatives of patients with type 1 diabetes have been screened for expression of cytoplasmic ICA, GAD65 and ICA512 autoantibodies. Amongst 16,253 such relatives 659 were cytoplasmic ICA [...]

Chemical defoliants, used to strip plants of their leaves, are sprayed over cotton fields in California every autumn. The chemicals can drift from the fields into surrounding areas; this may be hazardous to the health of people living close by. Theoretical calculations had indicated that the amount of exposure likely in communities around the fields probably would not affect health. But for over 15 years, persons living in the San Joaquin and Imperial Valleys of California have complained to health officials about various symptoms during the time of defoliant spraying. In the fall of 1987, the California Department of Health Services conducted an investigation of the possible health effects of cotton defoliants. Communities near cotton fields were compared with communities involved in other types of agriculture. Cotton communities had 60 to 100 percent more frequent complaints of fatigue, nausea, diarrhea, and eye, throat and nose irritation. The rates of these problems remained elevated after the results were adjusted for factors such as cigarette smoking and chronic illness. More symptoms were reported when the chemicals had been sprayed from airplanes and when a strong odor was present. The link between illness and chemical odor suggests that the offending chemicals were DEF and Folex, two organophosphate defoliants. (Consumer Summary produced by Reliance Medical Information, Inc.), Acute Health Effects of Community Exposure to Cotton Defoliants ABSTRACT. In September and October of 1987, the California Department of Health Services responded to community complaints by investigating the relationship [...]

Life-Table Analysis of Progression to Diabetes of Anti-Insulin Autoantibody-Positive Relatives of Individuals With Type I Diabetes Cytoplasmic islet cell antibody--negative ([ICA.sup.-]; [is less than] 20 Juvenile Diabetes Foundation units, n [...]

Secondary adrenocortical insufficiency can have fatal consequences if left untreated. The benefits of two diagnostic tests and glucocorticoid administration are discussed.

More cases of tuberculosis are reported from California than from any other state. The 5,382 cases reported in 1992 represent a 54% increase since 1985. California's case rate of 17.2 [...]

'I don't do leg raises. The legs fully extended position puts too much pressure on the lower back. Instead, I recommend doing knee raises and keeping the legs bent. I [...]

The Scientific Board of the California Medical Association presents the following inventory of items of progress in preventive medicine and public health. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established both as to scientific fact and important clinical significance. The items are presented in simple epitome and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, research workers, or scholars to stay abreast of these items of progress in preventive medicine and public health that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another The items of progress listed below were selected by the Advisory Panel to the Section on Preventive Medicine and Public Health of the California Medical Association, and the summaries were prepared under its direction., THE RECENT NATIONAL ATTENTION focusing on the issue of food safety prompted us to examine two studies of the actual occurrences of pesticide-related food contamination to see how well the [...]

This article discusses the benefits of good urban planning to health and environment in the U.S. Background on syndemic disorders; Influence of urban design on the health of the community; Vision for an urban design.