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The participation of a student with Multiple Sclerosis (MS) in recess can often be both challenging and rewarding for the student and teacher. This paper will address common characteristics of students with MS and present basic solutions to improve the experience of these students in the recess setting. Initially, the definition and prevalence of MS will be presented. This will be followed by a brief discussion of MS in regards to special education law. Next, the benefits of the recess setting for all students will be addressed. The paper will then address the modifications for specific MS symptoms in the recess setting. Lastly, specific methods of proactively including a student with MS in three recess activities will be discussed.

Americans' perceptions of childhood disability have changed dramatically over the past century, as have their ideas about health and illness, medical developments, threats to children's health and development, and expectations for child functioning. Neal Halfon, Amy Houtrow, Kandyce Larson, and Paul Newacheck examine how these changes have influenced the risk of poor health and disability and how recent policies to address the needs of children with disabilities have evolved. The authors examine the prevalence in the United States of childhood disability and of the conditions responsible for impairment, as well as trends in the prevalence of chronic conditions associated with disability. They find that childhood disability is increasing and that emotional, behavioral, and neurological disabilities are now more prevalent than physical impairments. They stress the importance of, and lack of progress in, improving socioeconomic disparities in disability prevalence, as well as the need for better measures and greater harmonization of data and data sources across different child-serving agencies and levels of government. They call on policy makers to strengthen existing data systems to advance understanding of the causes of childhood disabilities and guide the formulation of more strategic, responsive, and effective policies, programs, and interventions.The authors offer a new and forward-looking definition of childhood disability that reflects emerging and developmentally responsive notions of childhood health and disability. They highlight the relationship between health, functioning, and the environment; the gap in function between a child's abilities and the norm; and how that gap limits the child's ability to engage successfully with his or her world. Their definition also recognizes the dynamic nature of disability and how the experience of disability can be modified by the child's environment. (Contains 70 endnotes, 4 tables and 1 figure.)

Technological innovation is transforming the prevalence and functional impact of child disability, the scale of social disparities in child disability, and perhaps the essential meaning of disability in an increasingly technology-dominated world. In this article, Paul Wise investigates several specific facets of this transformation. He begins by showing how technological change influences the definition of disability, noting that all technology attempts to address some deficiency in human capacity or in the human condition. Wise then looks at the impact of technology on childhood disabilities. Technical improvements in the physical environment, such as better housing, safer roads, and poison-prevention packaging, have significantly reduced childhood injury and disability. Other technological breakthroughs, such as those that identify genetic disorders that may lead to pregnancy termination, raise difficult moral and ethical issues. Technologies that identify potential health risks are also problematic in the absence of any efficient treatment. Wise stresses the imbalance in the existing health care delivery system, which is geared toward treating childhood physical illnesses that are declining in prevalence at a time when mental and emotional conditions, many of which are not yet well understood, are on the rise. This mismatch, Wise says, poses complex challenges to caring for disabled children, particularly in providing them with highly coordinated and integrated systems of care. Technology can also widen social disparities in health care for people, including children with disabilities. As Wise observes, efficacy--the ability of a technology to change health outcomes--is key to understanding the relationship of technology to social disparities. As technological innovation enhances efficacy, access to that technology becomes more important. Health outcomes may improve for those who can afford the technology, for example, but not for others. Hence, as efficacy grows, so too does the burden on society to provide access to technology equitably to all those in need. Without such access, technological innovation will likely expand disparities in child outcomes rather than reduce them. (Contains 68 endnotes and 2 figures.)

The purpose of this study was to examine cardiac function following a 100-mile ride in high ambient temperatures by healthy, competitive cyclists. Methods: Subjects were six (n=6) competitive cyclists racing in a 100-mile road race. Measures (pre/post) included: body mass (kg); E:A ratio (ventricular compliance); stroke volume (ml); ejection fraction (%) through echocardiography; age (y); training status (hrs*week[superscript -1]); years of racing experience (YE); race finish time (hrs); height (cm); mean race heart rate (b*min[superscript -1]), and post race blood troponin I (cTnI) to assess myocyte damage. Results: subject means ([plus or minus]SE) were the following: age, 24.2 (1.2) y; height, 181.1 (5.5) cm; training status, 18 (2.4) hrs*week[superscript -1]; racing experience, 5.8 (4.6) y; race heart rate, 159.3 (3.9) b*min[superscript -1]; pre/post E:A ratio, 2.04(0.41)/1.27(0.39); pre/post stroke volume, 98.6 (21.6)/72.6(11.8) ml*min[superscript -1]; cTnI, 0.13 (0.15); ejection fraction pre/post, 67.3 (3.8)/65.1(2.2)%; finish time 4.05 (0.54) hrs. Significant (p less than 0.05) differences were determined pre/post for E:A ratio, stroke volume, and pre/post body mass, 76.4 (5.9)/72.4 (1.8) kg. cTnI was elevated above established levels of 0.03 ng*ml[superscript -1] for cellular disruption. Conclusion: The differences in E:A ratio (i.e., ventricular compliance), stroke volume and elevated cTnI indicate reduced cardiac function indicative of cardiac fatigue. (Contains 1 table and 3 figures.)

This study examined the epidemiology of HIV among AI/ANs in Montana. Barriers to HIV testing and motivations to test also were explored. Analysis of data revealed that there were no significant changes in regard to HIV/AIDS case rates, demographic characteristics, or risk behaviors of AI/ANs infected with HIV/AIDS since reporting began in 1985. Barriers to testing included low perception of risk and fear of people finding out about the test. Despite major barriers to testing identified in this study, AI/ANs appeared to be testing at a higher rate than Whites. (Contains 4 tables and 1 figure.)

The purpose of this study was to study the effect of a multimedia computing program on the production of activities and self-regulated learning processes in 18 students of the Dentistry postdegree (Celaya, Mexico). A multi-method design (quasi-experimental, pretest-post-test and qualitative: Think aloud protocol) was used. Self-regulated activities were identified with the MSLQ questionnaire. Results of the MSLQ pretest/post-test questionnaire didn't show an intervention effect. In contrast, the qualitative methodology allowed the registration of a high frequency of self-regulated dimensions on the metacognitive area, on the making of inferences (cognitive area), and on the planning time and effort (behavioural area). Our data revealed the usefulness of a qualitative methodology for the understanding of the complex nature of the self-regulatory processes on learning environments based on computers.

The global rise of Internet-based education is discussed in relation to models drawn from social studies and epidemiology. Experiential and data density models are highlighted, also the capacity for technological change, and phenomena observed in the spread of disease. The lesson of these illustrations is that even apparently permanent phenomena can be transient and that current online practices may rapidly be superseded by other technologies regardless of their apparent success. It is hoped that these illustrations will help to prepare distance educators for the technological, social, and economic changes that could naturally affect their future work, particularly at times of economic crisis.

Fred Wulczyn explores how data on the incidence and distribution of child maltreatment shed light on planning and implementing maltreatment prevention programs. He begins by describing and differentiating among the three primary sources of national data on maltreatment. Wulczyn then points out several important patterns in the data. The first involves child development. Based on official reports, maltreatment rates are highest during certain periods of children's lives, especially infancy and adolescence. Bringing a new baby into the home, in particular, heightens stress and increases the risk of maltreatment by parents, who tend to be younger and less experienced as parents. These data patterns should help shape strategies that target these families. A second pattern in the data involves social context and the contribution of race and poverty to maltreatment. Children of color, for example, are much more likely than white children to be reported. Research, however, suggests that when the whites and minorities who are being compared live in a similar social context, disparities in maltreatment rates narrow to some extent. What scholars must examine more closely is the means by which community processes contribute to maltreatment. Thus, the question for researchers is not whether investments in communities are an important part of the prevention strategy, but rather what type of investment is most likely to replace what is missing in a given community. Wulczyn also explores substance abuse and maltreatment recurrence. He points out that substance abuse not only increases the risk that a parent will neglect a child but also appears to affect that child's experience in the child welfare system: when substance abuse is part of an allegation history, decisions affecting the child tilt in favor of deeper involvement with the system. Patterns of recurrence mirror those already described. Base rates of recurrence are about 9 percent but are higher for infants when allegations involve substance abuse and when children received services following the initial report. Wulczyn stresses that much more research remains before analysts understand the mechanisms that underpin these persistent patterns--knowledge that is essential to designing sound interventions. (Contains 5 figures and 81 endnotes.)

Breast cancer is the most common cancer among women in North Africa. Women in this region have unique reproductive profiles. It is essential to obtain reliable information on reproductive histories to help better understand the relationship between reductive health and breast cancer. We tested the reliability of a reproductive history-based questionnaire. We interviewed 25 breast cancer patients and 25 non-cancer controls from hospitals in Morocco and Egypt about their reproductive history in colloquial Arabic. The questions included pregnancy history, breastfeeding practices, menstruation, contraceptive use and knowledge of breast screening and re-interviewed the same women after 2 weeks. Two-way paired t-test was used to compare observed mean changes in response, and the Fishers Exact test was used for small-cell data. Pearson's correlation test was used to estimate the correlation of subjects' responses to continuous questions between the first and second interview. For categorical questions, percentage of agreement was calculated along with Cohen's Kappa Coefficient values. Moroccan subjects showed good to excellent agreement for responses to all demographic and reproductive questions (r = 0.87 to 0.99). Egyptian subjects had excellent agreement for these questions (r = 0.87 to 0.99), except for those regarding duration of oral contraceptive pill use and reported age at menarche (r = 0.72 and 0.59, respectively). We showed highly correlated responses to most reproductive questions. Duration of contraception use and age at first pregnancy elicited slightly less than reliable responses. In Egypt, responses relating to self-reported age at menarche were less reliable than those given by Moroccan subjects. Future epidemiological studies should take these differences into account when constructing reproductive history questionnaires. (Contains 5 tables.)

This paper reviews methodological issues related to the use of P less than 0.05 in health behavior research and suggests how application and presentation of statistical significance may be improved. Assessment of sample size and P less than 0.05, the file drawer problem, the Law of Large Numbers and the statistical significance arguments in epidemiology, health behavior, and psychology were examined. The reporting of confidence intervals (CI), effect sizes (ES), and use of non-statistical graphics can improve portrayal and understanding of findings. Health behavior literature has had some scholarly examination of how to improve analysis of findings but has not had an in-depth dialog on other concepts related to P less than 0.05. Attention to these concepts could improve clarity in how research outcomes are presented and thereby increase credibility of health behavior research. (Contains 1 table.)

This study aimed to confirm whether autistic traits are normally distributed across a population and to describe their association with the sociodemographic characteristics of Japanese workers. The participants were 2075 workers aged 23-65 years from various parts of Japan. Autistic traits were measured using an abridged Japanese version of the Autism-Spectrum Quotient (AQ-Short). The AQ-Short comprises five subcomponents assessing a fascination for numbers and patterns (numbers/patterns), difficulties with imagination, a preference for routine, difficulties with social skills, and difficulties with switching attention. The five subcomponents of the autistic phenotype as well as the overall autistic phenotype itself were continuously distributed across the sample population of Japanese workers. Men had significantly higher AQ-Short scores than women. AQ-Short scores were not associated with age. Except for the numbers/patterns scores, workers of a lower socioeconomic status had significantly higher AQ-Short scores than their respective counterparts. For the numbers/patterns trait, workers of a higher socioeconomic status scored higher. Workers with low general physical activity had or tended to have higher scores for total and all subcomponent traits, except for the numbers/patterns trait. Generally, the autistic phenotype was more prevalent in workers of a low socioeconomic status, while a particular trait was prevalent among workers of a high socioeconomic status.

Purpose: The aim of the study was to provide an overview of population science as applied to speech and language disorders, illustrate data sources, and advance a research agenda on the epidemiology of these conditions. Method: Computer-aided database searches were performed to identify key national surveys and other sources of data necessary to establish the incidence, prevalence, and course and outcome of speech and language disorders. This article also summarizes a research agenda that could enhance our understanding of the epidemiology of these disorders. Results: Although the data yielded estimates of prevalence and incidence for speech and language disorders, existing sources of data are inadequate to establish reliable rates of incidence, prevalence, and outcomes for speech and language disorders at the population level. Conclusions: Greater support for inclusion of speech and language disorder-relevant questions is necessary in national health surveys to build the population science in the field.

Substance use and alcohol abuse during pregnancy are significant public health concerns. Neonatal abstinence syndrome (NAS) is a withdrawal syndrome that infants exposed to opioids may experience in the first few days of life. For most infants with NAS, exposure to opioids occurs during pregnancy while they are fetuses. Similarly, prenatal alcohol exposure (PAE) is the most common preventable cause of intellectual and developmental delay and disabilities in the United States. Fetal alcohol spectrum disorders (FASDs) is a term used to describe preventable birth defects and intellectual/developmental disabilities resulting from PAE. This article offers a general overview of NAS assessment, management, and treatment considerations, as well as a brief overview of FASD.

Through a scoping review, the current state of physical activity research in people with intellectual disability was examined. A search of publications between 2000 and 2014 retrieved 362 articles that met inclusion criteria. Eligible studies were coded according to the Behavioral Epidemiological Framework. Of the articles identified, 48% examined associations between physical activity and health outcomes, 9% developed or tested methodology to measure physical activity, 34% examined factors that influence physical activity, 8% evaluated interventions to change physical activity, and 1% examined the dissemination of physical activity/health promotion programming. The categories with lower proportions of studies represent the need for greater population-specific research in physical activity measurement, interventional designs, and translational programs.

The aim of the article is to investigate, in the light of the emphasis laid on scaling by UNESCO (UNESCO, 2014a), how subjectification of those involved in educational innovations both enables and constricts scaling understood as a learning process. This is carried out through a case study of the Alforja Educativa, an educational project in Ecuador on antibiotic resistance (ABR). The ABR has been described as a sustainability challenge comparable to climate change. The way in which subjectification enables and constricts scaling as a learning process is analysed by drawing on educational scaling research and the article illustrates how the subject positions of those involved in scaling emerge as scaling subjects in transactional relationships, both with the sites where the educational project is to be scaled, and in relation to that, which will be scaled.

Developmental coordination disorder (DCD) is frequently comorbid with attention-deficit hyperactivity disorder (ADHD). DCD results in functional impairment in activities of daily living, and children's physical activities with peers. Children with DCD report fewer friendships, more bullying, and less confidence in their ability to participate in peer activities. DCD is frequently associated with depressive and anxiety disorders. Because of its relationship with lower level of physical activity, DCD is a risk factor for obesity, cardiovascular disease, and diabetes mellitus. The developmental outcomes of DCD persist through adolescence and into adulthood. Consequently, school psychologists should incorporate screening for DCD when evaluating students with ADHD diagnoses or suspected of having ADHD. This paper provides a review of the underlying brain-behavior relationships between ADHD and DCD, a description of developmental trajectories associated with DCD, and recommended screening and assessment strategies.

From the first mention of impairments in attention in the scientific literature by the Scottish physician Alexander Crichton in 1798, the correlation between educational attainment and learning has been persistently noted. Since then, the impact of attention deficits on school achievement has been a central component in a significant portion of research, despite continual disagreements within the scientific community on identification, diagnosis, and efficacious interventions to address core symptoms of what is now referred to as Attention Deficit-Hyperactivity Disorder (ADHD). This article provides the historical context in which the construct of ADHD was developed, as well as a discussion of two commonly used interventions to address symptoms of ADHD (e.g., pharmaceuticals and the use of electroencephalographic [EEG] operant conditioning, or "neurofeedback."). While use of pharmaceutical interventions is relegated only to medical professionals, neurofeedback may have the potential to be used by highly trained special educators and school psychologists in academic settings.

While medical television programs are popular among health profession trainees, it is not clear to what extent these programs affect their knowledge, perceptions, and/or behaviors. Therefore, we conducted a systematic review of research evaluating associations between program exposure and outcomes. We conducted systematic literature searches in Pubmed, CINAHL, and PsycINFO. Selected studies were required to be scholarly research, involve exposure to fictionalized medical television programming by health professional students, and assess associations between exposure and outcomes. Studies were classified according to quality and factors related to population, exposure, and outcomes. Of 3541 studies identified, 13 met selection criteria. Six studies involved undergraduate medical students, one involved nursing students, two involved both medical and nursing students, two involved medical residents, one involved medical students, residents and attending physicians, and one involved graduate epidemiology students. Mean study quality according to the MERSQI was 8.27. The most commonly assessed television programs were "ER" and "Grey's Anatomy" (six each). Five studies assessed regular viewing habits, and found that fictional medical programs are popular among students and that students recall health topics from episodes. The eight studies that assessed the association with outcomes when using clips as educational tools reported high satisfaction and increased knowledge of the presented health topics. While relatively few published studies have explored influences of fictional medical television on health professional students, those conducted suggest that students often view these television programs independently and that integration of this programming into medical education is feasible and acceptable.

We examined the association between autistic traits and sexual orientation in a general adult population (N = 47,356). Autistic traits were measured with the ten items Autistic Quotient questionnaire using a cut-off score of = 6. Sexual orientation was assessed by self-report. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for sexual orientation categories. Participants with autistic traits were more likely to identify as bisexual (OR 1.73; 95% CI 1.01-2.9) and to feel that their sexual orientation could neither be described as hetero-, homo- nor bisexual (OR 3.05; 95% CI 2.56-3.63), compared to individuals without autistic traits. Autistic traits are associated with minority sexual orientation, and perhaps with uncertain self-identification and/or a defiance of traditional ways of categorizing sexual identity.

Introduction: Children and young people in India have a high prevalence of dental decay. As part of a broader epidemiological study, we interviewed 10 head teachers to understand the status of, and challenges to, inclusion of oral health education in the curricula of public and private schools in Tamil Nadu, India. Objectives: The two main objectives of this study were (1) to describe the views of head teachers about the implementation of oral health education in school curricula and (2) to identify challenges to achieving oral health education in public and private schools in Tamil Nadu. Method: Qualitative descriptive design, with a purposive sample of 10 head teachers who participated in semi-structured interviews. Thematic coding was used to analyse and report on the data. Results: There is a lack of oral health education in public and private schools in Tamil Nadu, India. Four main types of barriers to the initiation and implementation of oral health education were lack of recognition, academic burden, prioritisation of other health needs and policy inequities. Head teachers acknowledged the lack of oral health education in their schools, yet also acknowledged the importance of oral health education in promoting students' health. Conclusion: Health curricula in Tamil Nadu schools lack integration of oral health education. Limited access to the services, cultural factors, policy deficiencies, insufficient awareness among policy-makers, the nature of the education system and lack of research contribute to the current situation. Policy-makers should address these barriers to enable and promote oral health education strategies in both private and public schools of Tamil Nadu.

Some sociologists referred to W.E.B. Du Bois, a 19th century sociologist, as the founding father of American Sociology due to his trailblazing social science research, The Philadelphia Negro. However, The Philadelphia Negro globally revolutionized social science and epidemiological research that expands far beyond sociology and the United States. This study, which was groundbreaking for its era in its implication of social, spatial, intercultural, and intracultural health determinants, authenticated the existence of racial disparities and how systemic inequalities impact health. Du Bois was a social epidemiology frontrunner, yet compared to his contemporaries, acknowledgment of his global contributions to social epidemiology has been practically mute. It is time that Du Bois and Duboisian research are fully acknowledged in the social epidemiology field.

Immunology is increasingly becoming a core biomedical discipline in recent times. Students' interest in Science, Technology, Engineering and Mathematics programs is essential for better academic performances and outcomes in a University of Science Technology. To this end, we assessed the factors that influence students' interest in immunology among a group of 32 graduate students in a tertiary institution in Ghana. The study was conducted using quantitative instruments (questionnaires) after which principal component analysis (PCA) was used to reveal the underlying factors affecting students' interest in the course. In all, six components were found including students' perception, instructor quality, student's interest/motivation, teaching methods, teaching materials and teaching facilities. Students' interest in immunology correlated negatively but significantly with perception; however, interest correlated positively with teaching methods (p < 0.001). Our study is the first to investigate the factors that influence students' interest in immunology in Ghana and supports the growing functionality of PCA approach for dimension reduction and exploratory factor analysis.

Schools are valuable venues for research institutions. Research can also be beneficial to public schools. School administrators should be proactive in identifying research topics and establishing standards and expectations for the university researchers. This article describes the partnership between a university researcher and a K-12 director of curriculum and instruction over a six year period.

While a growing number of studies indicate associations between experiences of bullying and autism spectrum disorder (ASD), it is not clear what roles comorbid behavioral problems may play. We investigated the experiences of children with ASD as victims and/or perpetrators of bullying. Children with ASD epidemiologically ascertained participated in a cross-sectional study. Although children with ASD showed significantly increased risk for bullying involvement compared to community children, after controlling for comorbid psychopathology and other demographic factors, increased risks for being perpetrators or victim-perpetrators disappeared while risk for being bullied/teased continued to be significantly elevated. This finding will help guide medical, educational and community personnel to effectively identify children with ASD at risk for school bullying and develop interventions.

Objective: This study's purpose was to describe urban college students' communication about hookah with health care providers. Participants: Participants included a random sample of undergraduate urban college students and health care providers. Methods: Students surveyed determined the epidemiology of hookah use in this population, how many health care providers asked about hookah, and how many students admitted hookah use to a physician. Results: Of 375 students surveyed, 78 (20.8%) had never tried it, 284 (75.7%) had smoked hookah at least once, and 64 students (22.6%) were classified as frequent hookah smokers. Only 15 (4.7%) reported a health care provider asking about hookah during visits, whereas 36 (12.7%) admitted their hookah use to a health care provider. Conclusion: Hookah use was found to be highly prevalent among students in one urban university. This study supports the hypothesis that few health care providers broach the topic with patients. Additional research on health consequences of hookah use, education, and improved screening is warranted.

Randy Shilts (1987), author of "And the Band Played On: Politics, People and the AIDS Epidemic," uses the analogy of the sinking ship and the "band playing on" to draw attention to America's false sense of security in the midst of the growing AIDS crisis. We describe a doctoral curriculum in which students examine the conflicts inherent in their ethical practice through a case study analysis of the AIDS epidemic. Moral development theory and critical pedagogy provide a rationale for the selection of subject matter and method designed to awaken the critical consciousness of students to social justice. The curriculum encourages students to explore how acts of discrimination and oppression related to race/ethnicity, class, gender, and sexual orientation influenced the responses of leaders to the AIDS epidemic.

In this paper, the author points out that youth with mental disorders make up a significant subgroup of youth who appear in U.S. juvenile courts. And he notes that juvenile justice systems today are struggling to determine how best to respond to those youths' needs, both to safeguard their own welfare and to reduce re-offending and its consequences for the community. He examines research and clinical evidence that may help in shaping a public policy that addresses that question. (Contains 61 endnotes.)

Obesity is an important worldwide public health problem. Obesogenic environments have been associated with increasing rates of overweight and obesity. The relationship between obesity and the built environment, along with its implications for health education are discussed in this article.

Development of academic partnerships between developing and developed countries is a sustainable approach to build research capacity in the developing world. International collaboration between the Department of Public Health of Fukushima Medical University School of Medicine in Japan and the University of Medicine and Pharmacy, Ho Chi Minh City in Vietnam began in 2002. The relationship has now grown into multifaceted efforts in public health research and education. During the past five years, two joint research projects were launched. Education projects included an epidemiology training course for Vietnamese physicians that has been carried out twice, an overseas public health elective for Japanese medical students that has been offered three times, and additional exchanges of medical professionals. The present article summarizes our past partnership activities and discusses several issues that need to be resolved in hopes of better promoting similar networks between Asian countries. (Contains 3 tables.)

The purpose of this study was to test the effectiveness of a middle school epidemiology curriculum called Detectives in the Classroom. The curriculum presents epidemiology as the science of public health, using health-related issues that capture the interest of young students and help prepare them to make evidence-based health-related decisions. The curriculum was field tested among seventh-grade urban students using a quasi-experimental design. Analysis of covariance of pre- and post-test scores examined five outcomes, including students' perceptions of their abilities in science as inquiry, scientific literacy, and knowledge about five enduring epidemiologic understandings; their self-reported interest in science, and assessment of students' epidemiological reasoning ability. The 378 experimental students, compared to 620 controls, had generally higher post-test improvements in epidemiology-related outcomes and smaller increases in the other measures. A dose-response was suggested by higher scores among students exposed to more than 10 lessons. Strengths of this evaluation include a large sample and availability of data to account for differences in demographic and school performance variables. Limitations of this evaluation include randomization by school as opposed to student, the relatively short-term and generally self-reported outcomes, and inconsistencies in proportion of the curriculum actually taught. The findings offer encouragement about the potential for Detectives in the Classroom to improve students' perceptions of their science abilities and scientific literacy, their interest in science and their abilities in basic epidemiologic reasoning. Further tests of this and other epidemiology curricula are needed to respond to the growing interest in teaching public health science to younger students. And while it is important to test near-term impacts, an additional challenge from a curriculum evaluation standpoint will be to follow students over several years to examine subsequent choices concerning selected courses, college majors, and career paths. (Contains 4 tables and 2 figures.)

Peer-reviewed literature is the single most important forum in which research findings are presented for critical review. College biology students can benefit a great deal from early exposure to this resource, but insufficient background information, technical jargon, and complex statistical analyses often present considerable obstacles to entry-level students. This paper describes an instructional module on asthma that seeks to overcome some of the barriers to use of the primary scientific literature with introductory college biology classes. Twenty-four papers have been selected from major international biomedical journals reporting on clinical and epidemiological studies of asthma, each of which explores one or a few possible causes of the disorder in everyday life. A different paper is assigned to each student or group of students. Background material on asthma and alternative research designs is presented to prepare students for their assigned reading. At the conclusion of the module, each student or group presents a paper, its methods and findings, along with insights into the study's strengths and weaknesses. (Contains 2 figures.)

The toxic shock syndrome (TSS) crisis is a historical public health success story from which much can be learned and applied to contemporary public health issues. Following the first reports, multiple research teams initiated studies designed to ascertain the risk factors associated with TSS. Those studies evolved over several years--each building upon previous findings in an attempt to further understand both the nature and causes of toxic shock. After the first report of TSS in a May 1980 issue of the "MMWR," multiple studies contributed to the body of knowledge that ultimately informed and facilitated interventions to reduce the incidence of TSS. Examination of the public health response to toxic shock syndrome highlights the effective use of epidemiological studies in successfully building a foundation for efficient responses to emerging problems and also highlights political and legal issues that remain for health professionals today.